Labium Minus Vulvar Cancer

Labium minus cancer refers to cancer that develops in the inner folds (labia minora) of the vulva. The vulva includes the external female genital organs, and labium minus refers specifically to the smaller inner folds of skin that surround the vaginal opening. Cancer in this area is rare but can be serious if not diagnosed and treated early.

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Pathophysiology (Structure, Blood, Nerve Supply)

Structure of the Labium Minus

• Anatomy: The labium minus (plural: labia minora) consists of delicate tissue folds that contain blood vessels, nerve endings, and skin. These folds protect the vaginal and urethral openings.
• Blood Supply: The labium minus receives blood from the internal and external pudendal arteries. These arteries supply oxygen-rich blood to the tissue for nourishment.
• Nerve Supply: The labium minus is richly innervated, meaning it has many nerve endings. The pudendal nerve, which is responsible for sensation in the genital region, supplies the labia minora.

Cancer Development

When abnormal cells in the labium minus grow uncontrollably, they can form a tumor, eventually leading to vulvar cancer. These cells may invade surrounding tissues or spread to other parts of the body.

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Types of Vulvar Cancer

1. Squamous Cell Carcinoma: The most common type, originating from the squamous cells that line the labia minora.
2. Melanoma: A rare but aggressive form of skin cancer affecting the vulva.
3. Basal Cell Carcinoma: A slow-growing cancer that typically forms in the basal layer of the skin.
4. Adenocarcinoma: Cancer originating from glandular cells in the vulva.
5. Sarcoma: Cancer that starts in the connective tissues.

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Causes of Labium Minus Vulvar Cancer

1. Human Papillomavirus (HPV) Infection: One of the most common causes, particularly HPV types 16 and 18.
2. Smoking: Increases the risk of developing vulvar cancer.
3. Chronic Vulvar Irritation: Prolonged inflammation may contribute to cancer formation.
4. Age: Vulvar cancer is most common in older women, typically over 60 years.
5. Weak Immune System: People with weakened immune systems are more vulnerable.
6. Diabetes: Increases the risk of skin infections and may contribute to vulvar cancer.
7. History of Vulvar Disorders: Conditions like lichen sclerosus can increase risk.
8. Genetics: A family history of cancer may increase risk.
9. Obesity: Excess weight can lead to hormonal changes that promote cancer.
10. Skin Conditions: Certain chronic skin disorders may predispose to cancer.
11. Previous Cancer Treatments: Radiation therapy for other cancers can increase the risk of vulvar cancer.
12. Poor Hygiene: Lack of proper genital hygiene can lead to chronic irritation.
13. Infections: Chronic bacterial or fungal infections may increase the risk.
14. Hormonal Therapy: Long-term hormone replacement therapy can increase cancer risk.
15. History of Vaginal Infections: Repeated infections can alter the tissues and promote cancer.
16. Exposure to Carcinogens: Environmental toxins may contribute to cancer risk.
17. Multiple Sexual Partners: Increases the likelihood of HPV infection.
18. Unprotected Sex: Lack of protection can increase the risk of HPV and other infections.
19. Immunosuppressive Drugs: Medications that suppress the immune system may increase vulnerability.
20. Increased Sun Exposure: Prolonged exposure to ultraviolet rays may contribute to melanoma in the vulva.

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Symptoms of Labium Minus Vulvar Cancer

1. Itching in the genital area.
2. Pain or tenderness in the vulva.
3. Lumps or bumps on the labium minus.
4. Bleeding that is not related to menstruation.
5. Changes in skin color of the vulva.
6. Sores that do not heal.
7. Painful urination.
8. Unexplained discharge.
9. Visible growths on the vulva.
10. Swelling around the vaginal area.
11. Persistent discomfort during sexual intercourse.
12. Foul-smelling discharge.
13. Tenderness in the groin area.
14. Pain in the pelvis.
15. Swollen lymph nodes in the groin.
16. Nausea and fatigue (in advanced stages).
17. Pain during bowel movements.
18. Loss of appetite (in advanced cases).
19. Weight loss (in later stages).
20. Changes in bowel or urinary habits.

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Diagnostic Tests for Vulvar Cancer

1. Physical Examination: Doctors may examine the vulva for abnormal growths.
2. Pap Smear: A sample of cells is collected for testing.
3. Biopsy: A sample of tissue is taken for lab testing.
4. Colposcopy: A detailed examination of the vulva using a microscope.
5. Pelvic Exam: Checking for any unusual changes in the reproductive organs.
6. Ultrasound: Imaging to view internal structures.
7. CT Scan: To check if cancer has spread to nearby tissues.
8. MRI Scan: Detailed imaging of soft tissues.
9. PET Scan: To detect cancer spread.
10. Blood Tests: To check overall health and organ function.
11. Lymph Node Biopsy: Testing of lymph nodes for cancer spread.
12. Chest X-ray: To check for lung involvement.
13. Cystoscopy: For checking bladder involvement.
14. Colorectal Endoscopy: To rule out rectal cancer.
15. Laparoscopy: A minimally invasive procedure to examine the abdomen.
16. Immunohistochemistry: Testing the tumor for specific markers.
17. Genetic Testing: To detect inherited cancer risks.
18. Electrocautery: A method of removing tissue to study cancer cells.
19. Excisional Biopsy: Removal of a growth for thorough testing.
20. Cytology: The study of cell samples for abnormal changes.

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Non-Pharmacological Treatments

1. Surgical Excision: Removing the tumor or affected tissue.
2. Laser Therapy: Using focused light to treat superficial cancer cells.
3. Cryotherapy: Freezing abnormal cells.
4. Radiation Therapy: Using high-energy rays to destroy cancer cells.
5. Physical Therapy: To strengthen pelvic muscles after treatment.
6. Psychological Counseling: For coping with the emotional effects of cancer.
7. Nutritional Counseling: To maintain strength during treatment.
8. Support Groups: Peer support for those diagnosed with cancer.
9. Stress Reduction Techniques: Relaxation and meditation to manage anxiety.
10. Acupuncture: To reduce symptoms like pain or nausea.
11. Yoga: To improve flexibility and reduce stress.
12. Mindfulness Practices: Techniques like breathing exercises.
13. Massage Therapy: For relaxation and relief from discomfort.
14. Aromatherapy: Using essential oils to alleviate symptoms.
15. Biofeedback: Monitoring physiological responses to manage symptoms.
16. Chiropractic Care: To relieve pain and discomfort.
17. Herbal Supplements: Some may help with symptom management.
18. Homeopathic Treatments: Alternative therapies for symptom relief.
19. Music Therapy: For emotional well-being during treatment.
20. Light Therapy: Exposure to natural light for mood enhancement.
21. Reiki: A form of energy healing.
22. Reflexology: Foot massage to alleviate stress.
23. Cognitive Behavioral Therapy: For managing thoughts and emotions.
24. Breathing Exercises: To improve relaxation and reduce anxiety.
25. Counseling for Caregivers: To help family members cope.
26. Herbal Teas: For comfort and calming effects.
27. Hot and Cold Compresses: To manage pain and swelling.
28. Sleep Hygiene: For better rest during treatment.
29. Hydrotherapy: Therapeutic use of water to ease discomfort.
30. Art Therapy: Using creative expression for emotional release.

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Drugs Used in Treatment

1. Chemotherapy Drugs: Drugs like cisplatin and paclitaxel.
2. Immunotherapy: Drugs that boost the immune system.
3. Painkillers: Non-steroidal anti-inflammatory drugs (NSAIDs).
4. Topical Steroids: To reduce inflammation.
5. Hormone Therapy: For hormone-sensitive cancers.
6. Analgesics: For managing severe pain.
7. Antibiotics: To prevent infection during surgery or treatment.
8. Antifungal Medication: For fungal infections during treatment.
9. Antiviral Drugs: In cases of HPV infection.
10. Blood Pressure Medications: To manage blood pressure during treatment.
11. Antiemetics: To manage nausea from chemotherapy.
12. Anti-inflammatory Drugs: To manage swelling and pain.
13. Antidepressants: For emotional support during treatment.
14. Antianxiety Medications: To manage anxiety.
15. Proton Pump Inhibitors: For acid reflux during chemotherapy.
16. Stimulants: To help with fatigue.
17. Opioids: For severe cancer pain.
18. Antioxidants: To support immune function.
19. Diuretics: To manage fluid retention.
20. Vitamins: Supplements for overall health.

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Surgical Treatments

1. Wide Local Excision: Removing the cancerous area and surrounding tissue.
2. Vulvectomy: Removing part or all of the vulva.
3. Lymphadenectomy: Removal of affected lymph nodes.
4. Laser Surgery: Using laser to destroy cancerous tissue.
5. Cryosurgery: Freezing cancer cells to destroy them.
6. Mohs Surgery: Precision surgery for skin cancers.
7. Sentinel Lymph Node Biopsy: Identifying and removing the first lymph node the cancer would spread to.
8. Pelvic Exenteration: Removing pelvic organs when cancer has spread.
9. Reconstructive Surgery: Restoring the vulva after removal.
10. Palliative Surgery: Surgery to relieve symptoms in advanced cancer.

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When to See a Doctor

• If you notice unexplained changes in the vulva, such as lumps, itching, bleeding, or pain, you should see a doctor.
• If you have a history of HPV or vulvar disorders, regular check-ups are recommended.
• Seek medical attention if you experience persistent discomfort or difficulty urinating.

 

Authors Information

 

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