Vulval/vaginal cancer

Vulvar/vaginal cancer is the fourth most common gynecologic cancer accounting for 5% of female genital tract malignancies. The signs and symptoms of vulvar cancer are similar despite different histologic subtypes. Primary vaginal cancer comprises approximately 3% of gynecologic malignancies. Most patients present with vaginal bleeding or discharge but many are asymptomatic. As with vulvar cancer, a biopsy of any suspicious vaginal lesion either in the outpatient setting or in the operating room can diagnose the malignancy. This chapter explores how immunosuppression contribute to the development of preinvasive or invasive cancer in women. It focuses on whether concurrent chemotherapy with radiation therapy compared to primary surgery improve clinical response in patients with unresectable locally advanced vulvar cancer. For vaginal cancer, primary surgery is rarely performed due to the close proximity of vaginal tumors to critical organs and the high risk of significant complications.