Diagnosing Vulvar Cancer
Vulvar cancer is a type of cancer that affects the vulva, which is the external area of the female genitals. To diagnose vulvar cancer, several examinations, screening tests, and procedures may be done. In diagnosing vulvar cancer, different specialists may be involved, including:
- Gynecologist: A gynecologist specializes in women's reproductive health and may perform the initial examinations and tests to diagnose vulvar cancer.
- Gynecologic oncologist: If vulvar cancer is confirmed, a gynecologic oncologist, who specializes in treating gynecologic cancers, may be involved in further evaluation and treatment.
- Pathologist: A pathologist specializes in examining tissue samples for abnormalities, including cancer.
- Radiologist: A radiologist specializes in examining imaging studies, such as X-rays and scans, for abnormalities that may be a sign of a disease, including cancer.
Examinations, tests or procedures that may be performed to diagnose vulvar cancer include:
- Physical examination and history: A healthcare professional will conduct a thorough examination of the vulva and ask about any symptoms or medical history that may be relevant.
- Pelvic examination: This involves a visual inspection and palpation of the vulva, vagina, cervix, uterus, ovaries, and rectum to check for any abnormalities.
- Pap smear: A sample of cells is collected from the cervix to check for any abnormal changes that could indicate the presence of cancer.
- HPV testing: Human papillomavirus (HPV) testing may be done to determine if the virus is present in the cells of the cervix or vulva. HPV infection is a risk factor for vulvar cancer.
- Colposcopy: This procedure involves using a special magnifying instrument called a colposcope to examine the vulva and cervix more closely. It helps identify any abnormal areas that may require further investigation.
- Biopsy: If abnormal areas are found during the physical or pelvic examination, a biopsy may be performed. During a biopsy, a small sample of tissue is removed from the suspicious area and sent to a laboratory for analysis by a pathologist. This helps confirm the diagnosis of vulvar cancer.
To determine the stage of vulvar cancer and identify factors or indicators of its progression, additional examinations, tests, or procedures may include:
- Lymph node biopsy: A small incision is made through the skin to remove one or more lymph nodes in the groin area. The lymph node tissue is sent to the lab for pathologist examination. The pathologist looks for spread of vulvar cancer to the lymph node.
- Cystoscopy: A small lighted tube with a camera is used to check the bladder for signs of cancer spread.
- Proctoscopy: A small lighted tube with a camera is used to check the rectum for signs of cancer spread.
- Imaging studies: These may be performed to assess the extent of tumor spread and determine the stage of vulvar cancer. Imaging studies include:
- Magnetic resonance imaging (MRI) scan
- Computed tomography (CT) scan
- Positron emission tomography-CT (PET-CT) scan
Prognostic factors: Various factors can influence prognosis in vulvar cancer. These include the presence or absence of lymph node involvement, spread to adjacent structures, size of the primary tumor, age at diagnosis, symptoms at diagnosis, location of lesions within the vulva or vagina, and tumor differentiation.
It's important to note that these examinations and tests are performed by healthcare professionals who specialize in diagnosing and treating vulvar cancer. If you have any concerns or suspect you may have symptoms related to vulvar cancer, it's essential to consult with your healthcare provider for an accurate diagnosis and appropriate management plan.