Question I am 10 months post op for two VIN2 leisons secondary to 27 years of lichen sclerosis. I am negative for HPV. The oncologist got clear margins with no lymph node involvement. Post op checks have not revealed new return of VIN. Will my risk of developing VIN again ever subside?
Answer You've posed a difficult question. VIN is not cancer, and most does not progress to cancer. Lichen sclerosis is a condition which is a precursor for VIN and real cancer. If your oncologist got clear margins and there was no lymph node3 involvement, your risk continues to be about 0.3% per year for VIN. If I were you I'd continue to have check-ups knowing that I might need more treatment in the future. There is some evidence that the application of steroids can reduce or eliminate lichen sclerosis, but whether this cuts down on the risk of VIN is unclear. Logically it should, but I can't find studies to this effect and given the small numbers of patients who get VIN it might be difficult to test. Hope this helps.
I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.
I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.
Organizations American Society of Clinical Oncology
Publications New England Journal of Medicine
American Journal of Medicine
Journal of the American Society of Clinical Oncology
Education/Credentials MD, Stanford University
Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO
Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY
Awards and Honors America's Best Physicians, last 14 years