Many women dread their yearly gynecology visit, searching for excuses to put off the evaluation. It’s common for women to skip the examination entirely if they are no longer in their reproductive years or if they’ve had a hysterectomy, because they don’t feel they need a Pap smear. 

It’s important to realize that during a pelvic exam your gynecologist is looking for more than just abnormalities of the uterus, cervix and ovaries. She is also looking for signs of vulvar cancer. 

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 very rare — affecting only 1 in 387 women — survival rates are relatively low because patients are often in an advanced state of disease by the time they seek medical help. Most patients experience symptoms for weeks, months or even years before they go see a doctor.

Some common symptoms that should prompt an evaluation are persistent itching or burning, wart-like bumps or masses that don’t heal, dark or irregular moles or spots, and skin thickening or pain.

Vulvar cancer is diagnosed by a simple biopsy that can often be done in your doctor’s office with local anesthesia. While many patients who are diagnosed with these cancers are reluctant to share their condition with their family and friends, most of these tumors are skin cancers that could occur anywhere on the body. It is only the location that makes it the cancer no one talks about. 

Risk factors for vulvar cancer include infection with the human papillomavirus, a history of atypical cells of the vulva or other skin diseases, and tobacco use.

When these cancers are found early, they are easily treated with surgery to remove the mass. Occasionally, sampling of the lymph nodes is also needed. Current surgery techniques 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. 

There are several steps you can take to protect yourself. First, become familiar with your vulva by performing monthly self examinations. If symptoms or sores last for more than seven days, schedule a visit with your doctor for an evaluation. Get a yearly pelvic exam, even if you’re not due for a Pap test, and ask your doctor about the HPV test.

Heather Pulaski, MD, is a gynecologic oncologist with UC Health and assistant professor at the UC College of Medicine. Pulaski sees patients at the UC Health Physicians Office in West Chester Twp. For appointments or referrals call (513) 584-6373.