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Lichen Sclerosis And Cancer: Is There A Link?

Lichen sclerosus is a skin condition that can increase your risk of cancer. It’s not a type of cancer on its own, but treating it can help you prevent vulvar cancer.

Lichen sclerosus causes symptoms such as itching, pain, and patches that form on the skin around your genitals. Treatment for the disease usually involves potent corticosteroids.

Read on to learn more about the link between lichen sclerosus and cancer.

Lichen sclerosus is a chronic skin condition that primarily affects postmenopausal people. But lichen sclerosus can affect people of any sex and age, especially people with vulvas.

Lichen sclerosus is directly associated with a increased risk of vulvar cancer.

Vulvar cancer is a type of skin cancer that forms around the genitals in areas like the labia or clitoris. Less than 1% of all cancers diagnosed in women each year are vulvar cancers.

About 4 percent of women with lichen sclerosus will develop vulvar cancer.

This means that people with lichen sclerosus have a much higher risk of vulvar cancer than people who don’t. But it can take years for cancer to develop after a case of lichen sclerosus.

Getting effective medical care and treatment for lichen sclerosus is thought to help reduce the risk of developing vulvar cancer.

Symptoms of lichen sclerosus include:

  • itch
  • discomfort
  • pain
  • smooth white patches on your skin near your genitals and anus
  • pain during urination
  • pain during sex
  • easy bruising in the genital area
  • easy formation of blisters in the pelvic area

Symptoms of vulvar cancer can be hard to spot at first. You may also not have any symptoms when the cancer first develops.

When symptoms appear, they often include:

  • a lump or bump on or near your vulva
  • a mole on your vulva that changes color or shape
  • itch
  • burning
  • pain
  • unusual vaginal discharge that may have an odor
  • vaginal bleeding that is unrelated to menstruation
  • raised patches of skin on your vulva that are a different color from the skin around them

Researchers don’t know what causes lichen sclerosus.

But they know it’s not contagious. You cannot catch it through sexual activity, sharing clothes, or other physical contact with someone who has it.

Researchers think lichen sclerosus may be linked to:

Other risk factors for vulvar cancer include:

  • smoking
  • genital warts
  • human papilloma virus (HPV)
  • vulvar intraepithelial neoplasia, a condition that occurs when the skin cells in your vulva change in response to inflammation or viral infections like HPV
  • be over 60
  • never having given birth
  • previous radiation treatments to your pelvic area
  • anterior vaginal or cervical cancer

Lichen sclerosus is normally diagnosed with a physical exam and talking about your medical history with a doctor.

To diagnose vulvar cancer, you will first need a biopsy. A biopsy can help your medical team determine the type of cancer you have. It will also confirm that your symptoms are caused by vulvar cancer and not another disease.

During a biopsy, a piece of affected tissue is removed from your vulva and sent to a laboratory for analysis to confirm the diagnosis of vulvar cancer.

You might also have lab work done to examine your levels of white blood cells, red blood cells, and other important health indicators.

In some cases, a doctor may order imaging tests to see if the cancer has spread and to get pictures of any internal tumors. Some possible imaging tests include:

Lichen sclerosus is treated with prescription corticosteroid creams. Treatment is intended to help manage your symptoms, prevent scarring, and reduce the risk of cancer.

Since lichen sclerosus is often associated with inflammation of the skin, first-line treatment usually includes the use of prescription corticosteroid creams to help restore tissue integrity. Steroid treatment may also help reduce some of the symptoms such as itching, irritation, and burning.

Treatment with steroids can take a long time, sometimes months to years. It is important to have close follow-up and regular monitoring with your doctor to make sure the disease does not progress or develop into something more serious like cancer.

If vulvar cancer develops, treatment depends on the stage of the cancer and your general health. Some vulvar cancer treatments include

  • Operation. Doctors can surgically remove the cancer and surrounding tissue. In some cases, this eliminates the cancer completely and helps keep it from coming back.
  • Radiotherapy. Radiation therapy can be used before and after surgery. Before surgery, radiation therapy can shrink the cancer and make it easier to remove. After surgery, radiation therapy can kill any cancer cells still present in your body.
  • Chemotherapy. Chemotherapy kills cancer cells. It is often used when cancer cells have spread beyond the vulva.

Treatment for lichen sclerosus often helps prevent the development of vulvar cancer.

In people with vulvar cancer, survival rates are better when the cancer is detected early. The 5-year survival rate when the cancer has not spread beyond the vulva is 86%.

A 2021 review in Gynecological oncology suggests that this rate can sometimes reach 93%. Once the cancer has spread to the lymph nodes in the groin, the 5-year survival rate drops to about 53%.

Other factors can affect your outlook, including:

  • age
  • overall health
  • response to treatment

Keep in mind that cancer survival statistics are also based on historical data. They are taken at regular intervals – often about every 5 years – but new cancer treatments are continually being developed, used and improved.

Survival rates for all cancers generally improve as treatment and early detections improve.

Lichen sclerosus is not cancer. But it can lead to vulvar cancer.

Treatment for lichen sclerosus can help prevent the development of this type of cancer. Vulvar cancer is also very treatable when diagnosed in its early stages.

Getting a diagnosis of lichen sclerosus and working with a doctor to create a treatment plan can help prevent the disease from turning into cancer. See a doctor as soon as possible if you have signs and symptoms of lichen sclerosus.