Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Vulvar and Vaginal Dysplasias and Cancers

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Although vulvar and vaginal dysplasia are uncommon – and cancer in these areas is even rarer – a diagnosis of any of these conditions can be very upsetting to a woman. It is important to know that dysplasias and cancers of the vulva and vagina are all highly treatable. Methodist Obstetrics and Gynecology Group offer you the advanced medical treatment and the personal support you need. Our experienced and caring physicians provide you with individualized care from diagnosis through therapeutic and reconstructive surgery, giving you your best chance to not only survive, but thrive and maintain a positive body image.

Vulvar Dysplasia and Cancer:

Vulvar dysplasia, or vulvar intraepithelial neoplasia (VIN), is – like cervical dysplasia – a growth of abnormal cells. It affects the external female genitalia and is generally considered a precancerous condition. However, most cases of VIN will not evolve into cancer, unless they are left untreated. This is due in part to the fact that VIN is very slow-growing and often produces symptoms such as itching and visible, wart-like lesions upon the vulva. Most cancer of the vulva generally develops from VIN, although in a small number of cases, the cancer may be of another type (such as melanoma, or cancer of the skin).

Vaginal Dysplasia and Cancer:

Vaginal dysplasia, also known as vaginal intraepithelial neoplasia (VAIN), is also a growth of precancerous cells – in this case, on the tissue lining the vagina, or birth canal. VAIN can, in some cases, become vaginal cancer (other vaginal cancers include melanoma as well as sarcomas, which grow below the surface of the vagina’s lining). Although they usually have no symptoms in their early stages, VAIN and vaginal cancer are easy to detect early through annual Pap tests and pelvic exams.

We invite you to visit the links below for more about our revolutionary treatment options for vulvar and vaginal dysplasias and cancers.

Surgical and Medical Treatment

For both vulvar and vaginal cancers, surgery is a commonly used treatment, and may be supplemented with radiation therapy and chemotherapy. Some of the main forms of therapy for cancer and precancerous conditions are listed below.

  • For dysplasia:
    • Laser ablation – destruction of the abnormal cells using a laser
    • local excision (surgical removal) to remove the dysplasia
    • (partial) vaginectomy to remove the upper vagina
  • For cancer:
    • chemotherapy (including topical chemotherapy, in which a cream is applied to cancerous lesions)
    • radiation therapy
      • external radiation – this form of radiation therapy is administered from outside the body, using a beam that targets the cancer cells.
      • internal radiation – in this procedure (also known as brachytherapy), materials that emit radiation are placed directly into the vagina, so as to get closer to the cancerous cells.
    • combination therapy – a combination of surgery, chemotherapy, and/or radiation (including chemoradiation)

The Methodist Hospital is a leader in radiation therapy, offering the most advanced technologies and a multidisciplinary approach for safe and accurate administration of radiation. Methodist also continues to innovate in the area of chemotherapy, offering clinical trials of special chemotherapy assays.

Clinical Trials for Vulvar and Vaginal Dysplasia and Cancers

As part of our ongoing commitment to groundbreaking research and advances in women’s health, The Methodist Hospital offers our patients the opportunity to participate in surgical and medical clinical trials. Please click here for information on our current studies. If you are interested in being a candidate for one of these trials, please talk to your physician and contact Dr. Carol Hodgson at 713-441-6616 to find out if you meet the criteria for participation.

We invite you to learn more about our clinical trials, including the types of trials we conduct, the benefits of participation and our commitment to patient safety.

Radical Surgery and Reconstruction

Radical surgery is a treatment option for advanced cancer. In vulvar cancer, all or part of the vulva, including the clitoris and surrounding tissues, may be removed. In the case of advanced vaginal cancer, the surgeon may remove the vagina, uterus, cervix and parts of any nearby organs with which the cancer is involved. The most extreme cases may require pelvic exenteration, in which all pelvic organs are removed.

Radical surgery is used in cases of recurrent or extremely advanced vaginal cancer, if previous treatments have not helped and it is the only option for survival. Since the surgery first came into use, however, there has been great innovation in the area of vaginal and pelvic reconstruction. The Center for Restorative Pelvic Medicine at The Methodist Hospital offers the most advanced forms of restoration available after radical surgery, including flap closure, a procedure using skin flaps and tissue from other parts of the body.

The center performs careful and detailed vulvar reconstruction and vaginal reconstruction, utilizing the patient’s own skin and tissues. These forms of reconstructive surgery are a help not only in your physical recovery, but also in preserving your sexual health and positive self-image.

Chemoradiation Therapy

Chemoradiation therapy combines both chemotherapy (intravenous and/or orally-administered anti-cancer medications) and radiation therapy. Chemoradiation may be used as neoadjuvant therapy – the first treatment, given before another treatment such as surgery – or adjuvant therapy, which is given after surgical or medical treatment to destroy any remaining cancer cells which may not be detectable. Your chemotherapy and radiation treatments may be given together, or in alternating sessions which are close together.

Chemoradiation is most often used in advanced or complicated cases of cancer. In many instances, the effectiveness of the treatment has been shown to be greater than that of chemotherapy or radiation alone.

Neoadjuvant Chemoradiation Therapy

This form of chemoradiation therapy is given to a patient before another procedure such as surgery. The aim of neoadjuvant chemoradiation is to shrink the cancer as much as possible before the surgery to make it easier to remove. This treatment is especially useful in advanced cases where the cancerous area is large and would be difficult to fully eliminate in surgery. Because of this benefit, it is sometimes used with surgical debulking, a procedure in which parts of a large or complex mass are initially removed in order to shrink it to a manageable size. Neoadjuvant chemoradiation also helps with cases in which surgery would present a high risk of complications.