VULVAL CARCINOMA

INCIDENCE:-

The lesion is rare, about 1.7 per 100,000 females. The distribution varies from 3-5 percent amongst genital malignancies.

ETIOLOGY:-

The etiology remains unclear. But the following factors are often related.

- Usually occurring in postmenopausal women with a median age of 60.

- More common amongst whites.

- Increased association with obesity, hypertension, diabetes and nulliparity.

-Associated vulval epithelial disorders (lichen sclerosus) specially of atypical type are the risk factors.

Human papilloma virus (HPV) DNA (type 16, 18) has been detected in patients with invasive vulval cancer.

Vulval cancer may have a causal relation with condyloma accuminata (HPV 6, 11), syphilis and lymphogranuloma venereum.

Chronic pruritus usually preceds invasive vulval cancer.

Chronic irritation of the vulva by chemical or physical trauma associated with poor hygiene may be a predisposing factor.

Other primary malignancies have been observed in about 20 percent of cases with vulval cancer.

Cervix is most commonly affected; other sites are breast, skin or colon.

CLINICAL FEATURES: -

Patient profile: The patients are usually postmenopausal, aged about 60 years often with obesity, hypertension and diabetes.

SYMPTOMS :

- Asymptomatic

- Pruritus vulvae

-Swelling with or without off ensive discharge

- Diffi culty in urination

- Vulval ulceration

- bleeding

- inguinal mass

- Pain

SIGNS

- Vulval inspection reveals an ulcer or a fungating mass on the vulva. The ulcer has a sloughing base with raised, everted and irregular edges and it bleeds to touch. Surrounding tissue may be edematous and indurated.

-Associated vulval lesions mentioned earlier may be present.

-Inguinal lymph nodes of one or both the sides may be enlarged and palpable. The enlargement may also be due to infection.

Clinical examination of the pelvic organs, including the cervix, vagina, urethra and rectum must be done. This is due to the coexistance of other primary cancers in the genital tract.

ROLE OF HOMOEOPATHIC MEDICINES IN MANAGING VULVAL CARCINOMA: -

THE MEDICINES THAT CAN BE THOUGHT OF ARE: -

Iodium:- Swelling and induration of ulcers mark weakness with menses and pain in thighs. Females prone to develop cancerous condition in early stages.

Kreosotum:- Specially indicated for squamous cell carcinoma. Indicated in Menopausal age due to rapid decomposition of secretion. Females having excessive vaginal Bleeding after coition. Excoriating discharge with granulation of vagina.

Hydrastis:- Indicated for Ulcerative type of Carcinoma. Malignancy of cervical cells associated with gastric and hepatic derangement. It modifies pain and destructiveness cause by malignant cells.

Graphites:- For vulval Carcinoma with gushing leucorrhoea. Ovaries are enlarged and hard. There is cauliflower like growth that causes burning in genital area with putrid bloody discharges