Is chemo effective in treating squarmous cell cancer of the vulva?
I was just told that i have squamous cell cancer of the vulva and that chemotherapy might help. What is the chance that it will work or even help?
Squamous cell cancer of the vulva is treated differently depending on the stage and the size of the tumor area. You need to have a thorough discussion of treatment options with your doctor and ask if chemotherapy will be a component in your treatment. Early stage cancers of the vulva are typically treated with excision or laser surgery. Often lymph nodes must be removed surgically as well. For stage II, III, and IV cancers, surgery is typically followed by chemotherapy, radiation, or both. Sometimes the chemotherapy and radiation are used first to shrink the tumor, followed by excision. Here are some suggestions for having a productive and open discussion with your oncologist about treatment options. If you are having trouble obtaining clear information from your oncologist, you may want to get a second opinion.
"Cancer of the vulva is not a common disease. There are about 4,000 new cases each year in the United States. Although it can occur in women in the third and fourth decade it is usually diagnosed in older women. Over 95% of vulvar cancers arise from the squamous epithelium. The remainder are mostly melanomas. The cause of squamous cancer of the vulva is unknown but there is a weak association with Human Papilloma Virus (HPV). The most important feature about vulvar cancers is the pre-malignant phase ...
TREATMENT OF VULVAR CANCER
Vulvar cancers are usually treated by surgery with a radical excision of the cancer and removal of the regional lymph nodes. If the cancer is clearly on only one side and small then only that one side may need to be removed. Radical excision means that there must be a good margin of uninvolved tissue removed with the cancer. Usually an acceptable margin is about two centimeters. This will result in some disfigurement if the cancer is larger than about two centimeters in size. Large cancers will also require some sort of plastic surgery technique to close the defect. Complications of surgery are closure breakdown with prolonged healing and sometimes a collection of fluid in the groin where the lymph nodes where removed. There may also be leg swelling.
If the cancer is very large and a radical resection would require removal of the anus, rectum or urethra then primary treatment can be given by radiation to preserve these vital structures. If there is cancer in the lymph nodes then that groin as well as the pelvic lymph nodes are irradiated upon recovery from surgery. Often when these cancers are being irradiated chemotherapy will also be given to increase the effects of the radiation.
The prognosis is in general good. If the lymph nodes are negative then the chance for a cure is excellent. Even with positive lymph nodes a significant number are cured.
Vulvar melanoma is no different from melanomas that occur elsewhere on the body. They are unpredictable and can be very aggressive. They are treated surgically if possible. The regional lymph nodes are usually removed at surgery. Melanomas are characteristically black in color, however there are amelanotic melanomas that are not pigmented and can be confused with the usual squamous cell cancer". Quoted from: William M. Rich, M.D. Clinical Professor of Obstetrics and Gynecology University of California, San Francisco Director of Gynecologic Oncology University Medical Center Fresno, California
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