{"id":532,"date":"2019-11-22T15:30:57","date_gmt":"2019-11-22T15:30:57","guid":{"rendered":"https:\/\/zeepedia.com\/?p=532"},"modified":"2020-01-27T11:21:06","modified_gmt":"2020-01-27T11:21:06","slug":"vulvar-cancer","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/diseases\/vulvar-cancer\/","title":{"rendered":"Vulvar Cancer"},"content":{"rendered":"\n<p>Tumor cancer means that a cancerous tumor has formed somewhere in the vulva, which are the outer parts of the female genital tract.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What is vulva cancer?<\/h2>\n\n\n\n<p>Cancer of the vulva means that a cancerous tumor has been formed in the outer parts of the genitals.\u00a0The vault is the outer and inner labia, the clitoris, the urethra, the ventricle, and the middle.\u00a0Here you can read more about the\u00a0genitals.<\/p>\n\n\n\n<p>You do not know everything about the causes of vulva cancer, but there are some known risks:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Skin\u00a0diseases similar to sclerosis and atrophicus.<\/li><li>HPV infections.<\/li><li>Smoking.<\/li><li>The impaired immune system, for example, due to immunosuppressive treatment following an organ transplant.<\/li><\/ul>\n\n\n\n<p>Tumor cancer is divided into different stages depending on whether the disease has spread and how much it has spread.<\/p>\n\n\n\n<p>The most common is that the cancer tumor is limited to the vulva.\u00a0In later stages, <strong>vulvar cancer<\/strong> can spread to the lymph nodes of the groin and pelvis.\u00a0The pelvis is the lower abdomen where, for example, the ovaries and uterus are located.<\/p>\n\n\n\n<p>It is rare, but sometimes the cancerous tumor can spread to the bladder or rectum.\u00a0It is unusual for cancer disease to spread to other parts of the body.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms of Vulvar Cancer<\/h2>\n\n\n\n<p>Tumor cancer can cause one or more of the following symptoms:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>It may feel like a hard lump or knot.<\/li><li>It can be a wound that does not heal.<\/li><li>It can be a bleeding wound.<\/li><li>It can itch or burn in the vulva.<\/li><\/ul>\n\n\n\n<p>If itching or burning it is usually due to something other than cancer, such as fungi, eczema or dry mucous membranes.\u00a0You can read more in the text about\u00a0itching in the genital area.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">When and where should I seek care?<\/h2>\n\n\n\n<p>Contact a gynecologist or\u00a0health care center if you have had any or all of the symptoms for a few weeks.\u00a0Many receptions can be contacted by\u00a0logging in.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Investigations<\/h2>\n\n\n\n<p>There are various examinations that the doctor may need to do to investigate your complaints.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Gynecological examination<\/h3>\n\n\n\n<p>The doctor examines the vulva, vagina, and uterus to make sure that the problems are limited to the vulva and that you feel good otherwise.\u00a0The doctor may need to take tissue samples in the vulva.\u00a0Then you first get\u00a0local anesthesia.\u00a0Tissue tests are also called a biopsy.<\/p>\n\n\n\n<p>You will usually be referred to a women&#8217;s clinic who will continue the investigation if you need further examination.\u00a0For example, more and more detailed tissue samples may need to be taken.\u00a0Then you may sometimes need to be\u00a0anesthetized for\u00a0a short while.\u00a0Most people go as usual afterward and can go home the same day.<\/p>\n\n\n\n<p>The tissue samples are sent to a laboratory and analyzed under a microscope to answer if you have cancer or any other disease and which treatment will be best.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">The investigation is conducted according to a standardized course of care<\/h4>\n\n\n\n<p>You are offered an examination according to a standardized course of care if the doctor suspects you may have <span style=\"text-decoration: underline;\">vulvar cancer<\/span>.<\/p>\n\n\n\n<p>Standardized care&nbsp;is a way of organizing the investigation so that it goes as quickly as possible.&nbsp;Among other things, there are times set for the investigations that may be needed.<\/p>\n\n\n\n<p>The doctor who writes the referral tells you why you should be investigated according to a standardized course of care and what it means and when you can be told if you have cancer or not.<\/p>\n\n\n\n<p>It is often quick to get calls for examinations in a standardized course of care.\u00a0It is good if you are clear about how the staff most safely reach you, so that you do not miss any notifications.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Investigations if you have cancer<\/h3>\n\n\n\n<p>Most often you need to be examined more if you have cancer.\u00a0The studies can show if cancer has spread.\u00a0The doctor may suspect it, for example, if the cancer tumor is large or if you have enlarged lymph nodes that the doctor can feel with your hands in your groin.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Lung X-ray, ultrasound, computed tomography or magnetic camera<\/h4>\n\n\n\n<p>You may need to be examined with\u00a0pulmonary x-ray,\u00a0ultrasound,\u00a0computed tomography\u00a0or\u00a0magnetic camera to map the disease and show if it has spread.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">The lymph nodes are examined<\/h4>\n\n\n\n<p>Tumor cancer can spread to the&nbsp;lymph nodes&nbsp;in the groin.&nbsp;Therefore, one or both groins may need to be examined.&nbsp;It can be done with one or more tissue samples.<\/p>\n\n\n\n<p>The doctor can take a tissue sample by inserting a needle into a lymph node, sometimes using\u00a0ultrasound.\u00a0You can get\u00a0local anesthesia\u00a0\u00a0and in addition to the needle stick, the sampling usually does not hurt.<\/p>\n\n\n\n<p>Sometimes one or more lymph nodes need to be removed for further examination.&nbsp;It is called surgery of the gateway gland or sentinel node surgery.&nbsp;The operation is usually done at the same time as the operation in the vulva.&nbsp;Read more in the chapter on Treatment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Treatment for Vulvar Cancer<\/h2>\n\n\n\n<p>The most common treatment is to remove cancer.\u00a0Sometimes the lymph nodes in one groin or both groins also need surgery.\u00a0After surgery, you may need radiation therapy.\u00a0Some receive radiotherapy along with cytostatic therapy.<\/p>\n\n\n\n<p>Sometimes it is possible to receive radiotherapy instead of being operated on.<\/p>\n\n\n\n<p>A group of different gynecologic cancer specialists advises on all people who have been diagnosed with <em>vulvar cancer<\/em>.\u00a0Your doctor will contact the specialists so that they can suggest the treatment that they believe will be best for you based on the examinations that have been done.<\/p>\n\n\n\n<p>Your doctor will tell you what the specialists will come up with.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The cancer tumor is removed<\/h3>\n\n\n\n<p>The doctor removes the tissue where there is cancer.&nbsp;Also, some of the tissue around it is removed to reduce the risk of cancer cells being left behind.<\/p>\n\n\n\n<p>The extent of the operation depends on the size of cancer and whether it has spread.<\/p>\n\n\n\n<p>The surgical wound is usually sewn together directly or the surgeon covers the wound with skin from, for example, the thighs or buttocks.\u00a0Anesthesia back anesthesia\u00a0is common.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">An operation to remove or examine the lymph nodes<\/h3>\n\n\n\n<p>The operation in the vulva may need to be combined with some type of surgery in one groin or both groin.\u00a0There are lymph nodes to which cancer can spread.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Lymph node clearance if cancer has spread<\/h4>\n\n\n\n<p>Lymph node clearance means that all lymph nodes in one or both groins are removed.\u00a0It is needed if the studies conducted so far show that cancer has spread there or if there may be a risk of it spreading.\u00a0The lymph node evacuation can be done at the same time as the operation in the vulva.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Doorman gland surgery to examine the spread<\/h4>\n\n\n\n<p>Sometimes it is unclear whether cancer has spread despite the investigations conducted to date.\u00a0Then the vulva operation is combined with an operation where only one or a few lymph nodes are removed.\u00a0The lymph nodes are called doorman glands because cancer only reaches them if the disease spreads.<\/p>\n\n\n\n<p>The doorman glands are sent to the laboratory where they are analyzed.&nbsp;No more lymph nodes need to be removed if the doorman glands are free of cancer.&nbsp;If there is cancer in the doormat glands, a lymph node clearance is made at a later time.<\/p>\n\n\n\n<p>You may come to the hospital earlier on the day you are to be operated on in the vulva if a concussion gland surgery is also to be done.&nbsp;Then you will be examined so that the doctor knows which lymph nodes are the guard glands.<\/p>\n\n\n\n<p>A harmless radioactive substance and a blue color are injected around the cancer tumor.&nbsp;From there, they spread to the lymph nodes in the same way as cancer cells.&nbsp;This allows the doctor to see which lymph nodes are the guard glands.<\/p>\n\n\n\n<p>The gatekeeper gland is also called the sentinel lymph node.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Before the operation<\/h4>\n\n\n\n<p>You get information in advance about what will happen during the operation.\u00a0When you come to the hospital you get to talk more with the contact nurse, the surgeon, and the anesthetist so you can ask more questions if you need it.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">After the surgery<\/h4>\n\n\n\n<p>How long you need to stay in the hospital depends on the size of the operation and how you feel.&nbsp;Most people need to stay for one to three days.&nbsp;You need to stay three to five days if a lymph node clearance in the groin or groin was done at the same time as the vulva operation.<\/p>\n\n\n\n<p>At the hospital you get help to rinse and ventilate the operating area a few times every day to make it heal well.<\/p>\n\n\n\n<p>You may need antibiotics to prevent wound infections.&nbsp;You can also get syringes with blood thinners to prevent blood clots.<\/p>\n\n\n\n<p>Some need a&nbsp;catheter in the bladder&nbsp;after surgery.&nbsp;The catheter usually needs to stay for a few days, sometimes longer.&nbsp;It varies from person to person.<\/p>\n\n\n\n<p>You may need a small plastic tube in one groin or both groin if you have operated on the lymph nodes.&nbsp;This is to allow blood and fluid to drain from the operating wound.&nbsp;It&#8217;s called drainage.<\/p>\n\n\n\n<p>The drainage may need to remain even after you leave the hospital.&nbsp;You can get a referral to the district nurse who helps with the drainage and can remove it when it no longer needs to be left.&nbsp;It can take from a few days to several weeks.<\/p>\n\n\n\n<p>When you leave the hospital, you will be given a prescription for pain-relieving drugs.&nbsp;You take the drugs if you need to, but most people do not feel so bad after the surgery.<\/p>\n\n\n\n<p>The operating wound may need to be re-examined several times so that it heals well.&nbsp;The healing can take two to six weeks.&nbsp;During that time, you should avoid bathing or having sex that includes the operating area.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Radiotherapy<\/h3>\n\n\n\n<p>Radiation therapy after surgery is sometimes needed to remove cancer cells that may have remained.\u00a0Then you often receive radiotherapy every weekday for five to six weeks.\u00a0Each treatment session takes about 15 minutes.<\/p>\n\n\n\n<p>Radiation therapy can sometimes be an alternative to surgery to remove the cancerous tumor.\u00a0This applies, for example, if the cancer tumor is large or if it sits so that it is difficult to get enough of the tissue around.\u00a0This also applies if the cancer tumor is located close to the rectum as there is a risk that an operation will damage the end muscle, making it\u00a0difficult to hold tight.<\/p>\n\n\n\n<p>You may need treatment every weekday for up to seven weeks if you are to receive radiotherapy instead of surgery.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Side effects of radiation therapy<\/h4>\n\n\n\n<p>The radiation is not felt, but after one to two weeks of treatment, it can start to burn and sometimes become sores where you get the radiation.\u00a0The staff will help you take care of your skin.\u00a0You get protective and pain-relieving ointment.<\/p>\n\n\n\n<p>Radiation can also make it difficult for you to\u00a0hold tight if you become pissed off\u00a0and you get loose stools.\u00a0There are medicines that relieve it.<\/p>\n\n\n\n<p>Many people get tired of getting radiation treatment.&nbsp;Most side effects go away or are alleviated a few weeks after treatment.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Chemotherapy<\/h3>\n\n\n\n<p>Cytostatic drugs are various drugs that inhibit cancer cells.\u00a0You can get cytostatic drugs while receiving radiation therapy.\u00a0Then the cytostatics make the cancer cells more sensitive to the radiation.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Side effects of cytostatic therapy<\/h4>\n\n\n\n<p>The treatment can make you feel tired and nauseous and difficult to concentrate.\u00a0Blood levels can be affected so you need\u00a0blood transfusions.\u00a0Nausea can be prevented by drugs.\u00a0There are several varieties.\u00a0Concentration difficulties often go away after treatment.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Good to quit smoking<\/h3>\n\n\n\n<p>Those who smoke and are going to have a lot to gain from quitting before surgery.\u00a0The wounds heal faster, blood circulation and fitness improve so you recover faster.\u00a0Stop smoking completely, if you can.\u00a0Otherwise, make a stop before the surgery and a few weeks afterward.<\/p>\n\n\n\n<p>Smoking can also affect whether you should receive radiation therapy.&nbsp;Treatment becomes more effective if you smoke less or preferably not at all.<\/p>\n\n\n\n<p>Talk to your doctor if you need help to quit smoking.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">After Controls<\/h2>\n\n\n\n<p>You need to go on post-check on multiple occasions for about five years when treatment is complete.&nbsp;Some need to go beyond five years.&nbsp;It is different how many post-checks are needed, but it is common to go more often the first time.<\/p>\n\n\n\n<p>At the post-checks, you will be told how you are doing.\u00a0The doctor does a gynecological examination and feels the groin.<\/p>\n\n\n\n<p>Seek care if you have new problems between the post-checks or after the post-checks have ceased.&nbsp;Contact the women&#8217;s clinic where you have gone after a check-up.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If the disease comes back<\/h2>\n\n\n\n<p>Cancer may return in the form of a new cancer tumor at another location in the vulva.\u00a0Then it can be possible to get rid of the disease again.\u00a0The doctor does a new examination to see which treatment can work.\u00a0The most common thing is to be operated on.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If the disease is not removable<\/h2>\n\n\n\n<p>If you can&#8217;t get rid of cancer, you can get treatment with\u00a0cytostatic drugs\u00a0that slow down the disease.\u00a0You also get the treatment you need to relieve the hassles you may have.\u00a0It is called\u00a0palliative care.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">You can get care in another place<\/h2>\n\n\n\n<p>The clinic&#8217;s\u00a0contact nurse\u00a0can help you with practical questions, for example, if you live far from the clinic and have a close relative who comes with you.\u00a0<\/p>\n\n\n\n<p>Post-checks are done at your nearest women&#8217;s clinic.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Life after treatment<\/h2>\n\n\n\n<p>It is good if you move as soon as you can after the treatment, but in the first few days you may need to take it a little carefully.<\/p>\n\n\n\n<p>Tumor cancer and the treatment of the disease will affect your life in some way.\u00a0How big the changes will depend on what treatment you have received, if you have other illnesses and how you feel otherwise.<\/p>\n\n\n\n<p>What you feel and how you feel can also vary.&nbsp;It is different from person to person but can also be changed from one period to another.&nbsp;Some have problems that may be greatest in the immediate time after treatment.&nbsp;Other problems can first be alleviated and then come back.<\/p>\n\n\n\n<p>Tell your contact nurse or other healthcare professionals how you are feeling.\u00a0The vast majority of inconveniences are helpful.<\/p>\n\n\n\n<p>Here are some examples of inconvenience and help available:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Urinary incontinence and bowel incontinence<\/h3>\n\n\n\n<p>Radiation treatment can cause incontinence.\u00a0This means that it is difficult to keep tight.\u00a0You may have\u00a0urinary incontinence\u00a0or\u00a0bowel incontinence.<\/p>\n\n\n\n<p>A physiotherapist can help you train your muscles so that you can pinch if needed.&nbsp;There are drugs that relieve the hassle.<\/p>\n\n\n\n<p>There are different types of incontinence protection.&nbsp;You can get free incontinence protection through the district nurse.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Sexuality and closeness<\/h3>\n\n\n\n<p>The possibility of sexual stimulation may be affected, for example, if all or part of the clitoris has been removed.&nbsp;The illness and treatments can also make you think differently about yourself and your body.&nbsp;Some lose their desire for feeling anxious or depressed.<\/p>\n\n\n\n<p>It can be difficult to talk about the changed situation.&nbsp;You can get help, for example by a psychotherapist or a sexologist.&nbsp;You can get help whether you have a partner or not.<\/p>\n\n\n\n<p>If you have a partner, the help can be about talking support so that you can talk to each other or discover new ways of being together.\u00a0You can read more in the article\u00a0\u00a0Cancer and Sexuality.<\/p>\n\n\n\n<p>Reportage:&nbsp;&nbsp;Paula and Thomas: We got to start from scratch<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The help that can prevent vomiting problems<\/h3>\n\n\n\n<p>Both surgery and radiotherapy can provide scar healing, which results in the opening of the wear.&nbsp;Then it can be more difficult to have intercourse or to be examined.<\/p>\n\n\n\n<p>You can prevent the inconvenience by using a dilator.\u00a0It is a rod that you insert into the vagina.\u00a0You get it at the clinic where you have been treated.\u00a0It is good if a doctor or a nurse help you try out the dilator so that you get the right size.\u00a0You may need to resize after a while.<\/p>\n\n\n\n<p>Using a massage stick may work, but it is important that it is the right size for you.<\/p>\n\n\n\n<p>Radiation therapy can lower the levels of estrogen so that the mucous membranes become dry and fragile.&nbsp;It may help with cream or ointment containing estrogen.&nbsp;Taking estrogen in this way does not affect cancer disease.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Lymphedema can be prevented and treated<\/h3>\n\n\n\n<p>You may get\u00a0lymphedema if the lymph nodes have been removed.\u00a0This means that lymph fluid is collected.\u00a0It can feel swollen, tense and heavy in the groin and in the legs or lower abdomen and towards the pubic bone.<\/p>\n\n\n\n<p>Lymphedema can be both prevented and treated, for example with compression stockings, compression pants or massages.&nbsp;You can use a panty that sits tight to relieve the swelling.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Fatigue<\/h3>\n\n\n\n<p>Many people with cancer feel very tired.\u00a0It can have different causes.\u00a0Maybe you don&#8217;t get the energy you need, the disease can create substances in the body that make you tired, the treatments can cause fatigue.\u00a0Anemia, anxiety or\u00a0depression\u00a0can also make you feel very tired.<\/p>\n\n\n\n<p>Fatigue means that you will not be rested even though you have slept.&nbsp;You may become more easily irritated and you may not be able to cope with things you usually do.&nbsp;It can affect your relationships.<\/p>\n\n\n\n<p>Tell the health care provider if you are very tired.&nbsp;Make sure you get to know about the fatigue and what it is due to.&nbsp;If you have close relatives, it is good that they also get information.&nbsp;It can help and increase the understanding of the surroundings.<\/p>\n\n\n\n<p>Sometimes exercise is adjusted doses can make you feel less tired.\u00a0Another thing that can be alleviated is to take several short rest breaks during the day rather than a single, longer rest break.\u00a0There are also medicines that can help with fatigue.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Several ways to get support<\/h3>\n\n\n\n<p>It is common for gender to be strongly associated with one&#8217;s identity.\u00a0Illness and treatment can cause feelings of loss and grief.<\/p>\n\n\n\n<p>You have the right to talk to a curator or psychologist about how you feel.\u00a0Some feel strengthened by contact with other people in the same situation.\u00a0For example, you can contact any of the patient associations that exist.\u00a0Here you will find contact information for advice and support in cancer.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Quality of life<\/h3>\n\n\n\n<p>Although it may feel difficult and much can be different, many have a good quality of life after treated vulva cancer.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Getting a cancer message<\/h2>\n\n\n\n<p>There are many ways to respond to a cancer message.&nbsp;You may need plenty of time to talk to your doctor and other healthcare professionals about what the message means.&nbsp;If possible, please let a relative accompany you.&nbsp;The related person can act as a support and help to remember what has been said.<\/p>\n\n\n\n<p>You can ask to have the information written down so you can read it peacefully.\u00a0Ask questions if you don&#8217;t understand.\u00a0You have the right to receive\u00a0interpreting assistance if you have a hearing impairment.<\/p>\n\n\n\n<p>In many hospitals, there are special nurses called\u00a0contact\u00a0nurses who\u00a0can provide support and also help with various practical things.<\/p>\n\n\n\n<p>For many, it usually feels easier once treatment has begun and they know what is going to happen.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">You can get support in several places<\/h3>\n\n\n\n<p>The contact nurse or the hospital&#8217;s curator can help you if you need to talk more or have questions.<\/p>\n\n\n\n<p>You can contact Cancer Counseling or the Cancer Foundation or, for example, a patient association.&nbsp;Beneficial is a compound for people with gynecological cancer.&nbsp;Tumor cancer is a form of gynecological cancer.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Children also need to know<\/h3>\n\n\n\n<p>A minor child has the right to receive information and support based on his or her own needs if a relative is ill.&nbsp;It is the responsibility of care.&nbsp;You can get help with what to say if you want to tell the child yourself.&nbsp;Often it is good to make children as involved as possible, regardless of their age.&nbsp;That doesn&#8217;t mean you have to tell everything.<\/p>\n\n\n\n<p>You can read more in the text\u00a0Talking to children when a parent is seriously ill.\u00a0<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Being related<\/h2>\n\n\n\n<p>Sometimes it can be difficult to be close to someone who is ill.&nbsp;You may want to give support to your loved ones while you have a strong concern and feel bad.&nbsp;It is very common to do so.<\/p>\n\n\n\n<p>Try to let other people in your vicinity support you.&nbsp;It can be family members, friends or acquaintances.&nbsp;Often it will be easier for them to help you by telling them how it feels and showing if you are worried and sad.<\/p>\n\n\n\n<p>You can get help from the\u00a0contact nurse or a curator at the hospital if you are close and need supportive calls.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Be involved and influence your care<\/h2>\n\n\n\n<p>It is important that&nbsp;you are involved in your care&nbsp;as much as possible.&nbsp;The healthcare staff should tell you what treatment options are available.&nbsp;The staff should ensure that you understand what the various alternatives mean, what side effects are available and where you can receive treatment.&nbsp;This way you can help decide which treatment is right for you.<\/p>\n\n\n\n<p>You can make a care plan together with the contact nurse, the doctor and other staff.&nbsp;It should answer questions that are important to you.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">New medical assessment<\/h3>\n\n\n\n<p>You can get a&nbsp;new medical assessment&nbsp;if you are unsure if you are receiving the care and treatment that is best for you.&nbsp;You will then see another doctor, usually at another specialist clinic.&nbsp;Ask your doctor if you want to know more about how to get a new medical assessment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tumor cancer means that a cancerous tumor has formed somewhere in the vulva, which are the outer parts of the female genital tract.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2,22,542],"tags":[667,664,665],"class_list":["post-532","post","type-post","status-publish","format-standard","hentry","category-diseases","category-cancer","category-types-of-cancer","tag-treatment-of-vulvar-cancer","tag-vulvar-cancer","tag-what-is-vulvar-cancer"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/532","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=532"}],"version-history":[{"count":5,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/532\/revisions"}],"predecessor-version":[{"id":3240,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/532\/revisions\/3240"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=532"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=532"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=532"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}