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Specialists detect rise in rare cancer

Cancer specialists have noticed a worrying increase in women presenting with advanced forms of rare cancer following Victoria’s COVID-19 lockdowns.

AAP understands some Melbourne practitioners have seen a 30 per cent rise in late-stage cases of vulvar cancer.

Epworth private hospital gynaecological oncologist Julie Lamont says she has noticed the jump, with women at progressed stages presenting with cancerous lesions.

“We’ve seen more women with more cancers rather than pre-cancers on the vulvar, that sometimes can lead to bigger decisions about treatment,” she told AAP.

“There has definitely been women who have turned up with lesions that are more advanced.”

Vulvar cancer occurs in the external areas of female genitalia and can begin as a rash or an itch but also as a lump or mass.

It is rare, representing 0.6 per cent of all female cancers diagnosed in 2021 but vulvar cancer is on the rise.

There were 359 new cases diagnosed nation-wide in 2017 and 433 this year, according to Cancer Australia.

The earlier it is diagnosed, the better.

However Dr Lamont says she is seeing more women requiring difficult advanced treatments, involving chemotherapy and radiation.

“We’ve definitely had some women come through who need that sort of next step of treatment,” she said.

It is also apparent some women have delayed follow-up appointments and surgery consultations since the pandemic began due a mixture of hesitancy and confusion around changing health restrictions.

With GPs offering more telehealth appointments than in-person consultations, some signs may not have been picked up as early as they would have pre-pandemic.

“With vulvar cancer, the management of that is very dependent on follow-up and clinical examination,” Dr Lamont said.

“We’ve noticed women either not coming in or delaying, there have been a lot of women who have said ‘I didn’t want to come’ from the country. Or even in Melbourne, just feeling hesitant of coming out and coming to the hospital.”

Dr Lamont is concerned the number of women presenting with the cancer could rise further.

“I anticipate that we are going to get an increase of people being referred with more vulval lesions, particularly more advanced lesions,” she said.

“Because the time frame is months and sometimes years in the development of these – it’ll be potentially six months or 12 months from now. It’s an ongoing problem.”

Another worry is a decline in uterine cancer diagnoses, particularly endometrial cancers, of which unusual bleeding is the main symptom.

“There has been a small reduction of people being diagnosed with that over the last year, an eight per cent reduction in women presenting as they would normally with that,” Dr Lamont said.

Women are also waiting longer than usual to have a colposcopy, a diagnostic procedure to examine the cervix, vagina and vulva.

Colposcopy clinics were busy leading up to the pandemic but demand has doubled after a screening push.

“That’s giving a bit of a strain on the system. Women who might have cancer or are screening for pre-cancer are now having to wait longer to get into the colposcopy clinics,” Dr Lamont said.

“That’s been one of the biggest issues, we are now getting more people because we’ve got that backlog coming through.”

The total number of cancers detected in the first year of the pandemic is still unknown, with the Victorian Cancer Registry to release its 2020 report on December 9.

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