Radical vulvectomy for Bartholin's gland cancer

Christina S. Chu, MD
Last Modified: January 13, 2002

Dear OncoLink "Ask The Experts,"

I have just been diagnosed with Transitional cell cancer of the Bartholin's gland. It seems that my Oncologist's decision for a radical vulvectomy is the most effective procedure. Does radical mean both left + right side? Will there be a normal sex life with just an abnormal appearing or will I no longer to have normal physical relations with my husband. I am sorry to bother you w/ what must seem trivial but I was thinking another expert opinion might help make me a more comfortable with this whole thing, which is pretty overwhelming. I had cervical cancer in 1976 and have had no problems of any sort.

Thank you in advance if you are able to reply

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

You have asked a difficult question. True cancers of the Bartholin's gland are rare. The classic treatment involves a radical removal of the vulva with removal of the lymph nodes in both groins. However, in some cases, some physicians have begun using a more conservative approach that involves either removing the vulva on the affected side only, or a radical local excision with groin node removal only on one side. If the nodes are positive, more surgery on the other side, or in the pelvis may be required. You are correct that these recommended surgeries may cause scarring and disfigurement of the vulvar area, and near the opening of the vagina. This may affect your ability and desire to have sex afterwards. However, these concerns should be weighed with the seriousness of your diagnosis. I would recommend you have a frank discussion with your surgeon to address your concerns. You should also ask your surgeon to outline what type of procedure is planned so you can have some idea of what areas will be removed with your surgery.