|
|||||||
|
Vulvar Cancer Treatment Surgery The amount of surgery required varies with the size, location, and stage of the cancer. The goal of surgery is to remove all cancerous or pre-cancerous tissue. This may simply require the removal of a small to moderate area of tissue in a specific location, termed a "wide local excision" or it may require the removal of part or all of the vulva and underlying tissue, a procedure called a "radical vulvectomy". In some cases, lymph nodes in the groin are also removed and checked for the spread of cancer. In larger tumors that are more advanced or that cover a wider area, skin grafts may be required to close the wound. Smaller procedures may not even require an overnight stay in the hospital. However, more involved surgeries can require a hospital stay of 5 - 10 days. After major surgery on the vulva, the patient is usually limited to bed rest for several days to prevent accidental pulling on the incisional area, which could cause wound breakdown. The nurses use special cleaning and drying techniques and the patient is taught how to care for the area as she gradually becomes more active. Clinical trials (research studies, see clinical trials) have allowed doctors to do much less extensive surgery on vulvar cancer patients while assuring a good result. Ongoing studies at Ellis Fischel and around the nation, are hoping to be able to identify tumor spread more accurately before surgery and further limit the extent of tissue removed, decreasing side effects and improving wound healing in much the same way breast cancer surgery has moved away from more radical procedures, with equally good results. Radiation Treatment with radiation may be recommended if lymph nodes are involved with cancer, or it the tumor was large or located in an area that did not allow the doctor to get enough of the tissue around the cancer to be sure that it would not come back. Radiation therapy can be given a variety of ways. Generally it is designed to treat a very specific location where cancer cells are suspected. It is usually given daily, Monday through Friday and takes 15 - 20 minutes. The radiation doctor, called a radiation oncologist, may recommend from two to six weeks of therapy. Side effects of treatment depend on the area being treated but usually involve reactions of normal tissue to the radiation. For example, radiation to the pelvis or groin lymph nodes can cause bladder irritation, diarrhea, and skin irritation. Chemotherapy Chemotherapy for vulvar cancer is usually reserved for more advanced or recurrent disease, wherein widespread treatment is desired, rather than radiation, which usually treats only a well-defined area of the body. Most often, chemotherapy is given using 2 - 3 drugs into the vein every 3-4 weeks for a period of 4 - 6 months. In most instances, the treatment is given in an outpatient center, which does not require an overnight stay and takes 1-2 days. Clinical trials are currently investigating whether adding low dose weekly chemotherapy during the time of radiation therapy, improves cure rates, in much the same way it has done with cervical cancer. (For side effect information, see Ovarian or Endometrial Cancer.) |
|
|||||
|
|||||||
