Is conservative treatment or surgery better for vulvar cancer?

Written by Yan Chun
Oncology
Updated on September 10, 2024
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Vulvar cancer is a malignant tumor in female gynecology. There are various treatment options for patients with vulvar cancer. The choice between surgical treatment and conservative treatment depends on multiple factors such as the patient's clinical stage and physical condition. For patients with early-stage vulvar cancer, radical surgical excision is the best treatment method. However, some patients with poor physical condition may not tolerate surgery and may instead receive curative radiotherapy or systemic chemotherapy as an alternative treatment. For patients with mid-to-late stage vulvar cancer, the best treatment method is comprehensive internal medicine treatments, such as chemotherapy and targeted therapy. For patients with advanced vulvar cancer who have a poor physical condition and cannot tolerate chemotherapy or other antitumor treatments, the best treatment method is conservative treatment aimed at maintaining stable vital signs.

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Written by Yan Chun
Oncology
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What tests are needed to determine the cause of vulvar cancer?

Vulvar cancer is a type of malignant tumor in female gynecology. Clinically, the following examinations can be used to identify the cause of vulvar cancer. First, testing for human papillomavirus (HPV) can be conducted. If the patient is found to be infected with HPV, then the cause of vulvar cancer can be considered to be due to viral infection. Additionally, herpes virus testing can also be performed, as many patients with vulvar cancer are caused by herpes virus infection. Thirdly, cytological examination of the vulva can be conducted to detect if there are any malnutritive lesions, such as vulvar lichen sclerosus, and other diseases like dermatophytosis, which are also reasons for the high incidence of vulvar cancer.

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Written by Cui Fang Bo
Oncology
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Can vulvar cancer be detected by B-ultrasound?

Vulvar cancer, due to its superficial location, does not require an ultrasound for detection. Vulvar cancer is a malignant tumor of the vulva, with primary squamous epithelium being the most common type. The main clinical manifestations are vulvar nodules, often accompanied by pain and significant itching. Local necrosis or infection can occur, and the lesions of vulvar cancer can be directly observed with the naked eye. However, ultrasound examination is also widely used in vulvar cancer, not for detecting the cancer itself, but for examining whether there is enlargement of the lymph nodes in the groin, abdomen, and pelvic regions, suspecting invasion by cancer cells.

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Written by Sun Ming Yue
Medical Oncology
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How long does it take for vulvar cancer to progress from early to late stage?

If you have vulvar cancer, and want to know how long it takes to progress from early to late stage, it varies from person to person and cannot precisely be determined. Each individual's constitution is different, so the progression of the disease varies. It is recommended that patients seek medical treatment as soon as they discover they have vulvar cancer, to try to control the growth of the tumor, prevent it from spreading, enhance immune system, and improve physique, thereby aiming to extend survival.

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Written by Yan Chun
Oncology
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Is the vulvar cancer nodule soft or hard?

Vulvar cancer clinically forms nodular lesions that are generally hard in texture with poor mobility and tend to adhere to surrounding tissues, and have indistinct borders. Due to the rapid growth of the nodules, their shape is usually irregular, easily forming granulomatous or cauliflower-like appearances, and they are prone to contact bleeding. Patients with vulvar cancer typically have nodular lesions that are likely to invade surrounding tissues or metastasize to lymph nodes. The chances of distant metastasis to the lungs, liver, bones, or brain are relatively lower. Clinically, it is common to see enlarged inguinal lymph nodes and pain caused by metastatic foci. Some patients may also experience local skin metastasis, subcutaneous nodules, or skin itching as clinical manifestations. For the treatment of vulvar cancer, radical surgery is primarily recommended, with radiation therapy and chemotherapy also being effective options.

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Written by Sun Ming Yue
Medical Oncology
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Late-stage vulvar cancer can spread to where?

Patients with vulvar cancer generally have lymphatic metastasis because there are many lymphatic vessels in the perineum, and the capillaries of the lymphatic system are interconnected. Thus, vulvar cancer can lead to bilateral lymphatic vessel spread. Initially, it leads to superficial inguinal lymph nodes, then it spreads to the bone lymph nodes below the groin, and eventually progresses to the lymph nodes alongside the aorta and the lymph nodes below the left clavicle. If the cancer is located in the clitoris, it may bypass the superficial inguinal lymph nodes and directly spread to the lymph nodes inside the pelvis. The tumor in the vulvar area will gradually increase in size; it generally does not invade the muscle fascia or adjacent structures. If the vagina is invaded, it can easily and immediately involve the levator ani muscles, rectum, urethral opening, and bladder, among others.