Treatment of vulvar cancer is based on factors such as the extent and stage of cancer, your general health and preferences. Your doctor will aim to cure the disease, but if this is not possible, the focus shifts to preventing the tumour from growing or spreading, increasing life expectancy and maintaining quality of life.
Standard treatment options for vulvar cancer include:
- Laser therapy.
- Radiation therapy.
Laser therapy: Laser therapy uses a laser beam (a narrow beam of intense light) to destroy the cancer cells. It is generally used in women in the early stage of the disease.
Radiation therapy: Radiation therapy or radiotherapy uses high-powered energy beams (x-rays or other types of radiation) to destroy cancer cells and shrink tumors. Radiation therapy is directed at cancer cells. Radiotherapy, however, damages normal cells of the body as well and can cause several side effects such as fatigue, nausea and vomiting and erythema of skin.Your doctor will recommend treatment based on the severity of the symptoms.
Radiation therapy can be given as:
- External beam radiation: In external beam radiation, radiation is given by a machine outside your body. The machine directs the beam of radiation to specific points on your body.
- Internal radiation (brachytherapy): In this technique, a radiation-filled device such as small seeds, wires or a cylinder is placed directly into or near the cancer.
The type of radiation therapy that your doctor uses will depend on the type and stage of your cancer. Radiation therapy may be used before surgery to shrink the tumour so that the surgery is more likely to be successful. Radiation therapy can be given along with chemotherapy as it makes cancer cells more sensitive to radiation therapy. If the cancer cells have spread to your lymph nodes, radiation may be given after surgical excision to the area around your lymph nodes to kill any cancer cells that might remain after surgery.
Chemotherapy: Chemotherapy uses certain drugs to destroy or kill the cancer cells. During chemotherapy, you may be given one, two or more drugs in combination. These medications may be given orally or through your veins (intravenously). In cases with advanced vulvar cancer (cancer that has spread to other areas of the body), chemotherapy may be used for treatment. Chemotherapy may be given with radiation therapy to shrink the size of big vulvar cancers so that the surgery is more likely to be successful.
Surgery: This is most often used in treating vulvar cancer. Surgery aims to remove (if possible) all the cancer without any damage to the woman's sexual function. Some of the surgeries done for vulvar cancer include:
- Wide local excision: In this procedure, the cancer and some normal tissues around the cancer is removed.
- Radical local excision: This procedure removes the cancer and a large amount of normal tissue around it. If the cancer has spread to nearby lymph nodes (in the groin), they may also be removed.
- Vulvectomy: This surgical procedure removes a part or all of vulva depending on the size of the cancer.
- Pelvic exenteration: If the cancer has spread wide in the pelvis (such as to lower colon, rectum, and bladder), surgery is done to remove these organs and other structures such as cervix, vagina, ovaries and nearby lymph nodes.
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