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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65885_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65885_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65885_"><span class="title" itemprop="name">Vulvar Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: July 14, 2016.</p><p class="small">Created: <span itemprop="datePublished">September 23, 2005</span>.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000419665__198">This PDQ cancer information summary has current information about the treatment of vulvar cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000419665__199">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000419665__1"><h2 id="_CDR0000419665__1_">General Information About Vulvar Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000419665__2">Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__118">Having vulvar intraepithelial neoplasia or HPV infection can affect the risk of vulvar cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__11">Signs of vulvar cancer include bleeding or itching.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__16">Tests that examine the vulva are used to detect (find) and diagnose vulvar cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__20">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000419665__2"><h3>Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva.</h3><p id="CDR0000419665__6">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044776/" class="def">Vulvar cancer</a> forms in a woman's external <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476624/" class="def">genitalia</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulva</a> includes:</p><ul id="CDR0000419665__189"><li class="half_rhythm"><div>Inner and outer lips of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>.</div></li><li class="half_rhythm"><div>Clitoris (sensitive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> between the lips). </div></li><li class="half_rhythm"><div>Opening of the vagina and its <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glands</a>.</div></li><li class="half_rhythm"><div>Mons pubis (the rounded area in front of the pubic bones that becomes covered with hair at <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000440113/" class="def">puberty</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321384/" class="def">Perineum</a> (the area between the vulva and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046523/" class="def">anus</a>).</div></li></ul><div id="CDR0000419665__197" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20vulva&p=BOOKS&id=373744_CDR0000742480.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65885.2/bin/CDR0000742480.jpg" alt="Anatomy of the vulva; drawing shows the mons pubis, clitoris, urethral opening, inner and outer lips of the vagina, and the vaginal opening. Also shown are the perineum and anus." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the vulva. The vulva includes the mons pubis, clitoris, urethral opening, inner and outer lips of the vagina, vaginal opening, and perineum.</p></div></div><p id="CDR0000419665__141">Vulvar cancer most often affects the outer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044308/" class="def">vaginal</a> lips. Less often, cancer affects the inner vaginal lips, clitoris, or vaginal glands. </p><p id="CDR0000419665__142">Vulvar cancer usually forms slowly over a number of years. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">Abnormal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> can grow on the surface of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulvar</a> skin for a long time. This <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000570425/" class="def">vulvar intraepithelial neoplasia</a> (VIN). Because it is possible for VIN to become vulvar cancer, it is very important to get treatment.</p></div><div id="CDR0000419665__118"><h3>Having vulvar intraepithelial neoplasia or HPV infection can affect the risk of vulvar cancer.</h3><p id="CDR0000419665__120">Anything that increases your risk of getting a disease is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will
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get <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>; not having risk factors doesn't mean that you will
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not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for vulvar cancer include the following:</p><ul id="CDR0000419665__121"><li class="half_rhythm"><div>Having vulvar intraepithelial neoplasia (VIN).</div></li><li class="half_rhythm"><div>Having <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045714/" class="def">human papillomavirus</a> (HPV) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>.</div></li><li class="half_rhythm"><div>Having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000642019/" class="def">history</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476624/" class="def">genital</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046652/" class="def">warts</a>.</div></li></ul><p id="CDR0000419665__180">Other possible risk factors include the following:</p><ul id="CDR0000419665__181"><li class="half_rhythm"><div>Having many sexual partners.</div></li><li class="half_rhythm"><div>Having first sexual intercourse at a young age.</div></li><li class="half_rhythm"><div>Having a history of abnormal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045978/" class="def">Pap tests</a> (Pap smears).</div></li></ul></div><div id="CDR0000419665__11"><h3>Signs of vulvar cancer include bleeding or itching.</h3><p id="CDR0000419665__13">Vulvar cancer often does not cause early <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. Signs and symptoms may be caused by vulvar cancer or by other conditions. Check with your doctor if you have any of the following:</p><ul id="CDR0000419665__14"><li class="half_rhythm"><div>A lump or growth on the vulva.</div></li><li class="half_rhythm"><div>Changes in the vulvar skin, such as color changes or growths that look like a wart or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390317/" class="def">ulcer</a>.</div></li><li class="half_rhythm"><div>Itching in the vulvar area, that does not go away.</div></li><li class="half_rhythm"><div>Bleeding not related to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046297/" class="def">menstruation</a> (periods).</div></li><li class="half_rhythm"><div>Tenderness in the vulvar area.</div></li></ul></div><div id="CDR0000419665__16"><h3>Tests that examine the vulva are used to detect (find) and diagnose vulvar cancer.</h3><p id="CDR0000419665__18">The following tests and procedures may be used:</p><ul id="CDR0000419665__19"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking the vulva for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">Biopsy</a></b>: The removal of samples of cells or tissues from the vulva so they can be viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer.</div></li></ul></div><div id="CDR0000419665__20"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000419665__22">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options depend on the following:</p><ul id="CDR0000419665__23"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer.</div></li><li class="half_rhythm"><div>The patient's age and general health.</div></li><li class="half_rhythm"><div>Whether the cancer has just been <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</div></li></ul></div></div><div id="CDR0000419665__24"><h2 id="_CDR0000419665__24_">Stages of Vulvar Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000419665__25">After vulvar cancer has been diagnosed, tests are done to find out if cancer cells have spread within the vulva or to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__151">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__194">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__190">In vulvar intraepithelial neoplasia (VIN), abnormal cells are found on the surface of the vulvar skin.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__30">The following stages are used for vulvar cancer:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000419665__175">Stage I</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__38">Stage II</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__41">Stage III</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__44">Stage IV</a></div></li></ul></li></ul></div><div id="CDR0000419665__25"><h3>After vulvar cancer has been diagnosed, tests are done to find out if cancer cells have spread within the vulva or to other parts of the body.</h3><p id="CDR0000419665__27">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulva</a> or to other parts of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:</p><ul id="CDR0000419665__28"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322873/" class="def">Pelvic exam</a></b>: An exam of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046588/" class="def">speculum</a> is inserted into the vagina and the doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">nurse</a> looks at the vagina and cervix for signs of disease. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045978/" class="def">Pap test</a> of the cervix is usually done. The doctor or nurse also inserts one or two <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046302/" class="def">lubricated</a>, gloved fingers of one hand into the vagina and places the other hand over the lower <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas.<div id="CDR0000419665__160" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Pelvic%20exam&p=BOOKS&id=373744_CDR0000609924.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65885.2/bin/CDR0000609924.jpg" alt="Pelvic exam; drawing shows a side view of the female reproductive anatomy during a pelvic exam. The uterus, left fallopian tube, left ovary, cervix, vagina, bladder, and rectum are shown. Two gloved fingers of one hand of the doctor or nurse are shown inserted into the vagina, while the other hand is shown pressing on the lower abdomen. The inset shows a woman covered by a drape on an exam table with her legs apart and her feet in stirrups." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.</p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045989/" class="def">Colposcopy</a></b>: A procedure in which a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046465/" class="def">colposcope</a> (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">Tissue</a> samples may be taken using a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046460/" class="def">curette</a> (spoon-shaped instrument) or a brush and checked under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for signs of disease.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045988/" class="def">Cystoscopy</a></b>: A procedure to look inside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a> to check for abnormal areas. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046455/" class="def">cystoscope</a> is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046535/" class="def">Proctoscopy</a></b>: A procedure to look inside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046523/" class="def">anus</a> to check for abnormal areas. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000742474/" class="def">proctoscope</a> is inserted into the anus and rectum. A proctoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">X-rays</a></b>: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. To stage <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044776/" class="def">vulvar cancer</a>, x-rays may be taken of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and bones inside the chest, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045087/" class="def">pelvic</a> bones.</div></li><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046333/" class="def">Intravenous pyelogram</a> (IVP)</b>: A series of x-rays of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidneys</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046638/" class="def">ureters</a>, and bladder to find out if cancer has spread to these organs. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">contrast dye</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a>. As the contrast dye moves through the kidneys, ureters and bladder, x-rays are taken to see if there are any blockages. This procedure is also called intravenous urography.</div></li><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the body. A small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046712/" class="def">Sentinel lymph node biopsy</a></b>: The removal of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045876/" class="def">sentinel lymph node</a> during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. The sentinel lymph node is the first <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph node</a> to receive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045760/" class="def">lymphatic drainage</a> from a tumor. It is the first lymph node the cancer is likely to spread to from the tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046305/" class="def">lymph</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046441/" class="def">ducts</a> to the lymph nodes. The first lymph node to receive the substance or dye is removed. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes. Sentinel lymph node biopsy may be done during surgery to remove the tumor for early-stage vulvar cancer.</div></li></ul></div><div id="CDR0000419665__151"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000419665__151_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000419665__151_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000419665__194"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000419665__194_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000419665__194_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000419665__196">The metastatic tumor is the same type of cancer as the primary tumor. For example, if vulvar cancer spreads to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, the cancer cells in the lung are actually vulvar cancer cells. The disease is metastatic vulvar cancer, not lung cancer.</p></div><div id="CDR0000419665__190"><h3>In vulvar intraepithelial neoplasia (VIN), abnormal cells are found on the surface of the vulvar skin.</h3><p id="CDR0000419665__192">These <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000570425/" class="def">Vulvar intraepithelial neoplasia</a> (VIN) may become cancer and spread into nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. VIN is sometimes called stage 0 or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a>.</p></div><div id="CDR0000419665__30"><h3>The following stages are used for vulvar cancer:</h3><div id="CDR0000419665__175"><h4>Stage I</h4><p id="CDR0000419665__177">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046120/" class="def">stage I</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has formed. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is found only in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulva</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321384/" class="def">perineum</a> (area between the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>). Stage I is divided into stages IA and IB.<div id="CDR0000419665__193" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Tumor%20sizes&p=BOOKS&id=373744_CDR0000415526.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65885.2/bin/CDR0000415526.jpg" alt="Tumor sizes; drawing shows different sizes of a tumor compared to the size of a pea (1 cm), peanut (2 cm), grape (3 cm), walnut (4 cm), lime (5 cm), egg (6 cm), peach (7 cm), and grapefruit (10 cm)." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Tumor sizes. The size of a tumor may be compared to the size of a pea (1 cm), peanut (2 cm), grape (3 cm), walnut (4 cm), lime (5 cm), egg (6 cm), peach (7 cm), or grapefruit (10 cm).</p></div></div></p><ul id="CDR0000419665__178"><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046120/" class="def">stage IA</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller and has spread 1 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044215/" class="def">millimeter</a> or less into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulva</a>. Cancer has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046120/" class="def">stage IB</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is larger than 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or has spread more than 1 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044215/" class="def">millimeter</a> into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulva</a>. Cancer has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000419665__186" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Millimeters%20(mm)&p=BOOKS&id=373744_CDR0000578121.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65885.2/bin/CDR0000578121.jpg" alt="Millimeters; drawing shows millimeters (mm) using everyday objects. A sharp pencil point shows 1 mm, a new crayon point shows 2 mm, and a new pencil-top eraser shows 5 mm." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Millimeters (mm). A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm.</p></div></div></div></li></ul></div><div id="CDR0000419665__38"><h4>Stage II</h4><p id="CDR0000419665__170">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046121/" class="def">stage II</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and has spread into the lower part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a>, the lower part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046523/" class="def">anus</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</p></div><div id="CDR0000419665__41"><h4>Stage III</h4><p id="CDR0000419665__171">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046122/" class="def">stage III</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and may have spread into the lower part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a>, the lower part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046523/" class="def">anus</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> has spread to one or more nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. Stage III is divided into stages IIIA, IIIB, and IIIC.</p><ul id="CDR0000419665__172"><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046122/" class="def">stage IIIA</a>, cancer is found in 1 or 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> that are smaller than 5 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044215/" class="def">millimeters</a> or in one lymph node that is 5 millimeters or larger.</div></li><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046122/" class="def">stage IIIB</a>, cancer is found in 2 or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> that are 5 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044215/" class="def">millimeters</a> or larger, or in 3 or more lymph nodes that are smaller than 5 millimeters.</div></li><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046122/" class="def">stage IIIC</a>, cancer is found in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> and has spread to the outside surface of the lymph nodes.</div></li></ul></div><div id="CDR0000419665__44"><h4>Stage IV</h4><p id="CDR0000419665__173">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046123/" class="def">stage IV</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> has spread into the upper part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a>, the upper part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, or to other parts of the body. Stage IV is divided into stages IVA and IVB. </p><ul id="CDR0000419665__174"><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046123/" class="def">stage IVA</a>:<dl id="CDR0000419665__179" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread into the lining of the upper <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a>, the upper <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>, or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>, or has attached to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045087/" class="def">pelvic</a> bone; or</p></dd><dt>-</dt><dd><p class="no_top_margin">cancer has spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> and the lymph nodes are not moveable or have formed an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390317/" class="def">ulcer</a>.</p></dd></dl>
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</div></li><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046123/" class="def">stage IVB</a>, cancer has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> or to other parts of the body.</div></li></ul></div></div></div><div id="CDR0000419665__47"><h2 id="_CDR0000419665__47_">Recurrent Vulvar Cancer</h2><p id="CDR0000419665__48"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">Recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044776/" class="def">vulvar cancer</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has recurred (come back) after it has been treated. The cancer may come back in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulva</a> or in other parts of the body.</p></div><div id="CDR0000419665__49"><h2 id="_CDR0000419665__49_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000419665__50">There are different types of treatment for patients with vulvar cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__54">Four types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000419665__56">Surgery</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__62">Radiation therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__65">Chemotherapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__182">Biologic therapy</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000419665__80">New types of treatment are being tested in clinical trials. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__153">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__155">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000419665__157">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000419665__50"><h3>There are different types of treatment for patients with vulvar cancer.</h3><p id="CDR0000419665__52">Different types of treatments are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044776/" class="def">vulvar cancer</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p></div><div id="CDR0000419665__54"><h3>Four types of standard treatment are used:</h3><div id="CDR0000419665__56"><h4>Surgery</h4><p id="CDR0000419665__58"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> is the most common treatment for vulvar cancer. The goal of surgery is to remove all the cancer without any loss of the woman's sexual function. One of the following types of surgery may be done:</p><ul id="CDR0000419665__59"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322858/" class="def">Laser surgery</a>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgical</a> procedure that uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045748/" class="def">laser beam</a> (a narrow beam of intense light) as a knife to make bloodless cuts in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> or to remove a surface <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesion</a> such as a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446983/" class="def">Wide local excision</a>: A surgical procedure to remove the cancer and some of the normal tissue around the cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443585/" class="def">Radical local excision</a>: A surgical procedure to remove the cancer and a large amount of normal tissue around it. Nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046375/" class="def">groin</a> may also be removed. </div></li><li class="half_rhythm"><div>Ultrasound surgical aspiration (USA): A surgical procedure to break the tumor up into small pieces using very fine vibrations. The small pieces of tumor are washed away and removed by suction. This procedure causes less damage to nearby tissue.</div></li><li class="half_rhythm"><div>Vulvectomy: A surgical procedure to remove part or all of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulva</a>:<dl id="CDR0000419665__133" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443586/" class="def">Skinning vulvectomy</a>: The top layer of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044974/" class="def">vulvar</a> skin where the cancer is found is removed. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046581/" class="def">Skin grafts</a> from other parts of the body may be needed to cover the area where the skin was removed.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000639914/" class="def">Modified radical vulvectomy</a>: Surgery to remove part of the vulva. Nearby lymph nodes may also be removed.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443589/" class="def">Radical vulvectomy</a>: Surgery to remove the entire vulva. Nearby lymph nodes are also removed.</p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322874/" class="def">Pelvic exenteration</a>: A surgical procedure to remove the lower <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a>, and nearby lymph nodes are also removed. Artificial openings (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045104/" class="def">stoma</a>) are made for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a> to flow from the body into a collection bag.</div></li></ul><p id="CDR0000419665__60">Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> after surgery to kill any cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.</p></div><div id="CDR0000419665__62"><h4>Radiation therapy</h4><p id="CDR0000419665__64"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy:</p><ul id="CDR0000419665__200"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000419665__201">The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated. External and internal radiation therapy are used to treat vulvar cancer, and external radiation therapy may also be used as
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</p></div><div id="CDR0000419665__65"><h4>Chemotherapy</h4><p id="CDR0000419665__67">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, or onto the skin, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). The way the chemotherapy is given depends on the type and stage of the cancer being treated.</p><p id="CDR0000419665__140"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046619/" class="def">Topical chemotherapy</a> for vulvar cancer may be applied to the skin in a cream or lotion. </p><p id="CDR0000419665__162">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/vulvar" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved to Treat Vulvar Cancer</a> for more information.</p></div><div id="CDR0000419665__182"><h4>Biologic therapy</h4><p id="CDR0000419665__184"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">Biologic therapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
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</p><p id="CDR0000419665__187"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045080/" class="def">Imiquimod</a> is a biologic therapy that may be used to treat vulvar <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesions</a> and is applied to the skin in a cream.</p></div></div><div id="CDR0000419665__80"><h3>New types of treatment are being tested in clinical trials. </h3><p id="CDR0000419665__89"> Information about clinical trials is available from the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000419665__153"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000419665__153_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000419665__153_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000419665__153_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000419665__155"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000419665__155_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000419665__155_30">Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">NCI's</a> listing of clinical trials. </p></div><div id="CDR0000419665__157"><h3>Follow-up tests may be needed.</h3><p id="CDR0000419665__157_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000419665__157_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p><p id="CDR0000419665__188">It is important to have regular <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> exams to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044776/" class="def">vulvar cancer</a>. </p></div></div><div id="CDR0000419665__90"><h2 id="_CDR0000419665__90_">Treatment Options by Stage</h2><div id="CDR0000419665__91"><h3>Vulvar Intraepithelial Neoplasia (VIN)</h3><p id="CDR0000419665__92">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000570425/" class="def">vulvar intraepithelial neoplasia</a> (VIN) may include the following:</p><ul id="CDR0000419665__93"><li class="half_rhythm"><div>Removal of single <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesions</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446983/" class="def">wide local excision</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322858/" class="def">Laser surgery</a>.</div></li><li class="half_rhythm"><div>Ultrasound <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgical</a> aspiration.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443586/" class="def">Skinning vulvectomy</a> with or without a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046581/" class="def">skin graft</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">Biologic therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045927/" class="def">topical</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045080/" class="def">imiquimod</a>.</div></li></ul></div><div id="CDR0000419665__95"><h3>Stage I Vulvar Cancer</h3><p id="CDR0000419665__96">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046120/" class="def">stage I vulvar cancer</a> may include the following:</p><ul id="CDR0000419665__97"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446983/" class="def">Wide local excision</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesions</a> that are less than 1 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044215/" class="def">millimeter</a> deep..</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443585/" class="def">Radical local excision</a> and removal of nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div>Radical local excision and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046712/" class="def">sentinel lymph node biopsy</a>. If <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045876/" class="def">sentinel lymph node</a>, nearby lymph nodes are also removed.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> for patients who cannot have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li></ul><p id="CDR0000419665__TrialSearch_95_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000419665__99"><h3>Stage II Vulvar Cancer</h3><p id="CDR0000419665__100">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046121/" class="def">stage II vulvar cancer</a> may include the following:</p><ul id="CDR0000419665__101"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443585/" class="def">Radical local excision</a> and removal of nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000639914/" class="def">Modified radical vulvectomy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443589/" class="def">radical vulvectomy</a> for large <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>. Nearby lymph nodes may be removed. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> may be given after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Radical local excision and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046712/" class="def">sentinel lymph node biopsy</a>. If <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045876/" class="def">sentinel lymph node</a>, nearby lymph nodes are also removed.</div></li><li class="half_rhythm"><div>Radiation therapy for patients who cannot have surgery.</div></li></ul><p id="CDR0000419665__TrialSearch_99_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000419665__103"><h3>Stage III Vulvar Cancer</h3><p id="CDR0000419665__104">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046122/" class="def">stage III vulvar cancer</a> may include the following:</p><ul id="CDR0000419665__105"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000639914/" class="def">Modified radical vulvectomy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443589/" class="def">radical vulvectomy</a>. Nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> may be removed.<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> may be given after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Radiation therapy or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> and radiation therapy followed by surgery.</div></li><li class="half_rhythm"><div>Radiation therapy with or without chemotherapy for patients who cannot have surgery.</div></li></ul><p id="CDR0000419665__TrialSearch_103_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000419665__107"><h3>Stage IV Vulvar Cancer</h3><p id="CDR0000419665__108">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046123/" class="def">stage IVA vulvar cancer</a> may include the following:</p><ul id="CDR0000419665__109"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443589/" class="def">Radical vulvectomy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322874/" class="def">pelvic exenteration</a>.</div></li><li class="half_rhythm"><div>Radical vulvectomy followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li><li class="half_rhythm"><div>Radiation therapy or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> and radiation therapy followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Radiation therapy with or without chemotherapy for patients who cannot have surgery.</div></li></ul><p id="CDR0000419665__185">There is no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046123/" class="def">stage IVB vulvar cancer</a>. Treatment may include a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</p><p id="CDR0000419665__TrialSearch_107_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div></div><div id="CDR0000419665__111"><h2 id="_CDR0000419665__111_">Treatment Options for Recurrent Vulvar Cancer</h2><p id="CDR0000419665__112">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044776/" class="def">vulvar cancer</a> may include the following:</p><ul id="CDR0000419665__113"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446983/" class="def">Wide local excision</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has come back in the same area.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443589/" class="def">Radical vulvectomy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322874/" class="def">pelvic exenteration</a> to treat cancer that has come back in the same area.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> and radiation therapy with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Radiation therapy followed by surgery or chemotherapy.</div></li><li class="half_rhythm"><div>Radiation therapy as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative treatment</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000419665__TrialSearch_111_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000419665__145"><h2 id="_CDR0000419665__145_">To Learn More About Vulvar Cancer</h2><p id="CDR0000419665__147">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about vulvar cancer, see the following:</p><ul id="CDR0000419665__163"><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/vulvar" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Vulvar Cancer Home Page</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/surgery/lasers-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Lasers in Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/drugs/vulvar" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved to Treat Vulvar Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">HPV and Cancer</a></div></li></ul><p id="CDR0000419665__145_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000419665__145_41"><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000419665__AboutThis_1"><h2 id="_CDR0000419665__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000419665__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000419665__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000419665__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000419665__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000419665__AboutThis_6">This PDQ cancer information summary has current information about the treatment of vulvar cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000419665__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000419665__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000419665__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000419665__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000419665__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000419665__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000419665__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000419665__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000419665__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000419665__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Vulvar Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/vulvar/patient/vulvar-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/vulvar/patient/vulvar-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389324]</p><p id="CDR0000419665__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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</p></div><div id="CDR0000419665__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000419665__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000419665__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000419665__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65885</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389324" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389324</a></span></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65885.2/?report=reader">PubReader</a></li><li><a href="/books/NBK65885.2/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65885" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65885" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Vulvar Cancer Treatment (PDQ®): Patient Version. 2016 Jul 14. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65885.15/">NBK65885.15</a></span> September 18, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65885.14/">NBK65885.14</a></span> January 9, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65885.13/">NBK65885.13</a></span> April 4, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK65885.12/">NBK65885.12</a></span> October 7, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65885.11/">NBK65885.11</a></span> February 22, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65885.10/">NBK65885.10</a></span> January 25, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65885.9/">NBK65885.9</a></span> January 13, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65885.8/">NBK65885.8</a></span> December 17, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65885.7/">NBK65885.7</a></span> August 27, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65885.6/">NBK65885.6</a></span> April 17, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65885.5/">NBK65885.5</a></span> April 9, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65885.4/">NBK65885.4</a></span> May 14, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65885.3/">NBK65885.3</a></span> October 13, 2017</li><li><span class="bk_col_itm">NBK65885.2</span> July 14, 2016 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65885.1/">NBK65885.1</a></span> July 30, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000419665__1" ref="log$=inpage&link_id=inpage">General Information About Vulvar Cancer</a></li><li><a href="#CDR0000419665__24" ref="log$=inpage&link_id=inpage">Stages of Vulvar Cancer</a></li><li><a href="#CDR0000419665__47" ref="log$=inpage&link_id=inpage">Recurrent Vulvar Cancer</a></li><li><a href="#CDR0000419665__49" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000419665__90" ref="log$=inpage&link_id=inpage">Treatment Options by Stage</a></li><li><a href="#CDR0000419665__111" ref="log$=inpage&link_id=inpage">Treatment Options for Recurrent Vulvar Cancer</a></li><li><a href="#CDR0000419665__145" ref="log$=inpage&link_id=inpage">To Learn More About Vulvar Cancer</a></li><li><a href="#CDR0000419665__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" 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