Vulvar cancer is a relatively rare diagnosis, representing about 5% of all gynecologic cancers, and only about 1% of all female cancers in general. There are about 3,500 new cases reported annually in the US and approximately 900 death a year attributed to this disease. The incidence of vulvar cancers has remained stable over the past two decades but the rates of precancerous lesions has more than doubled over the same period of time. The cause for the growing number of cases is not well-understood.
Vulvar cancer is most common in women over 50 years of age. Additional risk factors for vulvar cancer include having multiple sexual partners, cervical cancer, and the presence of chronic vaginal and vulvar inflammations. This typeof cancer is often associated with sexually transmitted diseases.
The vulva is the skin and fatty tissue between the upper thighs of women, from the area of the anus to about an inch below the pubic hairline. Cancer of the vulva most often affects the two skin folds (or lips) around the vagina, known as the labia.
Vulvar cancer is a rare type of cancer. It forms in a woman's external genitals, called the vulva. The cancer usually develops slowly over several years. First, precancerous cells grow on vulvar skin. This is called vulvar intraepithelial neoplasia (VIN), or dysplasia. Not all VIN cases turn into cancer, but it is best to treat it early.
Vulvar cancer forms in a woman's external genitalia. The vulva includes the inner and outer lips of the vagina, the clitoris (sensitive tissue between the lips), and the opening of the vagina and its glands. Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva.
At the front of the vagina, the labia minora meet to form a fold or small hood of skin called the prepuce. Beneath it lies the clitoris, an approximately ¾-inch structure of highly sensitive tissue that becomes swollen with blood during sexual stimulation. At the lower end, just beneath the vaginal opening, is the fourchette, where the labia minora meet. Beyond the fourchette is the anus, the opening to the rectum. The space between the vagina and the anus is called the perineum.
Most women with cancer of the vulva are over age 50. However, it is becoming more common in women under age 40. Women who have constant itching and changes in the color and the way the vulva looks are at a high risk to get cancer of the vulva. A doctor should be seen if there is bleeding or discharge not related to menstruation (periods), severe burning/itching or pain in the vulva, or if the skin of the vulva looks white and feels rough.
Vulvar cancer is usually treated with surgery. The type of surgery depends on the size, depth and spread of the cancer. Your doctor will review all the options for surgery and the pros and cons of each option. Some people may also need radiation therapy.
It is best treated by excision or sometimes by laser evaporation. If a large area is involved and must be removed, then a skin graft can be applied. These premalignant conditions are likely to recur after treatment so continued follow up is a necessity. Another condition that can occur on the vulva and also cause itching and soreness is called lichen sclerosis. It is not a premalignant change, but an atrophy of the skin. It will not be improved by anti-yeast medications either. It can be diagnosed by biopsy.
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