Carcinoma of the vulva is a rather rare type of oncology, which is characterized by uncontrolled growth of altered cells. It occurs in 2% of cancer patients with genital oncology. It is often asymptomatic and is detected during scheduled gynecological examinations. Women over 50 years of age are patients diagnosed with vulvar carcinoma most often, although childhood forms of cancer may also occur. Therapy is rather complicated: the intense blood flow to the pelvic organs and the aggressiveness of the tumor often leave the chance of cancer recurrence.
Content
- Why does vulvar cancer occur?
- What are the symptoms of vulvar cancer?
- Diagnostics of vulvar cancer in Germany
- Treatment tactics
- Rehabilitation
- Prognostic factors
- Why does vulvar cancer treatment in German hospitals show high success rates?
- Hospitals to undergo vulvar cancer treatment in
- Cost of treatment
- How to start vulvar cancer treatment in Germany?
Why does vulvar cancer occur?
Vulvar cancer develops gradually, often over several months or even years. It usually occurs against the background of hormonal changes in the body. In about half of the cases, patients with vulvar cancer are infected with the human papillomavirus. Therefore, if patients notice changes in the appearance of the genitals, this is a reason to consult a gynecologist specializing in oncology.
Also, vulvar carcinoma can occur due to various dermatoses in the genital area, like vulvitis and vulvar leukoplakia.
What are the symptoms of vulvar cancer?
Symptoms of vulvar carcinoma depend on the stage of the process. At the early stages of the disease, itching or burning around the external genitalia may be the patients’ main and often the only complaint. Other symptoms of vulvar cancer include purulent discharge from the vagina, presence of a tumor-like mass (condyloma, nodule, focal mass) in the vulvar tissues, ulceration, and pain around the lesion.
If vulvar carcinoma spreads to the neighboring organs, problems with emptying the bladder and intestines occur, regional lymph nodes are affected and as a consequence, the lymph drainage from the lower extremities is disturbed. The destruction of the tumor can result in heavy bleeding.
Diagnostics of vulvar cancer in Germany
The incidence of malignant diseases of the female reproductive system has increased in recent years. Every woman should therefore undergo regular examinations by a gynecologist. If vulvar cancer is detected at the early stage, complete recovery with preservation of the reproductive function is possible in most cases.
During the initial examination of patients, the doctor may detect a lumpy nodule with a dense structure. With a certain degree of neglect of the disease, ulcers appear on the tumor.
Such manifestations are not always the signs of vulvar carcinoma. In order to clarify the diagnosis, biopsy of suspicious tissues for further examination under a microscope and cytological analysis of biomaterial is required.
The diagnosis of metastatic cancer is carried out with the help of:
- CT scan and MRI, ultrasound scan of the pelvic area
- Excretory urography
- Cystoscopy
It is typical for vulvar carcinoma to metastasize to the mammary glands, so the examination of the breasts is carried out in patients as well.
After receiving detailed information about the tumor and the health condition of patients, vulvar cancer treatment is planned. The therapy program includes progressive methods that block the development of vulvar carcinoma and destroy the cancer cells in the body.
Treatment tactics
During the elaboration of an individualized treatment program for vulvar cancer, doctors necessarily take into account the degree of spread of cancer in the body, the type of cancer, the patient's general state of health, and other factors that may affect the tactics of treatment.
Surgical intervention is still the main method of treatment for vulvar carcinoma. In German hospitals, it is only used as an independent option at the first stage of vulvar cancer. Provided that vulvar carcinoma is small, and the depth of invasion does not exceed one millimeter, the neoplasm is a subject to removal.
In all other cases, a vulvectomy is performed, which involves removing the affected external genitalia, i.e. the clitoris, labia minora, and labia majora, as well as the subcutaneous fatty tissue in the pubic area. If metastases in lymph nodes are suspected, a vulvectomy is complemented with an inguinal-femoral or inguinal-femoral-iliac lymphadenectomy (so-called extended radical vulvectomy). If patients have an advanced malignant process, it is sometimes necessary to resect the rectum, create a colostomy, remove the bladder, the vagina, and excise the uterus.
For patients with larger tumors that penetrate more than 1 mm into the healthy tissues chemotherapy and radiation therapy without adjuvant treatment are recommended, in order to reduce the tumor size, and then surgical treatment is performed. This, on the one hand, helps protect the patient from a radical resection of the genitals (vulvectomy), and on the other hand, reduces the associated postoperative risks and the need for subsequent plastic reconstruction of the genitals. Larger tumors have an increased risk of metastasizing to lymph nodes. Therefore, if two or more lymph nodes are infiltrated, all pelvic lymph nodes must be removed (this is called lymphadenectomy). If the vulvar cancer is unilateral, removal of the inguinal lymph nodes is sufficient.
In most oncology cases, chemotherapy is carried out, sometimes – with direct injection of solution in the tumor blood vessels. Upon chemotherapy completion, a visualizing study is conducted to monitor the efficacy of therapy. The presence of cancer cells in the biomaterial harvested for a study is an indication for another chemotherapy course. If repeated chemotherapy also doesn’t show any result, doctors switch to other methods of cancer treatment.
It should be noted that one of the promising high-tech methods of treatment of vulvar cancer, available in German hospitals, is photodynamic therapy, which has already shown its high efficiency. Vulvar cancer treatment can also include laser therapy and cryoablation.
The extensive clinical experience of German doctors and the use of the most modern, high-precision equipment allow successfully managing this disease even at the advanced stages of its development.
Rehabilitation
A comprehensive course of treatment of vulvar carcinoma is usually followed by rehabilitation measures such as:
- Prescription of supplements and immunotherapy
- Physiotherapy
- Postoperative vaginoplasty (especially relevant for young women)
Modern techniques of chemotherapy and radiation exposure prevent the development of serious health consequences, so rehabilitation is more comfortable and as painless as possible.
Prognostic factors
Prognostic factors for recovery in vulvar cancer are determined primarily by how timely the malignant tumor was detected and how timely the adequate treatment was started. That is why German specialists pay special attention to preventive gynecological examinations, which recognize the problem at its early stages.
The prognostic factors include the stage and histological characteristics of vulvar carcinoma. At the first two stages, the chances of recovery are quite high, but even at the stage of the advanced cancer process, German doctors will help to prolong a patient's life and significantly improve its quality.
Why does vulvar cancer treatment in German hospitals show high success rates?
German specialists combine their medical practice with research work and are the developers of many effective methods of therapy. As soon as clinical trials of a new therapeutic and diagnostic methodology end with positive results, doctors include them in the cancer treatment program. Thus, treatment in German hospitals is an effective and professional help aimed at the best recovery results.
German hospitals have an advanced technical base that allows the application of the latest medical developments. Doctors use those methods not in the conventional treatment regimens but adjust and compound them so that therapy is as personalized as possible.
A detailed examination of the patient's body and making the correct diagnosis is of great importance as well, because the results of the diagnostics can determine how accurately a treatment program is chosen.
Hospitals to undergo vulvar cancer treatment in
The diagnostics, prevention, and comprehensive treatment of vulvar cancer and precancerous conditions in Germany are handled by several specialized medical institutions in the country, including:
- University Hospital Tuebingen
- Leverkusen Clinic
- Helios Hospital Berlin-Buch
- University Hospital Ulm
- University Hospital Carl Gustav Carus Dresden
Cost of treatment
It is worth noting that cancer treatment in Germany is not cheap. And there is an explanation for that, which is a high level of medicine in Germany, high professionalism of clinicians, and the use of advanced medical developments. At the same time, the cost of treatment is influenced by the stage of the disease, the status of the healthcare facility, and other factors.
However, if a comparative analysis of the prices for medical services in Germany and the US is to be performed, the conclusion would be: prices for cancer treatment in Germany are 25-50% lower.
People go abroad to treat vulvar cancer for several reasons, including high success rates of anti-cancer therapy and transparency of the pricing policy. Patients pay for medical services strictly according to the prices indicated in the price list of the hospital, meaning that hidden costs are eliminated with this approach. In addition, the preliminary cost calculated even before the patient arrives at the clinic will be as close to the ultimate bill as possible.
The cost of treatment with partial vulvectomy in Germany starts at 3,921 EUR, and the minimal cost of radical vulvectomy in Germany is 3,968 EUR. The cost of treatment with surgery and lymph nodes resection in Germany starts at 8,105 EUR.
Prices for other procedures are listed on the Booking Health website.
How to start vulvar cancer treatment in Germany?
Vulvar cancer treatment in German hospitals always begins with communication. The patient can and should discuss all organizational and financial issues before the treatment starts. The patient has the right to get free information about what modern methods of diagnosis and treatment are used, which clinics are the best in a particular field of medicine, and how much help of specialists will cost.
After receiving this information, the patient has the right to choose the healthcare facility that suits him best. Reliable and up-to-date information to make the right choice is always available with Booking Health.
Booking Health offers comprehensive medical programs with an indication of treatment methods and prices.
To find that all out, fill in the request form on the Booking Health website, so that a medical advisor could contact you.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Farrukh Ahmed. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Cancer Support Community
Cancer Treatment Centers of America
