Most people who have cancer of the vulva are treated with surgery. The procedure your doctor recommends will depend on how advanced your cancer is.
Laser surgery
Laser surgery is used to treat women whose disease is in the "pre-cancerous" stage, meaning that there are irregular cells present that probably would become cancer if not treated. This is a relatively simple procedure that uses a laser to remove the irregular cells.
Local excision
Local excision is a surgery to remove the cancer plus a margin of healthy tissue. If your doctor recommends a "radical" local excision, a larger margin of healthy tissue will be removed and you may have lymph nodes in the groin removed as well.
The lymph nodes are removed so that they can be biopsied to determine if the cancer has spread. Some women are candidates for a sentinel node biopsy, in which as few as one or two lymph nodes are removed.
Vulvectomy
There are different types of vulvectomy (surgery to remove the vulva, or external sexual organs). Some procedures are more extensive than others, and will be recommended if your cancer is more advanced. In some cases, your doctor will also remove lymph nodes in the groin to check if your disease has spread any further.
In many cases, the gynecologic oncologist who removes the tumor can also close the incision. When the cancer surgery is more extensive, a reconstructive surgeon may be involved. Often, they use skin from the same region of the body and rearrange it to make a new surface for the labia. If more tissue is needed, the surgeon may use tissue from your abdomen or thigh. Learn more about reconstructive surgery.
If biopsies and other tests show that your cancer has spread beyond the vulva, your physicians may recommend adding radiation, chemotherapy or both to control the disease.
Surgery for Fred Hutch gynecologic patients is done at UW Medical Center by UW Medicine surgeons.