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Your healthcare provider may find signs of vulvar cancer during a pelvic exam as part of a routine visit, even if you don’t have symptoms. You’ll likely have a Pap test and human papillomavirus test (HPV). Diagnosing vulvar cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, symptoms, risk factors, and family history of disease. Your healthcare provider will also give you an exam.
It’s very important that your findings be put into context by an expert. Gynecologic oncologists are specialists with advanced training in the diagnosis, treatment, and surveillance of female cancers. These include vulvar cancer. Your healthcare provider may have you see one of these cancer experts to find out for sure what’s causing the changes in your vulva. If this provider thinks you might have vulvar cancer, you’ll need a biopsy to be sure.
A biopsy is the only way for your healthcare provider to know for sure if you have cancer. If your healthcare provider sees an abnormal area, he or she may do a biopsy. He or she will do this by removing a small piece of tissue from that area. You may be numbed first with a local anesthetic. If the abnormal area is small, your healthcare provider may completely remove it. If it's bigger, he or she may punch out a portion of it using an instrument that looks like a tiny apple corer. (This is called a punch biopsy.) You usually don’t need stitches after this procedure. You may feel some pressure, but probably will have little or no pain.
For larger areas, your healthcare provider may cut out a small part of the skin with a scalpel. Then he or she may sew together your skin’s edges with surgical thread (suture). In most cases, your healthcare provider will also remove some surrounding normal skin around the abnormal areas.
Your healthcare provider may use a magnifying instrument called a colposcope to get a close look at the changed area. You may receive a solution on your vulva to make the changed areas white. This way, they are easier to see and remove.
Then your healthcare provider sends the removed tissue sample to a lab. This is where a pathologist checks the samples for cancer. The results of the biopsy usually take about one week to come back to your healthcare provider from the lab.
When your healthcare provider has the results of your biopsy, he or she will contact you with the results. Your provider will talk with you about other tests you may need if vulvar cancer is found. Make sure you understand the results and what follow-up you need.
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