General Information About Vulvar Cancer
Stages of Vulvar Cancer
Recurrent Vulvar Cancer
Treatment Option Overview
Treatment Options by Stage

Stage 0 (Carcinoma in Situ) Stage I Vulvar Cancer Stage II Vulvar Cancer Stage III Vulvar Cancer Stage IV Vulvar Cancer

Treatment Options for Recurrent Vulvar Cancer
Get More Information From NCI
Changes to This Summary (09/20/2007)
About PDQ

General Information About Vulvar Cancer

Key Points for This Section

Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva. HPV infection and older age can affect the risk of developing vulvar cancer. Possible signs of vulvar cancer include bleeding or itching. Tests that examine the vulva are used to detect (find) and diagnose vulvar cancer. Certain factors affect prognosis (chance of recovery) and treatment options.

Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva.

Vulvar cancer forms in a woman's external genitalia. The vulva includes the inner and outer lips of the vagina, the clitoris (sensitive tissue between the lips), and the opening of the vagina and its glands.

Vulvar cancer most often affects the outer vaginal lips. Less often, cancer affects the inner vaginal lips or the clitoris.

Vulvar cancer usually develops slowly over a period of years. Abnormal cells can grow on the surface of the vulvar skin for a long time. This precancerous condition is called vulvar intraepithelial neoplasia (VIN) or dysplasia. Because it is possible for VIN or dysplasia to develop into vulvar cancer, treatment of this condition is very important.

HPV infection and older age can affect the risk of developing vulvar cancer.

Risk factors include the following:

• Having human papillomavirus (HPV) infection.
• Older age.

Possible signs of vulvar cancer include bleeding or itching.

Vulvar cancer often does not cause early symptoms. When symptoms occur, they may be caused by vulvar cancer or by other conditions. A doctor should be consulted if any of the following problems occur:

• A lump in the vulva.
• Itching that does not go away in the vulvar area.
• Bleeding not related to menstruation (periods).
• Tenderness in the vulvar area.

Tests that examine the vulva are used to detect (find) and diagnose vulvar cancer.

The following tests and procedures may be used:

• Physical exam and history: An exam of the body to check general signs of health, including checking the vulva for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• Biopsy: The removal of cells or tissues from the vulva so they can be viewed under a microscope by a pathologist to check for signs of cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• The stage of the cancer.
• The patient's age and general health.
• Whether the cancer has just been diagnosed or has recurred (come back).

Stages of Vulvar Cancer

Key Points for This Section

After vulvar cancer has been diagnosed, tests are done to find out if cancer cells have spread within the vulva or to other parts of the body. The following stages are used for vulvar cancer: Stage 0 (Carcinoma in Situ) Stage I Stage II Stage III Stage IV

After vulvar cancer has been diagnosed, tests are done to find out if cancer cells have spread within the vulva or to other parts of the body.

The process used to find out if cancer has spread within the vulva or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

• Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
• Cystoscopy: A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope (a thin, lighted tube) is inserted through the urethra into the bladder. Tissue samples may be taken for biopsy.
• Proctoscopy: A procedure to look inside the rectum and anus to check for abnormal areas. A proctoscope (a thin, lighted tube) is inserted into the anus and rectum. Tissue samples may be taken for biopsy.
• X-rays: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. To stage vulvar cancer, x-rays may be taken of the organs and bones inside the chest, and the pelvic bones.
• Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer has spread to these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters and bladder, x-rays are taken to see if there are any blockages. This procedure is also called intravenous urography.
• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

The following stages are used for vulvar cancer:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found on the surface of the vulvar skin. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

In stage I, cancer has formed and is found in the vulva only or in the vulva and perineum (area between the rectum and the vagina). The tumor is 2 centimeters or smaller and has spread to tissue under the skin. Stage I vulvar cancer is divided into stage IA and stage IB.

• Stage IA: The tumor has spread 1 millimeter or less into the tissue of the vulva.
• Stage IB: The tumor has spread more than 1 millimeter into the tissue of the vulva.

Stage II

In stage II, cancer is found in the vulva or the vulva and perineum (space between the rectum and the vagina), and the tumor is larger than 2 centimeters.

Stage III

In stage III vulvar cancer, the cancer is of any size and either:

• is found only in the vulva or the vulva and perineum and has spread to nearby lymph nodes on one side of the groin; or
• has spread to nearby tissues such as the lower part of the urethra and/or vagina or anus, and may have spread to nearby lymph nodes on one side of the groin.

Stage IV

Stage IV is divided into stage IVA and stage IVB, based on where the cancer has spread.

• Stage IVA: Cancer has spread to nearby lymph nodes on both sides of the groin, or has spread beyond nearby tissues to the upper part of the urethra, bladder, or rectum, or has attached to the pelvic bone and may have spread to lymph nodes.
• Stage IVB: Cancer has spread to distant parts of the body.

Recurrent Vulvar Cancer

Recurrent vulvar cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the vulva or in other parts of the body.

Treatment Option Overview

Key Points for This Section

There are different types of treatment for patients with vulvar cancer. Four types of standard treatment are used: Laser therapy Surgery Radiation therapy Chemotherapy New types of treatment are being tested in clinical trials.

There are different types of treatment for patients with vulvar cancer.

Different types of treatments are available for patients with vulvar cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site ¹. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Four types of standard treatment are used:

Laser therapy

Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.

Surgery

Surgery is the most common treatment for cancer of the vulva. The goal of surgery is to remove all the cancer without any loss of the woman's sexual function. One of the following types of surgery may be done:

• Wide local excision: A surgical procedure to remove the cancer and some of the normal tissue around the cancer.
• Radical local excision: A surgical procedure to remove the cancer and a large amount of normal tissue around it. Nearby lymph nodes in the groin may also be removed.
• Vulvectomy: A surgical procedure to remove part or all of the vulva:
  • Skinning vulvectomy: The top layer of vulvar skin where the cancer is found is removed. Skin grafts from other parts of the body may be needed to cover the area.
  • Simple vulvectomy: The entire vulva is removed.
  • Modified radical vulvectomy: The vulva containing cancer and some of the normal tissue around it is removed.
  • Radical vulvectomy: The entire vulva, including the clitoris, and nearby tissue is removed. Nearby lymph nodes may also be removed.
• Pelvic exenteration: A surgical procedure to remove the lower colon, rectum, and bladder. The cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body into a collection bag.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may have chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, a body cavity such as the abdomen, or onto the skin, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Topical chemotherapy for vulvar cancer may be applied to the skin in a cream or lotion.

New types of treatment are being tested in clinical trials.

Information about ongoing clinical trials is available from the NCI Web site ¹.

Treatment Options by Stage

Stage 0 (Carcinoma in Situ)

Treatment of stage 0 may include the following:

• Wide local excision and/or laser therapy.
• Skinning vulvectomy with or without skin grafting.
• Simple vulvectomy.
• Topical chemotherapy.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage 0 vulvar cancer ².

Treatment of stage I vulvar cancer may include the following:

• Wide local excision.
• Radical local excision with removal of nearby lymph nodes.
• Radical vulvectomy and either removal of nearby lymph nodes or radiation therapy to the lymph nodes.
• Radiation therapy.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I vulvar cancer ³.

Treatment of stage II vulvar cancer may include the following:

• Modified radical vulvectomy and removal of nearby lymph nodes or radiation therapy to the lymph nodes. Radiation therapy to the area of surgery may also be given.
• Radiation therapy.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II vulvar cancer ⁴.

Treatment of stage III vulvar cancer may include the following:

• Modified radical vulvectomy and removal of nearby lymph nodes, with or without radiation therapy.
• Radical vulvectomy and removal of nearby lymph nodes, with or without radiation therapy.
• Radiation therapy followed by surgery.
• Radiation therapy with or without chemotherapy.
• A clinical trial of a new treatment.

Information about ongoing clinical trials is available from the NCI Web site ¹.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III vulvar cancer ⁵.

Treatment of stage IV vulvar cancer may include the following:

• Radical vulvectomy and pelvic exenteration.
• Radical vulvectomy followed by radiation therapy.
• Radiation therapy followed by surgery, with or without chemotherapy.
• Radiation therapy with or without chemotherapy.
• A clinical trial of a new treatment.

Information about ongoing clinical trials is available from the NCI Web site ¹.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV vulvar cancer ⁶.

Treatment Options for Recurrent Vulvar Cancer

It is important to have regular follow-up exams to check for recurrent vulvar cancer. Treatment of recurrent vulvar cancer may include the following:

• Wide local excision with or without radiation therapy.
• Radical vulvectomy and pelvic exenteration.
• Radiation therapy and chemotherapy given during the same period of time, with or without surgery.
• Radiation therapy followed by surgery or chemotherapy.
• Radiation therapy as palliative treatment to relieve symptoms and improve quality of life.
• A clinical trial of a new treatment.

Information about ongoing clinical trials is available from the NCI Web site ¹.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent vulvar cancer ⁷.

Get More Information From NCI

Call 1-800-4-CANCER

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Chat online

The NCI's LiveHelp® ⁸ online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write to us

For more information from the NCI, please write to this address:

NCI Public Inquiries Office

Suite 3036A

6116 Executive Boulevard, MSC8322

Bethesda, MD 20892-8322

Search the NCI Web site

The NCI Web site ⁹ provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.

There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.

Find Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator ¹⁰. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

Changes to This Summary (09/20/2007)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary.

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ⁹. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ¹¹. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy.

The opening of the rectum to the outside of the body.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

The organ that stores urine.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A group of abnormal cells that remain in the tissue in which they first formed. These abnormal cells may become cancer and spread into nearby normal tissue.

A flexible tube used to deliver fluids into or withdraw fluids from the body.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

The lower, narrow end of the uterus that forms a canal between the uterus and vagina.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.

A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.

Computed tomography scan. A series of detailed pictures of areas inside the body taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computed tomography scan, computerized tomography, computerized axial tomography scan, and CAT scan.

To heal or restore health; a treatment to restore health.

A thin, tube-like instrument used to look inside the bladder and urethra. A cystoscope has a light and a lens for viewing and may have a tool to remove tissue.

Examination of the bladder and urethra using a cystoscope, inserted into the urethra. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

The process of identifying a disease by the signs and symptoms.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.

The area where the thigh meets the abdomen.

A member of a family of viruses that can cause abnormal tissue growth (for example, genital warts) and other changes to cells. Infection with certain types of human papillomavirus increases the risk of developing cervical cancer. Also called HPV.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, radiation brachytherapy, and implant radiation therapy.

Within the layer of cells that form the surface or lining of an organ.

IVP. A series of x-rays of the kidneys, ureters, and bladder. The x-rays are taken after a dye is injected into a blood vessel. The dye is concentrated in the urine, which outlines the kidneys, ureters, and bladder on the x-rays. Also called IVP and intravenous pyelography.

One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.

A device that concentrates light into an intense, narrow beam used to cut or destroy tissue. It is used in microsurgery, photodynamic therapy, and for a variety of diagnostic purposes.

The use of an intensely powerful beam of light to kill cancer cells.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

Periodic discharge of blood and tissue from the uterus. From puberty until menopause, menstruation occurs about every 28 days when a woman is not pregnant.

A measure of length in the metric system. A millimeter is one thousandth of a meter. There are 25 millimeters in an inch.

A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, nuclear magnetic resonance imaging, and NMRI.

Abnormal and uncontrolled cell growth.

A health professional trained to care for people who are ill or disabled.

A part of the body that performs a specific function. For example, the heart is an organ.

One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

A procedure in which cells are scraped from the cervix for examination under a microscope. It is used to detect cancer and changes that may lead to cancer. A Pap test can also show noncancerous conditions, such as infection or inflammation. Also called a Pap smear.

A doctor who identifies diseases by studying cells and tissues under a microscope.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Having to do with the pelvis (the lower part of the abdomen located between the hip bones).

A physical examination in which the health care professional will feel for lumps or changes in the shape of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The health care professional will also use a speculum to open the vagina to look at the cervix and take samples for a Pap test. Also called an internal examination.

Surgery to remove the lower colon, rectum, and bladder, and create stomata (openings) through which urine and stool are passed out of the body. In women, the cervix, vagina, ovaries, and nearby lymph nodes are also removed.

The area of the body between the anus and the vulva in females, and between the anus and the scrotum in males.

An exam of the body to check for general signs of disease.

A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant.

Examination of the rectum using a proctoscope, inserted into the rectum. A proctoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

The likely outcome or course of a disease; the chance of recovery or recurrence.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

Energy released in the form of particles or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, and medical x-rays.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

Surgery to remove a tumor and a large amount of normal tissue surrounding it. Nearby lymph nodes may also be removed.

Surgery to remove the entire vulva (the external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina) and nearby lymph nodes.

Giving off radiation.

A small, radioactive pellet that is placed in or near a tumor. Cancer cells are killed by the energy given off as the radioactive material breaks down and becomes more stable.

The last several inches of the large intestine. The rectum ends at the anus.

To come back or to return.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

Treatment with anticancer drugs directed to a specific area of the body.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

Surgery to remove the entire vulva (the external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina).

Skin that is moved from one part of the body to another.

Surgery to remove the top layer of skin of the vulva (the external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina). A skin graft may be used to replace the skin that was removed.

An instrument used to widen an opening of the body to make it easier to look inside.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spinal column encloses the spinal cord and the fluid surrounding the spinal cord. Also called spine, backbone, and vertebral column.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called standard of care or best practice.

A surgically created opening from an area inside the body to the outside.

The material in a bowel movement. Stool is made up of food that was not digested, bacteria, mucus, and cells from the intestines. Also called feces.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Treatment with anticancer drugs that travel through the blood to cells all over the body.

A group or layer of cells that work together to perform a specific function.

Treatment with anticancer drugs in a lotion or cream applied to the skin.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

The tube that carries urine from the kidney to the bladder.

The tube through which urine leaves the body. It empties urine from the bladder.

Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the womb.

The muscular canal extending from the uterus to the exterior of the body. Also called birth canal.

Having to do with the vagina (the birth canal).

The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina.

Cancer of the vulva (the external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina).

Surgery to cut out the cancer and some healthy tissue around it.

A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.