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Wednesday, 22 November 2017
Cancer of the Vulva

A close-up photograph of  a piece of equipment in the Stour Centre.

The vulva
The vulva is the area of skin between a woman’s legs. It consists of two outer lips (the labia) which are covered in hair and two inner lips (also called the labia) which are thin and delicate. At the front of the vulva is the clitoris, and just behind the clitoris is the urethra (the thin tube through which women pass urine). Just behind this is the vagina. The anus (opening to the back passage) is close to, but separate from, the vulva. All these are visible from the outside.

In the groins (creases at the top of each leg) are glands called lymph glands. These are connected, by very fine lymph vessels, to other lymph glands all over the body to make up the lymphatic system. Lymph glands filter out bacteria or debris.

Cancer of the vulva is an uncommon cancer. It usually affects women between the ages of 55 and 75 years, but can occur in younger or older women.

Diagnosis
So that the doctor can decide definitely whether or not a lump is cancer, he or she will need to do a biopsy. This is a very minor operation, done under local or general anaesthetic, when a small sample of tissue is taken from the vulva and examined for cancer cells under the microscope. If the biopsy shows cancer of the vulva, the doctor will probably request further tests to check the exact position of the tumour, to detect any spread of the disease and to plan the most effective treatment.

As cancer of the vulva is a slow growing cancer, and does not spread quickly to other parts of the body, surgery may be the only treatment needed. Sometimes radiotherapy, may be used and more rarely chemotherapy.

Surgery
The doctor or nurse will discuss the most appropriate type of surgery, depending on the size and any spread of the cancer. All operations for cancer of the vulva will involve removing the area of the skin where the cancer is growing. In many women it is also necessary to remove the lymph glands in each groin. The operation is called a vulvectomy.

Nowadays, because only a limited amount of skin is removed with the cancer and the skin in this part of the body is very stretchy, it is often possible to stitch the remaining skin neatly together. However, if it is necessary to remove quite a lot of skin; a skin graft may be needed. To do this, the surgeon will take a thin flap of skin from another part of the body (usually the thigh or abdomen) and stitch it onto the operation site. Unfortunately, it is often necessary to remove the clitoris during an operation for cancer of the vulva but the nurse will discuss the implications of this.

Once fully recovered from the operation, patients are able to pass urine and open their bowels in the usual way. The entrance to the vagina may be a little narrower but again the nurse will discuss any relationship issues when patients feel ready to talk.