Has anyone had Paget's disease of the vulva?

Posted by chaka67 @chaka67, Apr 18, 2023

I am about to have my 6th vulva surgery for Paget's of the vulva in less than 10 years. That means for about a month after surgery I cannot drive, sit or walk, & I am the my husband's caregiver.
I also had a mastectomy 10 years ago, but was told they were unrelated. Also unrelated is any support for Paget's disease. They have marches for breast cancer. Yet I have never met someone with Paget's. Even this message box underlines the word Paget's as if I am misspelling the word!!

Interested in more discussions like this? Go to the Gynecologic Cancers Support Group.

Profile picture for joyceinil @joyceinil

How do you know it is not invasive? Did they test lymph nodes? I 'm hoping I can get some sort of treatment like you are doing. I'm not a candidate for surgery as I am 85, on Eliquis (blood thinner) because of A-fib. Have hiatal hernia, diabetes, arthritis and many other old-age type of disorders.

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I actually saw my oncologist yesterday after a CT scan and blood tests. Not the surgeon or hospital where the Paget's was discovered. Gynecologist are centred at a different hospital. My oncologist has ordered a biopsy of a lymph gland in my neck, a PET scan which will apparently show signs if there is cancer. Plus an MRI. He is very concerned (as am I) about cancer not necessarily related to the Paget's. He said there's no way to know it is invasive without tests like biopsies, if I understood correctly. That blood tests aren't precise enough... anyhow - I am shaken - but so thankful not to, at 77 1/2 have gone for the horrific, very large surgery that was suggested for Paget's. I may be dealing with an entirely different beast - and will know more after the PET scan, etc.

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Profile picture for ameliae @ameliae

No. I didn't try surgery. It's not unbearable. Itch and burn. Cannabis products prescribed help. The surgery would be massive including taking skin from my thighs. There has been very little experience with EMPD where I am. I suspect some people mis-diagnosed as I was for about 10 years. My life is good. I'm 77. going on 78. The idea that it just keeps coming back - I'm opting right now for quality of life. As far as I know it is not invasive. I get test results of scan next Friday.

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How do you know it is not invasive? Did they test lymph nodes? I 'm hoping I can get some sort of treatment like you are doing. I'm not a candidate for surgery as I am 85, on Eliquis (blood thinner) because of A-fib. Have hiatal hernia, diabetes, arthritis and many other old-age type of disorders.

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No. I didn't try surgery. It's not unbearable. Itch and burn. Cannabis products prescribed help. The surgery would be massive including taking skin from my thighs. There has been very little experience with EMPD where I am. I suspect some people mis-diagnosed as I was for about 10 years. My life is good. I'm 77. going on 78. The idea that it just keeps coming back - I'm opting right now for quality of life. As far as I know it is not invasive. I get test results of scan next Friday.

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Profile picture for ameliae @ameliae

I was diagnosed with Paget's Disease of the Vulva on April 28th, almost by accident. I have had it for at least 7-8 years, followed by my GP. So few medical people know anything about it, including my GP. I was having a polyp removed in late March and a good friend (a pharmacist) suggested I ask the surgeon to biopsy my vulva. Alas! There it is. I've wrestled with it. had tests. Seen different docs and ended in the oncology/gynecology clinic with amazing women surgeons who work as a team. I've been on a roller coaster since April 28th, but now, after various tests, options presented, knowledge that margins are not clear and that it comes back in a very high percentage of cases, my age (almost 77), and I live alone - I have pretty well decided to live while I'm alive and not have the surgery. It has been slow growing. Maybe that will continue. Vaseline helps with the pain present in one spot more than others. I have an appointment with the cannabis clinic at the hospital to see how they can help with pain. I had a consult with a plastic surgeon who says he could do it --- huge areas of my thigh used ... however, he also suggested I might ask for surgery to remove the most painful areas. Next appointment with surgeon mid-October. I've done a lot of research to educate myself. It has been beyond stressful, as you know. May your healing come ... Troubling that so few medical people know about it. For that reason, I gave permission (it was mine to make)for the others the plastic surgeon brought in to see. Looking for other ways to share - and have done so with friends and on facebook ... would like to be able to do more at a hospital level or in other ways. I keep speaking of it there. Only two others have been treated for it at this hospital.

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Thank you for sharing your story. So just to clarify, you did try surgery in the past, but have now decided to do without surgery? Where are you at with things now? Hope you are healing!

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Profile picture for bijou68 @bijou68

Hi! Yes, the biopsies in that fragile and highly sensitive area are brutal. I no longer allow biopsies to be done without preparation following a discovery of spots on the vulva by either OB/GYN or oncologist, because the lidocaine shot hurts as much of biopsy itself. I asked for: oxycodon with anti nausea pill then lather my area with lidocaine 5% then I go to my appointment and they put more lidocaine gel, then lidocaine shot or shots for multiple biopsies then it goes painless. Amen! My theory is: if you don't ask and obtain a yes that they will follow, ask forcefully again. I deal with Kaiser and happy to say they oblige me. Thank goodness.

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I was able to have less pain too, by using the topical lidocaine, in conjunction with an ice pack, applied before and after each biopsy. They told me the painful part of the injection is the chemical used to limit bleeding (forgetting the name at the moment) epinephrine (? ). Not all lidocaine shots carry epinephrine. You can try asking for one without the epinephrine.

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Profile picture for bijou68 @bijou68

Hi! I do not know what a punch biopsy is, but when you find out, can you share with me? Best regards, Bijou

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I certainly will. But I'm not getting many answers these days. Couldn't be because this is such a rare disease, could it?

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Hi! I do not know what a punch biopsy is, but when you find out, can you share with me? Best regards, Bijou

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Profile picture for bijou68 @bijou68

Maybe it depends where exactly where your biopsy was done, on clitoris or on the labia where mine were and on both sides.

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bijou68
I have another question maybe you can answer. I don't remember who mentioned this, but what is a punch biopsy?

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Profile picture for joyceinil @joyceinil

I am going to see a dermatologist tomorrow. Will discuss all with him. Area doesn't look too bad. Thank you for your help.

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Is there anyone who lives near St Louis, MO and has had found a place to get treatment?
I went to my dermatologist who discovered the EMPD and he said he found on place that would take me as a patient. That was St Louis University in St Louis. I live 55 miles from there but I'm sure that is the closest place for me. Washington University is the most prestigious research hospital near me. Surprised they were not interested in my case. I'm just glad there is at least ONE place where I can go for treatment. My appt is June 19. So I have a few more weeks to stew about this.

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Profile picture for bijou68 @bijou68

Maybe it depends where exactly where your biopsy was done, on clitoris or on the labia where mine were and on both sides.

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I am going to see a dermatologist tomorrow. Will discuss all with him. Area doesn't look too bad. Thank you for your help.

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