Cancer of the Vulva

Healthcare

robert-j-miller-md
PowerPoint Presentation Cancer of the Vulva www.aboutcancer.com Vulvar cancer accounts for about 5% of cancers of the female genital system in the United States. Median age 68 1 Possible signs of vulvar cancer include bleeding or itching should lead to an examination by a physician Possible signs of vulvar cancer include bleeding or itching. -A lump or growth on the vulva. -Changes in the vulvar skin, such as color changes or growths that look like a wart or ulcer. -Itching in the vulvar area, that does not go away. -Bleeding -Tenderness in the vulvar area. Female Cancers in the US in 2014 Cancer Incidence Deaths Breast 235,030 40,420 Uterus 52,630 8,590 Ovary 21,980 14,270 Cervix 12,360 4,020 Vulva 4,850 1,030 Vagina 3,170 880 What causes Vulva Cancer? Two independent pathways of vulvar carcinogenesis are felt to currently exist, the first related to mucosal HPV (Human Papilloma Virus) infection second related to chronic inflammatory (vulvar dystrophy) or autoimmune processes The risk of developing vulvar cancer is increased by the following: Older age Precancerous changes (dysplasia) in vulvar tissues Lichen sclerosus, which causes persistent itching and scarring of the vulva Human papillomavirus (HPV) infection Cancer of the vagina or cervix Heavy cigarette smoking Chronic granulomatous disease (a hereditary disease that impairs the immune system) Age Distribution NCDB 2000-2011 SEER rates for new vulvar cancer cases have been rising on average 0.5% each year over 2002-2011. Death rates have been rising on average 0.5% each year over 2001-2010. Histology and Prognosis About 90% of vulvar carcinomas are squamous cell cancers. Survival is dependent on the pathologic status of the inguinal nodes and whether spread to adjacent structures has occurred. Most Common Histologies Squamous: >90% Melanoma: 5-10% Basal Cell: 2% Sarcoma: 1-2% Paget: 2 cm in size or with stromal invasion >1.0 mm, confined to the vulva or perineum, with negative nodes. Stage II Tumor of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with negative nodes. Vulva Stage System Stage I and II Vulva Cancer Stage III Tumor of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguino-femoral lymph nodes. IIIA (i) With 1 lymph node metastasis (≥5 mm), or (ii) 1–2 lymph node metastasis(es) (
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PowerPoint Presentation Cancer of the Vulva www.aboutcancer.com Vulvar cancer accounts for about 5% of cancers of the female genital system in the United States. Median age 68 1 Possible signs of vulvar cancer include bleeding or itching should lead to an examination by a physician Possible signs of vulvar cancer include bleeding or itching. -A lump or growth on the vulva. -Changes in the vulvar skin, such as color changes or growths that look like a wart or ulcer. -Itching in the vulvar area, that does not go away. -Bleeding -Tenderness in the vulvar area. Female Cancers in the US in 2014 Cancer Incidence Deaths Breast 235,030 40,420 Uterus 52,630 8,590 Ovary 21,980 14,270 Cervix 12,360 4,020 Vulva 4,850 1,030 Vagina 3,170 880 What causes Vulva Cancer? Two independent pathways of vulvar carcinogenesis are felt to currently exist, the first related to mucosal HPV (Human Papilloma Virus) infection second related to chronic inflammatory (vulvar dystrophy) or autoimmune processes The risk of developing vulvar cancer is increased by the following: Older age Precancerous changes (dysplasia) in vulvar tissues Lichen sclerosus, which causes persistent itching and scarring of the vulva Human papillomavirus (HPV) infection Cancer of the vagina or cervix Heavy cigarette smoking Chronic granulomatous disease (a hereditary disease that impairs the immune system) Age Distribution NCDB 2000-2011 SEER rates for new vulvar cancer cases have been rising on average 0.5% each year over 2002-2011. Death rates have been rising on average 0.5% each year over 2001-2010. Histology and Prognosis About 90% of vulvar carcinomas are squamous cell cancers. Survival is dependent on the pathologic status of the inguinal nodes and whether spread to adjacent structures has occurred. Most Common Histologies Squamous: >90% Melanoma: 5-10% Basal Cell: 2% Sarcoma: 1-2% Paget: 2 cm in size or with stromal invasion >1.0 mm, confined to the vulva or perineum, with negative nodes. Stage II Tumor of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with negative nodes. Vulva Stage System Stage I and II Vulva Cancer Stage III Tumor of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguino-femoral lymph nodes. IIIA (i) With 1 lymph node metastasis (≥5 mm), or (ii) 1–2 lymph node metastasis(es) (
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