Treatments for Vulvar Cancer
Treatment options for women with cancer of the vulva will depend on the disease’s stage and the woman’s age, overall health and medical history. Treatments for this condition involve surgery—either excision of the cancer cells, laser surgery to destroy cancer cells or the surgical removal of part or all of the vulva tissues, called a vulvectomy—radiation therapy or chemotherapy.
In the earliest stage of vulvar cancer—Stage 0—wide local excision, laser surgery or a combination may be the preferred treatment. In addition, skinning vulvectomy (a removal of the top layer of vulvar skin) and an ointment containing a chemotherapy drug may be employed.
In Stage I, wide local excision or radical local excision, which removes nearby lymph nodes in the groin and upper part of the thigh, may be used, as may radical vulvectomy or radiation therapy. In Stage II, your doctor may recommend a radical vulvectomy and the removal of nearby lymph nodes, and radiation therapy may be used after surgery if cancer cells are found in the lymph nodes. Standalone radiation therapy may also be used in certain patients.
Treatments for Stage III vulvar cancer also include a radical vulvectomy and the removal of lymph nodes in the groin and thigh on both sides of the body, followed in some cases by radiation given to the pelvis and groin if the cancer is found in the lymph nodes, or only radiation to the vulva if the tumor is large but has not spread. Radiation, with or without chemotherapy, a radical vulvectomy and the removal of lymph nodes on both sides of the body, may also be used for Stage III vulvar cancer.
Treatments for Stage IV vulvar cancer include a radical vulvectomy along with the removal of the lower colon, rectum or bladder, depending on where the cancer has spread, along with the removal of the uterus, cervix and vagina, called a pelvic exenturation. Other treatment options are a radical vulvectomy followed by radiation therapy, radiation therapy followed by a radical vulvectomy, and radiation therapy with or without chemotherapy and possibly following surgery.
For vulvar cancer that comes back after treatment, called recurrent vulvar cancer, treatment options include wide local excision (with or without radiation therapy); radical vulvectomy and the removal of the lower colon, rectum or bladder, as well as a pelvic exenturation; radiation therapy plus chemotherapy, with or without surgery; radiation therapy for local occurrences or to reduce symptoms; and clinical trials that test new treatments for vulvar cancer.