Vulvar cancer accounts for four percent of cancers of the female reproductive organs and about .6 percent of all cancers in women. In recent years, about 4,850 vulvar cancers have been diagnosed in the U.S. About 1,000 U.S. women die of this cancer annually.
It is essential to detect and treat vulvar cancer at the earliest possible stage. The five-year survival rate for squamous cell vulvar cancer (the most common type) declines significantly as the cancer worsens.
What is Vulvar Cancer?
The vulva is the outer part of the female genitals, comprised of the vaginal opening, clitoris, labia major (outer lips), and labia minor (inner lips). Cancer of the vulva most often affects the inner edges of the labia major or labia minor. The four types of vulva cancer are squamous cell carcinoma, adenocarcinoma, melanoma, and sarcoma.
Squamous cell carcinoma, the most common vulvar cancer, begins in the squamous cells (the main type of skin cell). Adenocarcinoma (about eight percent of vulvar cancers) begins in the Bartholin Gland cells just inside the vaginal opening. Bartholin Gland cancer is easily mistaken for a cyst, so a delay in an accurate diagnosis is not unusual. Melanoma is a type of skin cancer, and comprises about six percent of vulvar cancers (usually the labia minor or clitoris). Sarcoma is a cancer that begins in cells of bones, muscles or connective tissues and accounts for about two percent of vulvar cancer cases.
How is Vulvar Cancer Diagnosed?
Vulvar cancer tends to occur in older women. Less than 20 percent of vulvar cancer cases are in women younger than 50, and more than 50 percent occur in women over 70. The average age of women diagnosed with invasive vulvar cancer is 70.
About one-half of all vulvar cancer is linked to an infection of certain human papilloma virus (HPV) types, which are often transmitted through sexual contact with someone who already has the virus. An HPV infection may produce no visible signs until pre-cancerous changes appear or the cancer develops.
Smoking further increases the risk of developing vulvar cancer among women who have a history of HPV infection. If women are infected with a high-risk HPV, they have a much higher risk of developing vulvar cancer if they smoke.
Almost all women with invasive vulvar cancers will exhibit symptoms. For instance, a distinct tumor might develop. The cancer might also appear as a red, pink, or white bump (or bumps) with a wart-like surface. The affected area could also appear white and have a rough surface.
Other symptoms include persistent itching, a burning sensation in the affected area, painful urination, and bleeding and discharge not associated with the normal menstrual period. Another sign of vulvar cancer is an open sore that lasts for more than a month.
A lump on either side of the opening to the vagina can be the sign of a Bartholin gland carcinoma, although a non-cancerous Bartholin gland cyst often causes a lump in this area.
A physical exam (including a pelvic exam) should include a detailed review of your risk factors and medical history. The only definitive way to determine if vulvar cancer is present is to undergo a biopsy where a small piece of tissue from the suspicious area is removed and examined under the microscope by a pathologist. If a suspicious area is small, a doctor may remove it completely for examination. If the abnormal area is larger, the doctor may do a punch biopsy instead, which involves removing a small, cylindrical sample of the skin.
Missed or Delayed Diagnosis of Vulvar Cancer
Medical professionals may miss or delay a diagnosis of vulvar cancer due to any number of missteps. Examples include:
- A treating physician unnecessarily delaying referral to a gynecologist
- Misdiagnosing symptoms without ordering follow up tests for a more definitive diagnosis
- Failing to recognize the significance of symptoms warranting referral to a specialist for a proper evaluation and management of a patient’s care
- Failing to order a biopsy to rule out cancer
- Conducting a biopsy improperly
- Misreading biopsy results
- Mislabeling or mishandling biopsy specimens obtained for examination
- Failing to communicate test results to a patient
- Failing to obtain test results previously ordered.
Consequences of Missed or Delayed Diagnoses of Vulvar Cancer
For Stage I of the disease, the survival rate is 93 percent, according to National Cancer Institute statistics, compared to 79 percent for Stage II, 53 percent for Stage III and 29 percent for Stage IV.
Treatments of this disease largely depend on the stage of the cancer when diagnosed. A small tumor of 1 millimeter or less (Stage I) can be surgically removed. If the cancer has spread to the anus, lower third of the vagina, and/or lower third of the urethra (Stage II), one treatment option is a partial radical vulvectomy (removal of the tumor, nearby parts of the vulva, and other tissues containing cancer). Surgery is sometimes combined with radiation therapy to ensure all cancer cells are treated and removed.
If the cancer has spread to nearby lymph nodes (Stage III), treatment can include surgery to remove the cancer and affected lymph nodes, and either radiation therapy or chemotherapy. When the cancer has spread to other organs and tissues in the pelvic region or beyond (Stage IV), surgery is an option depending on the extent of the cancer spread, along with radiation and chemotherapy.
If the vulvar cancer has spread to organs and/or tissues outside the pelvic region, surgery is not curative but may be undertaken to relieve symptoms of bowel or bladder blockages.
Our Delayed Vulvar Cancer Diagnosis Attorneys Can Help You
Founded in 1987, Powers & Santola, LLP, has established a reputation for excellence by devoting its full attention and resources to helping clients who have been unjustly harmed, including those who are victims of a missed or delayed cancer diagnosis.
If you believe that you or a loved one has suffered due to the missed or delayed diagnosis of vulvar cancer, we can help you find the answers you need. Call Powers & Santola or contact us online to schedule a free consultation about your case. We serve clients in Albany, Syracuse, Rochester, and surrounding areas in New York.