Treatment for vulvar cancer usually involves surgery or radiation. You might also have chemotherapy and/or radiation therapy either before surgery (neoadjuvant) to shrink the cancer for the best surgical outcome or after (adjuvant) surgery to kill cancer cells beyond your vulva.
Your personal care team will work with you to design a treatment plan that is best for your general health, the size, and stage of your cancer. Our goal is to give you the most advanced treatments with the least harmful impact on your body.
Surgery for vulvar cancer can be delicate or complex. Gynecologic oncologists are the best surgeons for vulvar cancer. Our surgeons at the Center for Advanced Gynecologic and Pelvic Surgery at Columbia University are world-renowned specialists from several disciplines who undertake the most complex surgeries as a team.
Surgery for vulvar cancers may include:
- Excision, which removes cancer from your vulva.
- Radical vulvectomy, which involves removing all or parts of your vulva.
- Inguinal or pelvic lymph node dissection, which removes these lymph nodes if cancer has spread. A procedure called sentinel lymph node biopsy is now often performed to remove only those lymph nodes at greatest risk for cancer, the sentinel lymph nodes.
Radiation therapy uses high-energy X-rays to destroy cancer cells. Radiation therapy may be part of your treatment plan based on the tumor size, extent, and location. If your doctors determine you are not a candidate for surgery, radiation is usually delivered in combination with chemotherapy with the goal to destroy tumor cells while preserving urinary and bowel function. Your radiation oncologist, who is part of your personal care team, will design an optimal treatment plan for you for the best possible results.
Your radiation treatment plan may include one or a combination of the following types of radiation therapy depending on your disease stage:
External Beam Radiation
External beam radiation is used to deliver radiation to the pelvis. We use conformal techniques to help minimize radiation dose to the bladder, bowel, and rectum while focusing the radiation on areas within the pelvis where tumor cells have or may have spread to.
Treatments are delivered daily as an outpatient over a few weeks. Each treatment lasts only a few minutes.
Brachytherapy, or internal radiation, is a treatment where a radioactive source is placed directly inside or very close to the tumor. It is able to deliver very high doses of radiation while sparing surrounding normal tissues. There are many different types of applicators that may be used to deliver brachytherapy in the pelvis. Your radiation oncologist will meet with you to discuss whether brachytherapy should be part of your treatment plan and what type of brachytherapy would be most appropriate.
Chemotherapy uses medications (chemicals) to stop cancer growth and spread and to prevent cancer from recurring by causing rapidly dividing cancer cells to become damaged and die. For women with vulvar cancer, chemotherapy is most commonly administered at the same time as radiation. This “radiosensitizing” chemotherapy is a low dose of chemotherapy that improves the efficacy of radiation. The most commonly used chemotherapy drug for vulvar cancer is cisplatin.
You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship of cervical cancer patients. You can talk to your care team about whether a clinical trial is an option for you.
Gynecologic Oncology Survivorship Program
Once you’re finished with treatment, you’ll enter a period of surveillance to make sure your cancer doesn’t return, and if it does, to catch it early.
Our experts in the Gynecologic Oncology Survivorship Program create an individualized Survivorship Plan for you. This plan is a comprehensive assessment that includes all the treatment you received, possible late side effects to watch for, a blueprint for future cancer screening, a surveillance plan, and a personalized plan for wellness activities to improve your lifestyle.