Vulvar Cancer: Precancerous Changes
What is vulvar intraepithelial neoplasia?
Vulvar intraepithelial neoplasia (VIN) is a precancerous change in your vulva. VIN is not cancer. But if it's not treated it can turn into cancer.Intraepithelial means that the precancerous cells are only in the surface of the vulvar skin.
Another name for VIN is dysplasia. The terms used to describe dysplasia are mild dysplasia, moderate dysplasia, and severe dysplasia. The last stage before invasive cancer is called carcinoma in situ. These cell changes become more serious as they progress toward cancer. However, this process may take many years.
Understanding the vulva
The vulva is the outer part of the female reproductive system. It’s also called the external genitalia. The vulva includes:
The mons pubis, the rounded area in front of the pubic bones. It becomes covered with hair at puberty. It includes the skin folds under the pubic hair that protect the opening of the urethra. This is the tube that carries urine out of the body and the vagina.
Two folds of skin. The outer folds are called the labia majora. The inner folds are called the labia minora.
The prepuce or the hood of the clitoris. Thisis made by the inner fold of the vulva
Theclitoris is below the prepuce. It’s a sensitive piece of tissue that swells with blood when stimulated.
The fourchette is at the bottom of the inner folds of the vulva. It’s where the labia minora meet.
The perineum is area between the fourchette and the anus.
What are the signs and symptoms of VIN?
VIN often does not cause symptoms. So, most women do not know they have it.These may be signs of VIN:
Mild to severe itching or burning on the vulva.
Changes in the skin color on your vulva. It may be white, pink to red, gray, or dark brown.
Thickness around skin on the vulvar area. The skin may be smooth or irregular, or look wart-like.
Ulceration or cracking of the skin on your vulva
How does my healthcare provider know I have VIN?
Your healthcare provider may suspect VIN after looking at your vulva. However, you’ll need a biopsy to confirm the diagnosis. VIN can be treated, but it can also return.
What can I do to reduce my risk of VIN?
VIN has been linked to cigarette smoking.Quitting smoking can reduce your risk. It can alsobring many other health benefits. If you’ve been diagnosed and treated for VIN, pay close attention to your body. Do regular self-exams of your vulva as your healthcare provider directs you. Also, keep up with your checkups. Tell your healthcare provider if you have pain or burning in the vulvar area or if you have any skin changes.
Getting regular pelvic exams can reduce your risk of vulvar cancer. VIN develops slowly. This way, your healthcare provider can help find VIN while it’s small and easier to treat. Treating VIN early helps reduce the chance that the changed cells will progress to cancer.
How is VIN treated?
All cases of VIN should be treated. You should follow up regularly with your healthcare provider. Protect yourself by getting any tests and treatments that your healthcare provider suggests. When healthcare providers find and treat precancerous vulvar changes early, they can often prevent vulvar cancer.
Treatment can destroy or remove all of the precancerous cells. Surgery may be used to cut out the changed area and an edge of normal tissue around it. This is done to assure that all the changed cells have been taken out. Your healthcare provider may also uselaser treatments to burn out the VIN cells.
In some cases, your healthcare provider may use a topical prescription medicine that’s applied to the skin of the vulva. Medicines used include imiquimod or fluorouracil (5-FU). This is called topical chemotherapy.
The type of treatment used and the long-term changes to the vulva depend on many factors. These include the stage of dysplasia, the location, and the size of the changed area.
Talk with your healthcare provider
If you have questions about VIN or your risk for vulvar cancer, talk with your healthcare provider. He or she can help you understand more about this precancer and what it means for you.
March 21, 2017
Goodman, Howard, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS