Treatment options for vulvar cancer depend on the type and stage of your cancer, your overall health and your preferences.
Operations used to treat vulvar cancer include:
Surgery to remove the entire vulva carries a risk of complications, such as infection and problems with healing around the incision. In addition, with part or all of the vulvar padding gone, it can be uncomfortable to sit for long periods. Your genital area may feel numb, and it may not be possible to achieve orgasm during sexual intercourse.
Vulvar cancer often spreads to the lymph nodes in the groin, so your doctor may remove these lymph nodes at the time you undergo surgery to remove the cancer. Depending on your situation, your doctor may remove only a few lymph nodes or many lymph nodes.
Removing lymph nodes can cause fluid retention and leg swelling, a condition called lymphedema.
Doctors are studying a technique that may allow surgeons to remove fewer lymph nodes. Called sentinel lymph node biopsy, this procedure involves identifying the lymph node where the cancer is most likely to spread first. The surgeon then removes that lymph node for testing. If cancer cells aren′t found in that lymph node, then it′s unlikely that cancer cells have spread to other lymph nodes.
Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy for vulvar cancer is usually administered by a machine that moves around your body and directs radiation to precise points on your skin (external beam radiation).
Radiation therapy is sometimes used to shrink large vulvar cancers in order to make it more likely that surgery will be successful. Radiation is sometimes combined with chemotherapy, which can make cancer cells more vulnerable to radiation therapy.
If cancer cells are discovered in your lymph nodes, your doctor may recommend radiation to the area around your lymph nodes to kill any cancer cells that might remain after surgery.
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs are typically administered through a vein in your arm or by mouth.
For women with advanced vulvar cancer that has spread to other areas of the body, chemotherapy may be an option. Sometimes chemotherapy is combined with radiation therapy to shrink large vulvar cancers in order to make it more likely that surgery will be successful.