Vulvar cancer cases more than triple in Brazil – 09/29/2024 – Equilíbrio e Saúde

The total number of vulvar cancer cases registered each year in Brazil tripled in a decade, according to the DataSUS Oncology Panel. It jumped from 405, in 2013, to 1,436, in 2023, the highest volume in the panel’s historical series.

The disease has also increased among younger women. If in 2013 women up to 48 years old, the average age at which menopause begins in Brazil, received 13.6% of diagnoses, last year they represented 22.4% of cases.

The Ministry of Health warns of underreporting of data on the panel. Glauco Baiocchi Neto, director of the Department of Gynecological Oncology at ACCamargo Cancer Center, confirms the increase in diagnoses in younger women in recent decades and associates this with HPV (human papillomavirus).

This is the case of Bárbara (name changed at the request of the interviewee), from Arapongas (PR), who was diagnosed with the disease in February, at the age of 37. The itching and the appearance of warts and lesions on her vulva led her to seek medical help.

The woman from Paraná says she was expecting a diagnosis of an STI (sexually transmitted infection). She saw four gynecologists and it took eight months to be diagnosed with the carcinoma, which, until then, she had never heard of. “My world collapsed, it felt like a death sentence. Even more so because it was a rare cancer, the doctors felt at a loss,” he says.

According to Baiocchi, HPV causes around 40% of cases of the disease, while the other 60% are related to vulvar atrophy, which has among its causes the reduction in estrogen levels, as in post-menopause, and chronic diseases of the vulva. mainly lichen sclerosus —an inflammatory disease of the skin of the genital region and anus. According to data from DataSUS, the average age of women diagnosed with this cancer, in 2023, was 62 years old.

The doctor states that patients, in general, feel ashamed and delay seeking health services. However, the disease is rarely metastatic and, when a single tumor is identified in the vulva, at an early stage, the chance of cure is 95%.

Bárbara says that the treatment initially recommended for her was radical vulvectomy, a surgery that removes the entire vulva. “It maims the woman, ends her life. All that’s left is the urine duct and the vaginal duct. You’ll never be able to wear pants, ride a motorbike, ride a bicycle again. Because the vulva is the protection there”, he says.

The other option offered by the oncologist was partial vulvectomy, which removes only the lesions, followed by chemotherapy and radiotherapy. The patient chose this second path. Even though the treatment was successful, she reports that she is still psychologically shaken. “The fear is constant. Any itch, any burning sensation, any slight pain is terrifying.”

Luciana Holtz, psycho-oncologist and president of the Oncoguia Institute, states that vulva surgery impacts female self-esteem due to the direct connection with sexuality. “It’s even more complex because it’s an area full of taboos, shame and even low knowledge”, he comments.

“Vaccination is the effective and safe way to prevent this and other tumors caused by HPV”, adds Luisa Villa, researcher at the Faculty of Medicine of the University of São Paulo (FMUSP) and the Cancer Institute of the State of São Paulo (Icesp) .

Villa warns that the virus cannot be treated. The only ways are to prevent contamination or treat the diseases it causes, such as cancers of the vulva, cervix, penis, anal canal and oropharyngeal canal.

The vaccine is available in the SUS (Unified Health System) for girls and boys aged 9 to 14, victims of sexual violence, immunosuppressed people and cancer patients aged 9 to 45. However, vaccination has not yet reached the Ministry of Health’s 2030 target of vaccination coverage of 90% among girls up to 15 years of age. In 2019, 87% of this population was vaccinated; in 2022, it fell to 75.8%.

The researcher considers that scientific dissemination in different media and languages ​​is the way to raise awareness among the population about the importance of the vaccine.

This report was produced during the 9th Science and Health Journalism Training Program at Sheetwhich was sponsored by Roche Laboratory and Hospital Israelita Albert Einstein.