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Vulvar Cancer Affects Older Women

 
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Vulvar cancer is one of the least well-known cancers of the female reproductive system. It develops in the external female genitals, known as the vulva.

The U. S. National Library of Medicine's MedlinePlus website recommends that women consult a doctor if they notice a lump in the vulva, itching or tenderness in the vulva, or genital bleeding unrelated to the menstrual period. The prognosis is good with early treatment.

Dr. Zhihui Wang of Oslo University Hospital, Norway, and colleagues provided a research article on evaluation of cancer of the vulva. Surgery is the standard treatment option. Radical surgery produces “considerable morbidity”, Wang reported. “In a bid to decrease the incidence of complications, there has been a movement towards individualized therapy and less radical surgery.”

Wang's group studied the CDC25 phosphates, which contribute to regulating cell division. Abnormally high levels of CDC25A have been reported in other female cancers of the breast and ovary, as well as in esophageal, hepatocellular, and colorectal cancer.

Wang's study included 300 cases of vulvar squamous cell carcinoma. The median age at diagnosis was 74 years. The age range was 35 to 96 years. Wang noted that this cancer usually affects older women, but the incidence is increasing in younger women.

The results were different from breast and ovarian cancer. The CDC25A phosphate was not found to be important in cancer of the vulva. However three other phosphate types were associated with more aggressive vulvar cancer.

The prognosis for cancer of the vulva is better than that for many other types. Wang showed disease-specific survival plots for patients with two different phosphate values.

For women with low phospho-CDC25C, more than 60 percent survived 20 years after diagnosis. For women with high phospho-CDC25C, the survival rate was approximately 40 percent after 20 years.

Lab tests for this phosphate, therefore, could be valuable in estimating an individual's prognosis. Other phosphates showed a smaller association with vulvar cancer.

Human papillomavirus (HPV) infection is a risk factor for development of vulvar cancer, according to the Medline Plus web site. Wang and colleagues found a correlation between HPV and two of the phosphates in their study.

The National Cancer Institute has a web page for vulvar cancer. This organization estimates 4,340 new cases and 940 deaths in 2011. Links are provided for clinical trials.

References:

1. U. S. National Library of Medicine. MedlinePlus. Web. Nov. 4, 2011.
http://www.nlm.nih.gov/medlineplus/vulvarcancer.html

2. Wang Z et al, “Overexpression of CDC25B, CDC25C and phospho-CDC25C (Ser216) in vulvar squamous cell carcinomas are associated with malignant features and aggressive cancer phenotypes”, BMC Cancer 2010; 10: 233. http://www.ncbi.nlm.nih.gov/pubmed/20500813

3. National Cancer Institute. Vulvar Cancer. Web. Nov. 4, 2011.
http://www.cancer.gov/cancertopics/types/vulvar

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

Reviewed November 16, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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