This wasn’t my plan for today’s post. However, I can feel myself avoiding this topic in favour of writing about remedies and healing practices.
A woman in one of the online communities posted last night that she is booked for surgery after receiving results of vulvar squamous cell cancer.
I think it’s best we pull up a chair and clear the air around lichen sclerosus and cancer. It won’t get heavy. I’m not a doctor. I have poked around the research in this area. My tendency is not to dwell on what could happen, while at the same time being informed of what needs attention.
So, what about lichen sclerosus and cancer?
I know it’s easy to say don’t worry. It’s harder to do. Worry has never solved anything. I don’t brush off the increased cancer risk, but I certainly don’t make it my focus. This is between you and your doctor to stay on top of. It is also one of the reasons to develop a wellness/spiritual practice to reduce your stress. I’ve already talked about Lichen sclerosus and breath. More on this in upcoming posts.
The increased risk of cancer among those with LS is reported by various sites to be between 3 and 6%. So, let’s first put that in perspective. I would hazard a guess that chronic worrying is more harmful to our health than a 3-6% increased risk of vulvar cancer. That said, it is not my intention to disregard it. It’s one more reason to take better care of ourselves.
Early research did not support long-term steroids as a cancer preventative:
While topical steroid therapy is clearly beneficial in terms of symptom control, there is little evidence that its long-term use or optimal control of symptoms reduces the risk of malignancy. Because lichen sclerosus confers an increased risk of vulvar malignancy, long-term follow-up is required. Persistent or suspicious lesions (e.g., ulcerations, masses) should be biopsied in order to exclude intraepithelial neoplasia or invasive squamous cell cancer.1
Cancer Therapy Advisor
As much as I wanted to find a study that proved steroid treatment wasn’t needed to prevent the possibility of cancer, more recent research indicates otherwise:
A study of 507 women, of which 357 adhered to treatment with topical corticosteroids (compliant) and 150 did not carry out the advised treatment (partially compliant). “There was a significant difference in symptom control, scarring, and occurrence of vulvar carcinoma between compliant and partially compliant patients.” 2
National Library of Medicine
The above study showed that 4.7% of those who didn’t use topical corticosteroids or used them irregularly developed precancerous cells or carcinoma. What the study doesn’t take into account is a group using other treatment methods. We understand that using no treatment increases the risk. However, how about those using acupuncture, TCM, naturopathic remedies, PRP injections, herbs, laser therapy or other treatment protocols? The 4.7% is in line with the 3-6% increase reported by various sources.
The good news is… according to the study above, treatment appears to be effective. It just doesn’t agree with every person. A study in Clinical Trials has this to say:
The current “gold standard” treatment for lichen sclerosus is potent steroids creams. When used correctly, steroid creams help to decrease the symptoms of itching and burning and can prevent further vulvar scarring. In addition, proper treatment reverses the underlying inflammation of LS, and may lower the risk of getting cancer. While useful, steroid creams may have serious side effects that include thinning of the skin, fungal infections, and lowering the immune system. 3
What has fuelled my investigation of LS, beyond this mysterious condition itself, is my desire for an effective treatment that doesn’t involve a lifetime of steroid use. While I’m grateful for access to modern medicine, I’m curious about other treatment approaches.
Let’s add one more stat to the conversation. According to the American Cancer Society, the 5-year survival rate for vulvar cancer (all stages combined) is 71%:
Women now being diagnosed with vulvar cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least five years earlier. 4
When we take all of this into account, yes, LS is reported to increase your chance of vulvar cancer by around 3-6%. That’s already low. On top of that, those who do develop vulvar cancer have at least (improving with time) a 71% 5-year survival rate. The research showed 86% for localized cancer.
There are women in the online communities who have had surgery or minor procedures to remove cancerous areas. And they report doing well. There are far more women who are cancer-free. And, according to the study mentioned above, conventional treatment appears to be successful in eliminating cancer risk from LS.
I can’t tell you what to do. This is why LS (really, most health issues) is such a personal condition. Have the conversations you need to have with your health care team and make choices that are best for you.
What we know is that regular check-ups are needed, self-exams keep you alert to any changes, and a holistic healing lifestyle (addressing all the parts of you and LS) helps ease your mind and support your body.
I mentioned oxidative stress and its role in LS in Lichen sclerosus and stress. OS also plays a role in cancer. By reducing our burden of stress, we are well on our way to managing LS.
There. We did it. We had the cancer conversation. I welcome anything you have to add in the comments below.
Much love,
Stephanie
Read the next post in the series: How to heal lichen sclerosus naturally
**This blog is meant to inform, not diagnose or treat specific health conditions. It is not a substitute for professional medical advice, diagnosis and treatment. Always consult your doctor or health care practitioner.
2 https://pubmed.ncbi.nlm.nih.gov/26070005/
3 https://clinicaltrials.gov/ct2/show/NCT03665584
4 https://www.cancer.org/cancer/vulvar-cancer/detection-diagnosis-staging/survival-rates.html
Stephanie Hrehirchuk - Author 
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