Objectives
  • To be able to describe the epidemiology, aetiology and risk factors (including human papilloma virus (HPV)) for vulvar and vaginal cancers

  • To understand the presentation of melanoma primary to the vulva and vagina

  • To understand the methods of prevention of vulvar and vaginal cancers, including diagnosis and management of pre-invasive disease

  • To be able to perform specialist assessment, staging, treatment and counselling of patients with primary vaginal and vulvar cancers

  • To be able to counsel and treat patients with recurrent disease

  • To recognise metastatic cancers to the vulva and vagina

Awareness
  • Awareness of staging procedures, including diagnostic and radiological procedures for staging

  • Recognition of the importance of the multimodality approach to treatment, including the roles of surgery and radiation oncology

  • Awareness of diagnosis, staging and treatment of melanoma primary to the vulva and vagina

  • Appreciation of the role of biological treatments and immunotherapy agents in the treatment of melanoma

Knowledge
  • Familiarity with the role, indications and limitations of staging studies, including magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT), and staging lymphadenectomy with respect to treatment planning

  • Understanding of the role of primary surgery in the treatment of vulvar cancer and early stage vaginal cancer

  • Understanding of the indications for chemo-radiation therapy for advanced (unresectable) vulvar cancer and for most vaginal cancers

  • Understanding of the indications for adjuvant therapy following radical surgery

  • Understanding of the role of chemotherapy in the management of patients with advanced, persistent or recurrent disease

  • Understanding of the complications that derive from disease progression and those that are treatment-associated in the context of being familiar with supportive and palliative care strategies

Skills
  • Ability to contribute actively to a variety of vulvar and vaginal cancer clinical scenarios and patient presentations

  • Ability to discuss critically the treatment options/recommendations

  • Ability to perform a history and physical examination, including pelvic and rectal examinations

  • Ability to contribute to discussions on general management strategies in order to understand all the considerations on which treatment to use

  • Ability to prescribe chemotherapy with radiation therapy, including managing acute toxicity during treatment

  • Ability to manage side effects of radical surgery, irradiation and chemo-radiation therapy

  • Ability to discuss the options for patients with persistent or recurrent disease following primary therapy

  • Ability to discuss prevention strategies with patients