The Skin Cancer No One Talks About: Vulvar Intraepithelial Neoplasia 3


There’s a lot of talk and awareness about skin cancer and how to prevent it. Common knowledge tells us to slop on the sunscreen, stay out of the sun during the late morning/midday hours when the UV rays are at their highest concentration, and to avoid using tanning beds. The personal stories I read about these skin cancers are ones that seem to be found on the face or upper body or occasionally the legs.

On July 10 I found a strange looking mole on my vulva.

No one ever seems to talk about moles found in your private parts. I’ve certainly never read any articles like that. I came upon this mole purely by accident as I was trimming the “Lady Garden.”

It jumped out at me because of its sudden appearance. I knew for a fact it hadn’t been there six months ago because on February 7 I had my right hip replaced. In preparation for that surgery I had also done some “garden management” and there were no moles in evidence at all.

The minute I laid eyes on this mole I sensed it was going to be trouble. All the classic signs were there — larger than a pencil eraser, irregular shape, bleeding on the edge when I rubbed at it. Alarm after alarm starting going off in my head. I made a beeline to the phone and called my doctor’s office to set up an appointment.

Now it’s important to know that I already live with chronic pain and chronic fatigue and have for many years. I also have several complex medical issues, including fibromyalgia, osteoarthritis, D.I.S.H., trigeminal neuralgia, type 2 diabetes (on insulin), hypothyroidism and bipolar disorder. I’m not a person who tends to panic because my body always seems to be throwing something at me.

This discovery scared me though.

I have a fantastic relationship with my doctor. On appointment day when he entered the room he shook my hand as always. We said hello and then I said to him, “OK this is how it’s going to go. I want you to look at this mole, tell me I’m ridiculous to be worrying and send me home.”

Unfortunately, after examining it closely, he couldn’t quite do that. He agreed it should probably be removed, but he didn’t feel it was anything to worry about. He offered to do the removal himself, as I live in an area where the waitlist is several months for a dermatologist.

I agreed and went back the following week. My hubby came with me, the doctor froze the area with local anesthetic and a few short minutes and three stitches later the mole was gone. It was sent away to pathology and I was told I’d be called if there was a problem.

I was called.

I have a fantastic relationship with the receptionists at the front desk of the doctor’s office as well. When Nadia called me she seemed even more more chipper than she usually does (and she’s always chipper). I immediately knew something was up when she told me the pathology report was back and the doctor wanted to see me.

Now I know for a fact he wouldn’t call me in to say everything looked good; he knows I take public transportation to get to the office and it takes almost an hours. With my pain and fatigue issues he wouldn’t do that to me. But sure enough there was a problem.

Vulvar intraepithelial neoplasia 3 (VIN 3) consistent with squamous cell carcinoma in-situ.

Man, that’s a mouthful.

Basically, the mole that was on the top right fatty side of my vulva, less than an inch from my urethra and clitoris, had cells that are as close to being cancerous as you can get without being cancer. The size of the incision the doctor made wasn’t large enough, as those edges were changing as well, and so now I need to see a gynecologist to have a larger amount of the vulvar area removed (as well as possibly lymph nodes in the groin).

I also need to be examined inside and out to see if there are any other type of moles growing. There’s also a chance of changes in the vaginal cells because over the last few years sex has been painful and sometimes I’ve had bleeding afterward. I’ve always put this down to surgical menopause, as I had my uterus out in 1990 (when I was 28) and then had each ovary removed in separate surgeries just six months apart in 2006/2007. The last one put me instantly into medical menopause. I didn’t go on hormone therapy for a very long time but finally started about a year ago because of the painful sex. Unfortunately, I had to stop for six months from the time of my hip replacement and I’ve only just started again.

*le sigh*

I’m sharing all of this intimate information because you never see it shared anywhere else. No one ever seems to talk about things like skin cancer on the vulva or possibly in the vagina or for men, on the penis.

I mean, come on… it’s not like I’ve been flashing the world my private parts during the hot days of summer (well, maybe I have — it’s not like you know me or anything). Still, even if I lived a nudist lifestyle, I’d be using sunscreen. Especially if I lived a nudist lifestyle!

I’m waiting to get that appointment to see the gynecologist. My doctor has marked the referral as “urgent” which means I should get a call within the next two weeks. If I don’t hear from them I’m to follow up with a call to their office. And you can be sure I’ll be doing that because I’ve already seen how quickly this mole was evolving. I have no idea if there are nasty cells still under my skin trying to attack me.

So why am I writing this? To warn you not all skin cancers show up on faces and upper bodies and legs. Sometimes they show up in private places you’d never think to check, like the Lady Garden or possibly under the crease of your bum.

It’s time to let the shyness go and to start becoming aware of the fact that skin cancer can show up anywhere. Do yourself a favor and check. Make if fun with a partner or formal with a dermatologist if necessary. But do it one way or the other.

As for me… well, I’m gonna play Whack-a-Mole with this one. I’m good at that game. I always win.

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Thinkstock photo by StockSanta


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