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Surgery| is the main treatment for cancer of the vulva. Many women are cured of their vulval cancer with surgery. It may be used alone or in combination with radiotherapy| and chemotherapy| .
The aim of surgery is to completely take away the cancer. Making sure that all the cancer is removed is the most important factor in trying to cure the cancer. At the same time your surgeon will try, as far as possible, to preserve the appearance and function of the vulva and nearby tissues.
Different operations can be used to treat vulval cancer. The type of operation you have will depend on the size and position of the cancer. The operation aims to remove both the cancer and a border (margin) of normal tissue all around it. The lymph nodes in one or both groins may also be removed during the operation.
The main treatment for cancer of the vulva is surgery. Radiotherapy and chemotherapy may also be used.
Radiotherapy may sometimes be given to shrink the cancer before surgery. It can also be given after surgery to make sure any remaining cells are destroyed. Radiotherapy and chemotherapy can also be used together (chemoradiation). Occasionally, if the cancer has spread to other parts of the body, chemotherapy may be used on its own.
A team of specialists, called a multidisciplinary team (MDT), will meet to discuss and agree on the plan of treatment they feel is best for you. The MDT will have expert knowledge about vulval cancer, and will include a:
Other healthcare professionals who work closely with the MDT may include:
Cancer specialists follow national guidelines for treating vulval cancer. The treatment you have will be based on these guidelines, but tailored to your particular situation. The team will plan your treatment by taking into consideration a number of factors, including the type of cancer, its position and size, whether it has spread (its stage| ) and your general health.
You may be invited to take part in a clinical trial| of a new treatment.
If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse. It often helps to make a list of questions for your doctor and to take a close friend or relative with you. They can remind you of questions you want to ask, and help to remember what the doctor says.
Before you have any treatment your doctor will explain the aims of the treatment to you. You will usually be asked to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:
If you don’t understand what you’ve been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations. Again, it can be helpful to have a friend or relative with you.
People often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.
You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it’s first explained to you.
You’re also free to choose not to have the treatment, and the staff can explain what may happen if you don’t have it.
If you decide not to have treatment it’s important to tell the doctor, so that they can record your decision in your medical notes. You don’t have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.
Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. The success of treatment depends very much on the stage| of the cancer.
In women with early stage vulval cancer, surgery is often performed with the aim of curing the cancer. Occasionally, additional treatments are also given to reduce the risk of it coming back.
If the cancer is at a more advanced stage then usually more than one type of treatment is needed. The treatment may be able to cure the cancer or control it for a time, leading to an improvement in symptoms and a better quality of life.
If you’ve been offered treatment that aims to cure your cancer, deciding whether or not to accept it may not be difficult. If a cure isn’t possible, however, and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead with treatment. Deciding whether to have treatment in these circumstances is often difficult, and you may need to discuss this in detail with your doctor. If you choose not to have treatment, you can still have supportive (palliative) care, with medicines to control any symptoms.
A team of cancer specialists work together to decide the most suitable treatment for each patient. Even so, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion if you feel it will be helpful. Getting a second opinion may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will provide useful information.
If you decide to have a second opinion, it may be a good idea to take a friend or relative with you and to have a list of questions ready. This can help you to make sure your concerns are covered during the consultation.
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