Vulvar Cancer

Treatment

If you have vulvar intraepithelial neoplasia, a precancerous condition (Stage 0 cancer), your doctor will remove the cancerous tissue using surgery or laser treatment.

If your cancer is Stage I or higher, your doctor will use surgery, radiation therapy, chemotherapy, reconstructive surgery or a combination of these therapies to treat your cancer.

• Surgery. Until recently, doctors treated invasive vulvar cancers by removing the vulva and nearby lymph nodes in your groin. However, Mayo Clinic doctors may treat cancers confined to small areas of the vulva with a less extensive type of surgery.
  
  Surgery usually involves the removal of diseased tissue and lymph nodes. If your cancer covers multiple areas, your doctor may remove large amounts of tissue. If your cancer has invaded to a depth greater than 1 millimeter, it may have spread to the lymph nodes in your groin, so your doctor will remove and biopsy these lymph nodes to determine how far the cancer has spread.
• Radiation therapy and chemotherapy. Doctors sometimes use external beam radiation therapy with or without chemotherapy after surgery when the risk of cancer recurrence is high. Radiation with or without chemotherapy also may be an option if your cancer has invaded your lymph nodes or if you have tumors that can't be removed without risk to you. If you require a colostomy or urinary diversion, your doctor may sometimes substitute external radiation for surgery.
• Reconstructive surgery. At Mayo Clinic, a gynecologic oncologist and a plastic surgeon work together to restore as much of your anatomy and function as possible. This teamwork is especially important when surgical reconstruction is part of the treatment plan. Mayo Clinic doctors perform a full range of gynecologic reconstructive surgery procedures, including:
• Reconstruction of the vulva
• Rebuilding of the vagina after extensive cancer treatment
• Use of skin grafts after radiation therapy or surgery for recurrent cancer in the vulva and groin
• Rebuilding of vital organs, such as a urinary bladder, vagina or pelvic floor, that were removed to treat advanced cancer or were badly damaged after radiation therapy
• Reconstruction of the pelvic floor to correct pelvic prolapse and urinary or rectal incontinence

Doctors at Mayo Clinic consider your age and psychological and sexual concerns when recommending a treatment plan. Reconstructive surgery techniques can produce cosmetically pleasing and functional results that improve your quality of life.