Vulvar Cancer Treatment

At Penn Medicine's Abramson Cancer Center, we offer a comprehensive cancer program that provides women more options for treating vulvar cancer. Specialists at the Jordan Center for Gynecologic Cancers are dedicated to identifying vulvar cancer, eliminating it, and preventing it from recurring.

Our treatment options for vulvar cancer include:

Chemotherapy and Biologic Therapies for Vulvar Cancer

Penn Gynecologic Oncology offers the latest advances in chemotherapy for treating vulvar cancer. Our gynecologic oncologists are board certified in obstetrics and gynecology, and have completed additional training required for treating cancer. This training includes all currently available forms of treatment, including surgery, radiation therapy, chemotherapy and clinical research therapies. Our gynecologic oncologists also communicate regularly with other Penn specialists and the patients' personal physicians to provide comprehensive, integrated care.

Chemotherapy

Chemotherapy may be given before or after surgery, or alone to treat vulvar cancer. In addition to managing a patient's medical oncology treatment, gynecologic oncologists at the Jordan Center for Gynecologic Cancer work closely with dedicated chemotherapy nurse practitioners. Nurse practitioners offer specialized care for those undergoing chemotherapy, making sure they receive seamless, coordinated care from the first chemotherapy session through follow-up care.

Hormone Therapy

Hormone therapy keeps cancer cells from receiving the hormones they need to grow and spread.

Hormones are chemicals produced by various glands in the body. They circulate in the bloodstream and some hormones can affect the way certain cancers grow. Hormones that can stimulate cancer include:

  • Estrogen
  • Progesterone
  • Testosterone

Hormone therapy blocks the production or the effects of these hormones and helps stop the cancer from growing. Treatment may include the use of drugs that change the way hormones work, or surgery to remove the ovaries in order to stop hormone production.

Clinical Trials for Vulvar Cancer

Today, more and more people are surviving cancer. Clinical trials benefit patients with access to breakthrough therapies and treatments. These new advances in cancer treatment are occurring every day at Penn Medicine, giving patients hope that even greater discoveries lie ahead.

Through clinical trials:

  • Diagnosing cancer has become more precise.
  • Radiation and surgical techniques have advanced.
  • Medications are more successful.
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes.
  • Strategies to address the late effects of cancer and its treatment are improving quality of life.

Radiation Therapy for Vulvar Cancer

Radiation therapy uses high-energy X-rays to kill cancer cells. Penn Radiation Oncology uses the latest equipment and technology available to treat vulvar cancer. We are recognized leaders in techniques that target radiation precisely to the treatment area while sparing normal tissue.

At Penn, women with gynecologic cancer have access to new and advanced treatment options and ongoing clinical trials in radiation therapy. As part of our commitment to advancing cancer care in patients, radiation oncologists are also interested in understanding how radiation treatment affects the quality of life for cancer patients.

Conformal Radiation Therapy

Conformal radiation therapy gives doctors more control when treating tumors.

In conformal radiation, a special computer uses CT imaging scans to create 3-D maps of the location of the cancer in the body. The system permits the delivery of radiation from several directions, and the beams can then be shaped, or conformed, to match the shape of the cancer. Conformal radiation therapy limits radiation exposure to nearby healthy tissue as well as the tissue in the beam's path.

Image-Guided Radiation Therapy (IGRT)

Image-guided radiation therapy (IGRT) uses frequent imaging during a course of radiation therapy to improve the precision and accuracy of the delivery the radiation treatment.

In IGRT, the linear accelerators (machines that deliver radiation) are equipped with imaging technology that take pictures of the tumor immediately before or during the radiation treatment. Specialized computer software compares these images of the tumor to the images taken during the simulation to establish the treatment plan. Necessary adjustments can then be made to the patient's position and/or the radiation beams to more precisely target radiation at the cancer and avoid the healthy surrounding tissue.

Intensity-Modulated Radiation Therapy (IMRT)

Intensity-modulated radiation therapy (IMRT) is an advanced mode of high-precision radiotherapy utilizing computer-controlled linear accelerators to deliver precise radiation doses to tumors or specific areas within the tumors. Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing or stopping tumor growth. In many cases, radiation therapy is capable of killing all of the cancer cells.

Using 3-D computed tomography (CT) images of the patient in conjunction with computerized dose calculations, IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor by controlling, or modulating, the intensity of the radiation beam in multiple small volumes. The therapy allows higher radiation doses to be focused to regions within the tumor while minimizing the dose to surrounding normal critical structures.

Surgery for Vulvar Cancer

Surgery is the most common treatment for cancer of the vulva. Women who had extensive vulvar surgery may choose to have reconstructive surgery to improve their quality of life.

At Penn, our gynecologic specialists continue their efforts to devise and enhance new and even better options for complex gynecologic surgery through the Penn Center for Advanced Gynecologic Surgery.

Laser Surgery

A focused laser beam destroys the layer of skin containing abnormal cells. Laser surgery is used as a treatment for pre-invasive vulvar cancer. It is not used to treat invasive cancer.

Oophorectomy

An oophorectomy is a procedure in which both ovaries are removed.

Pelvic Exenteration

Pelvic exenteration is a radical surgery that removes all organs from the pelvic region. It is not commonly performed by Penn Medicine gynecologic oncologists, but may be used to treat cancer that has spread to surrounding reproductive and pelvic organs.

Vulvectomy

Vulvectomy is the surgical removal of all or part of the vulva. There are three types of vulvectomy:

  • Skinning vulvectomy is a rare operation in which the top layer of skin affected by the cancer is removed.
  • Simple vulvectomy is removal of the entire vulva.
  • Radical vulvectomy is a rare operation that can be complete or partial. A partial vulvectomy involves the removal of the vulva, including the deep tissue. In a radical vulvectomy, surgeons remove the entire vulva, deep tissue and the clitoris. This surgery is only performed in extensive cancer cases.

Other Treatments for Vulvar Cancer

In addition to standard treatments and clinical trials, you may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy. These therapies do not have curative intent, and are designed to complement standard treatments, not take their place.

Integrative Oncology Services

At Penn, our integrative oncology services can supplement traditional cancer treatments such as chemotherapy, surgery and radiation therapy. While conventional medicine plays a critical role in eradicating cancer, integrative oncology services offer you ways to enhance the quality of your life, minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

Our cancer specialists are knowledgeable and supportive of complementary cancer treatments. Our cancer team works with you and your family to integrate these supportive programs into the overall care plan, while ensuring your health and safety.

The Abramson Cancer Center's range of integrative supportive services is designed to help you cope with the cancer experience and improve your overall sense of well-being.

Services include:

Joan Karnell Supportive Services at Pennsylvania Hospital offers an extensive variety of supportive care programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social work counseling, nutrition counseling, psychological counseling and spiritual counseling.

The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.

The Supportive Care Clinic helps to manage cancer-related symptoms. Integrative support programs include:

Palliative Care

Palliative care provides medical and non-medical interventions to ease the symptoms of cancer and its treatment. Palliative care includes physical, emotional and spiritual care that can enhance the quality of life for cancer patients. Palliative care can be used to complement traditional cancer therapies, or can be used when curative therapies are no longer an option to treat symptoms and improve quality of life.

Palliative care is an approach to patient care that can be integrated with curative therapies at any point from diagnosis to survivorship or end of life care. Palliative care services include palliative chemotherapy, radiation therapy and surgery as well as psychological counseling, art therapy and support groups for patients and families.

Penn Home Care and Hospice Services

Penn Medicine offers a full range of “at home” health care services, including specialized therapies and medications, for patients with cancer and cancer-related conditions.