The most common vulvar cancers in seniors are **squamous cell carcinomas**, which make up over 90% of vulvar cancer cases. These cancers arise from the squamous cells, the thin, flat cells that cover the surface of the vulva, particularly affecting areas like the labia majora. Squamous cell carcinoma typically develops slowly and is more frequently diagnosed in women over 70 years old. It often presents with symptoms such as persistent itching, burning sensations, lumps or sores on the vulva, pain during urination or intercourse, and sometimes bleeding.
Besides squamous cell carcinoma, other less common types of vulvar cancer seen in older women include **vulvar melanoma**, **adenocarcinoma**, **basal cell carcinoma**, and **sarcoma**.
– **Vulvar melanoma** is a rare but aggressive form accounting for about 5% of cases. It originates from pigment-producing cells (melanocytes) and tends to have a poorer prognosis due to its high potential for spreading both locally and to distant organs like lymph nodes, brain, lungs, and liver. Vulvar melanoma usually appears as an abnormal pigmented lesion on the vulva in women typically between their 60s and 80s.
– **Adenocarcinomas** arise from glandular cells within structures such as Bartholin’s glands on the vulva but are much less frequent than squamous cell carcinomas.
– Other rare types like basal cell carcinoma tend to be slow-growing skin cancers that can occur on external genital skin but are uncommon compared to squamous tumors.
Risk factors contributing to these cancers include chronic irritation or inflammation of the vulva (such as lichen sclerosus), persistent infection with high-risk strains of human papillomavirus (HPV), smoking history, multiple sexual partners increasing HPV exposure risk, previous cervical or vaginal neoplasia linked with HPV infection, immunosuppression conditions including HIV/AIDS or organ transplantation history among seniors.
Symptoms prompting evaluation often involve changes noticed by patients such as:
– Persistent itching or burning sensation around the vulva
– Visible lumps or thickened areas
– Ulcers that do not heal
– Pain during urination or intercourse
– Unexplained bleeding unrelated to menstruation
Diagnosis requires careful physical examination followed by biopsy confirmation since early lesions may mimic benign conditions like eczema or infections common in older age groups.
Treatment approaches depend on cancer type and stage but generally involve surgical removal ranging from local excision for small tumors up to partial or total vulvectomy combined with lymph node assessment if spread is suspected. Radiation therapy may be used postoperatively especially if lymph nodes are involved. Chemotherapy has a role mainly in advanced disease stages where surgery alone is insufficient. Newer biologic therapies targeting specific molecular pathways are under investigation but not yet standard care widely available for seniors specifically.
Because most cases occur after age 60–70 years when comorbidities increase risks related to treatment side effects—careful multidisciplinary planning involving gynecologic oncologists experienced with elderly patients ensures optimal balance between effective cancer control and quality-of-life preservation.
In summary: For senior women facing a diagnosis of vulvar cancer,
| Cancer Type | Frequency | Typical Age Range | Key Features |
|————————|———————|——————–|————————————————|
| Squamous Cell Carcinoma | >90% | Mostly >70 years | Slow growing; linked with HPV; itching/lumps |
| Vulvar Melanoma | ~5% | Usually 60–80+ | Aggressive; pigmented lesions; high metastasis |
| Adenocarcinoma | Rare | Variable | Glandular origin; Bartholin’s glands |
| Basal Cell Carcinoma | Very rare | Older adults | Slow growing skin tumor |
Understanding these distinctions helps guide timely diagnosis through symptom awarenes