Cincinnati—The term "pelvic exam” makes most women cringe. But UC Health specialists stress that this annual exam is an critical tool for detecting a host of gynecologic cancers that shouldn’t be dismissed—even after women are no longer in their reproductive years.
"Your gynecologist is looking for more than just abnormalities of the uterus, cervix and ovaries during a pelvic exam. She is also looking for signs of vulvar cancer,” says Heather Pulaski, MD, a gynecologic oncologist with UC Health and assistant professor at the UC College of Medicine.
Vulva is an anatomical term for the skin around the urethra and vagina, including the inner and outer labia, the clitoris and the pubic region. While cancer of the vulva is rare—affecting only 1 in 387 women according to the National Cancer Institute—survival rates are relatively low because patients are often diagnosed in an advanced stage of the disease by the time they seek medical help.
"Unfortunately, many patients experience symptoms for weeks, months or even years before they go see a doctor,” says Pulaski. "Most of these tumors are skin cancers that could occur anywhere on the body. It’s only the location that makes it the cancer no one talks about.”
Risk factors for vulvar cancer include human papillomavirus (HPV) infections, a history of atypical cells of the vulva or other skin diseases and tobacco use. Pulaski says there are recognizable symptoms that should prompt women to seek immediate evaluation, including:
· Persistent itching or burning
· Wart-like bumps or masses that don’t heal
· Dark or irregular moles or spots
· Skin thickening or pain
Vulvar cancer is diagnosed by a simple biopsy that can often be done in an outpatient setting with local anesthesia.
"When these cancers are found early, they can be treated with surgery. The techniques we use spare as much of the surrounding normal tissue as possible. For patients with advanced cancer, radiation and chemotherapy offer good treatment options for disease control,” adds Pulaski.
"Women should have a yearly pelvic exam, even if they are not due for a Pap test, and ask their doctor about a HPV test. It's estimated that 40 percent of vulvar cancers are related to HPV—the virus that causes most cases of cervical cancer.”
Pulaski and her colleagues specialize in the treatment of gynecologic cancers and minimally invasive surgery, including robotic surgery. The UC Health-based team offers numerous, active clinical trials for all types and stages of reproductive cancers. For appointments or referrals, call (513) 584-6373. For clinical trial information, call (513) 584-7698.