Diagnosis of Vulvar Cancer

By  , Expert Content
Jan 11, 2012

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Vulvar cancer is a rare type of cancer of the female external genitals. It usually starts as a precancerous change in the cells of the vulva called vulvar intraepithelial neoplasia (VIN). These changes progress slowly over a period of years to develop cancer. Diagnosis in the early stages has better prognosis and therefore needs less invasive treatment. If your doctor suspects vulvar cancer, he or she will recommend tests to confirm the diagnosis after examination.

History and examining your vulva: The doctor will take a history and may ask questions such as:

  • When did the symptoms start?
  • Have you been treated in the past for genital warts?
  • Is there any bleeding or spotting not related to menstruation?

The doctor will examine the vulva to look for abnormalities such as small lump or growth.

Colposcopy exam: In this examination, a special lens (magnifying glass) is used to examine your vulva. It allows the doctor to closely inspect your vulva for abnormal areas.

Biopsy: If your doctor suspects that there is an area of suspicious skin on your vulva, he or she may take a sample of the skin for testing. The tissue sample is examined by a pathologist (a doctor who specialises in diagnosing diseases by looking at cells and tissues under a microscope) for cancerous changes. The biopsy is taken under local anesthesia (to numb the pain). A scalpel or other special cutting tool is used to remove the suspicious area. If the site of incision is big, you may need stitches.

Determining the extent of cancer:
If vulvar cancer is diagnosed, tests will be done to determine the size and extent (stage) of the disease. Some tests that are done for staging include:

  • Pelvic exam: During the pelvic exam, the doctor checks the uterus, vagina, ovaries, fallopian tubes, bladder and rectum for any abnormalities in their shape or size. The doctor examines the pelvic structures by palpation (feeling with hand) or may insert a speculum (a metal or plastic device) in your vagina to open and spread the walls of your vagina so that the cervix (the mouth of your womb) and vagina are seen.
  • Cystoscopy: A special instrument with a small fiberoptic camera may be passed through the urethera to look inside the bladder. This permits your doctor to examine the inside of your bladder and take tissue samples if needed.
  • Proctoscopy: Proctoscope (a thin, lighted tube) a special instrument with a small fiberoptic camera may be inserted into the anus and rectum to check for abnormal areas. If any abnormality is suspected, the tissue samples may be taken for biopsy.
  • Imaging studies: Tests such as X-rays (of the abdomen, chest and the pelvic bones), computed tomography scan (CT scan) and MRI (magnetic resonance imaging) may be done to determine the extent of cancer spread.




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