But it may make the pain worse. This test may be used to see if the cancer has spread. The lump may be a different colorlighter or darkerthan the skin surrounding it, and it may also feel rough or thick, similar to a wart. Vaginal cancer is a malignant disease that starts in the vagina (primary vaginal cancer), and vulval cancer starts on the external women's genitals. Your healthcare provider may need to check your skin on a regular basis. A rotten odor that makes your nose wince and your face contort is not the norm. If not, how and when will you find out the stage of the cancer? 7. However, during the initial stages of vulvar cancer, you may not experience any symptoms. Diagnosed with granulosa cell (GCT) ovarian cancer, Diagnosed with endometrium adenocarcinoma few days ago, Skin changes, such as color changes or thickening, A lump, wartlike bumps or an open sore (ulcer). However, certain risk factors are thought to contribute to development of the disease. Around 80 out of every 100 women with stage 1 vulval cancer (around 80%) will survive for 5 years or more after they are diagnosed. Persisting open sore (lasts for more than one month) An itchy area that appears rubbery to touch. Types and Subtypes of Breast Cancer. The HPV vaccine can prevent the strains of HPV responsible for most. In short, in terms of cancer affecting women, after breast cancer is cervical cancer. Vaginal cancer is a rare cancer that occurs in your vagina the muscular tube that connects your uterus with your outer genitals. For reprint requests, please see our Content Usage Policy. All information these cookies collect is aggregated and therefore anonymous. There are several subtypes of lactobacilli, but the most . Ovaries and fallopian tubes may or may not be removed. When you do the right surgery or do the right radiotherapy in any stage cancer, the woman is cured. We can also help you find other free or low-cost resources available. Will I need other types of treatment, too? These are the categories of cervical cancer. Free Digital Marketing Webclass on How to Make $1,000 - $2,500 Monthly Online. What does vulvar cancer smell like? How did BCG come to be used for bladder cancer? We can also help you find other free or low-cost resources available. These cookies may also be used for advertising purposes by these third parties. Symptoms of vulvar cancer may include: a lump or warty growth. Elsevier; 2020. https://www.clinicalkey.com. Itching, burning, or bleeding on the vulva that does not go away. Become a volunteer, make a tax-deductible donation, or participate in a fundraising event to help us save lives. Since vulvar cancer develops on the surface of the vulva, it may have a particular smell. Will treatment include surgery? The vulva includes the lips surrounding the vagina (labia minora and labia majora), the clitoris, the vaginal orifice and the urinary meatus. This content does not have an English version. Safe and effective deodorization of malodorous fungating tumors using topical metronidazole 0.75% gel (Gk567): a multicenter, open-label, phase III study (RDT.07.SRE.27013). Accessed Sept. 30, 2020. Warner KJ. CT or CAT scan: This test uses x-rays to make detailed pictures of the inside of your body. The aim is not cure; the aim is to prolong the persons life. You will be subject to the destination website's privacy policy when you follow the link. For instance, if the woman is still a young lady, who has been sexually active, then radiotherapy might not be the best option for her because radiotherapy may cause fibrosis. Vaginas and vulvas are as unique as faces they all have the same parts, but everyone's looks a little different. 2019;11(9):1244. There are about 6,000 new cases of vulvar cancer in the U.S. each year. That is how it starts. Pain in the pelvic region. Vitamin B and vitamin D have been known to leave a fishy smell in urine. In the early stage, treatment can be radical surgery or radiotherapy. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. It is common because we do not have a structured screening programme. If found early, vulvar cancer has a high cure rate and the treatment options involve less surgery. Symptoms of vulvar itching (or pruritus vulvae) include itching, stinging, or burning sensation. How long can it take before cervical cancer is detected in a woman? https://www.nccn.org/professionals/physician_gls/default.aspx. In the U.S., close to 5,000 women are diagnosed with vulvar cancer each year. Symptoms may be caused by something other than cancer, but the only way to know is to see your doctor. Melanomas may be bluish black or brown and raised. About 10,000 women die every year in Nigeria. The vulva is the outside part of a womans genitals: There are a few kinds of vulvar cancer. It is as if God is kind to us. Practicing proper skin hygiene can help you avoid infection, and subsequently, foul odor. If there is cancer, this sugar shows up as hot spots where the cancer is found. Bax C, Lotesoriere BJ, Sironi S, Capelli L. Review and comparison of cancer biomarker trends in urine as a basis for new diagnostic pathways. Topical therapy means a cream or ointment is put right on the skin. Schnabel R, Fijten R, Smolinska A, et al. Why does the vagina smell? Skin changes where the radiation is given. Then, there is the early stage cervical cancer which can be cured. What can I do about side effects that I might have? If so, who will do the surgery? Then, with time, it develops into foul smelling, vaginal discharge and sometimes, abnormal vaginal bleeding. Your cancer can be stage 0, 1, 2, 3, or 4. The pudendal nerve is the main nerve in our pelvic area. Mayo Clinic does not endorse companies or products. Changes in the color and the way the vulva looks. Researchers are currently exploring the possibility of detecting the odor of cancer to help reach a diagnosis sooner. We call it post-coital bleeding. Vaginal cancer is nearly always caused by an infection from certain types of the human papillomavirus (HPV). Vulvar lichen sclerosus may slightly increase the risk of squamous cell skin cancer in women. Stage 0 is also called carcinoma in situ. Thickening of the skin of the vulva. Support Care Cancer. Sometimes, it is a result of a more serious health condition, such as a certain genital infections or cancer . Ask the doctor what you can expect. Thank you for taking the time to confirm your preferences. The infection that results can then cause a foul odor. The 5-year survival rate for people with vulvar cancer is about 70%. However, it is very serious because it is cancer. Radiationuses high-energy rays (like x-rays) to kill cancer cells. the good news is----its seems to have gone away with the radiation & chemo. Sniffer dogs can identify lung cancer patients from breath and urine samples. We apologise to the LAPO Group for the error in the identification of the name of the said microfinance bank where the deceased took the loan. For pre-cancers (vulvar intraepithelial neoplasia or VIN), topical therapy may be used. I am not aware of any harm to the man. There are many things that are considered before a woman is given treatment. You may wonder about these treatments. Chemotherapy or chemo (KEY-mo-THAIR-uh-pee): The use of drugs to fight cancer. CDC twenty four seven. So if vulvar cancer spreads to the bladder (or any other place), its still called vulvar cancer. A distinct mass (lump) on either side of the opening to the vagina can be the sign of a Bartholin gland carcinoma. Clinical trials are research studies that test new drugs or other treatments in people. The vagina is a tube between the vulva and the opening of the womb (cervix). The appearance of lichen planus is varied. How Is Cervical Cancer Diagnosed and Treated? Radiation therapy: X-rays, gamma rays and charged particles are used to fight cancer. It is the neck of the womb that is affected. According to Cleveland Clinic, 17 percent of women experience it during sex, even before hitting menopause.. Most vulvar cancers are squamous cell carcinomas. There is also the late stage cervical cancer which cannot be cured. The DNA contains the instructions that tell a cell what to do. Rest when you need to. Its important to note that there are no standard procedures to test for VOCs, nor has there been a proven clinical benefit to perform such tests. Itching. Well, we are in a very religious environment. A woman can be screened for cervical cancer through a pap smear. The pap smear identifies the precancerous lesions. What you can change is how you live the rest of your life making healthy choices and feeling as good as you can. Vaccines & Boosters | Testing | Visitor Guidelines | Coronavirus. It's important to note, however, that the study doesn't mention whether the dog identified VOCs in people without cancer. Treatment for vulvar cancer depends mainly on the stage of the cancer. Vulvar cancer can occur on any part of the external organs but most often affects the labia majora or labia minora. Vulvar cancer is a type of cancer that occurs on the outer surface area of the female genitalia. Whether you want to learn about treatment options, get advice on coping with side effects, or have questions about health insurance, were here to help. In the most advanced stages, foul-smelling vaginal discharge; blood-stained vaginal discharge between periods and abdominal pain. Gynecologic oncologists are subspecialists with advanced training in the diagnosis, treatment and surveillance of female cancers, including vulvar cancer. It has been found recently that the organism called human papillomavirus (HPV) is the cause of cervical cancer in almost all the cases. Each round of treatment is followed by a break. It may also be used alone to treat advanced cancer. Accessed Sept. 30, 2020. If you have a mole that has changed, ask your doctor to check it out. A normal discharge is made up from exfoliated vaginal skin cells, bacteria, and secretions from the cervix and vaginal walls. Because these changes are often caused by other conditions that are not pre-cancerous, some women don't realize that they might have a serious condition. Vaginal discharge or bleeding that is not normal for you. It will also discuss the impact of changes in body odors from cancer treatment. Some have been shown not to help. However, survival rates depend on several factors, including the type of vulvar cancer and the stage of disease at the time it is diagnosed. God gave us the opportunities to identify cervical cancer at a time it can be cured. Tests that may be done Editors Note Feil C, Staib F, Berger MR, et al. Almost all women with invasive vulvar cancers will have symptoms. While medications such as sulfonamide antibiotics (commonly used to treat UTIs as well as other fungal and bacterial infections), diabetes medications and rheumatoid arthritis medications, all of which fall into the sulfa drug group (medicines used to treat bacterial infections), can cause urine to have a foul-smelling odor. Because it is cancer, it affects surrounding organs and keeps on spreading. The drugs are often given through a needle into a vein. And if you do sign up for a clinical trial, you can always stop at any time. Cancer.org is provided courtesy of the Leo and Gloria Rosen family. Almost all cases of cervical and anal cancer are caused by HPV. Here's a rundown on five of the most common vulvar conditions: 1. Lichen sclerosus is a chronic skin disorder that mainly affects postmenopausal women, although premenopausal women and men can still experience the condition. (520) 874-4700. Any cell in the body can become cancerous but cervical cancer is unique in a way, now that it is essentially the disease of developing countries. Vulval cancer is uncommon with approximately 400 women in Australia diagnosed each year. Low back or abdominal pain. These may not always be standard medical treatments. simbada February 5, 2023 science 0 Comments. Always consult a doctor for diagnosis. This is because developed countries have structured screening programmes for their women. PET scan: PET scans use a kind of sugar that can be seen inside your body with a special camera. Elsevier; 2019. https://www.clinicalkey.com. An area of VIN may look different from normal vulvar skin. Cancer can start any place in the body. But in late-stage cancer, survival rate is poor and putting a percentage on it may be difficult in this environment. Then, with time, it develops into foul smelling, vaginal discharge and sometimes, abnormal vaginal bleeding. Tiredness can carry on for some weeks after the treatment has ended but it usually improves gradually. To doctors, the cancer cells in the new place look just like the ones from the vulva. Pain or burning. Border irregularity: The edges of the mole are ragged or notched. Weve invested more than $5 billion in cancer research since 1946, all to find more and better treatments, uncover factors that may cause cancer, and improve cancer patients quality of life. About 70% of cases of throat cancer are . However, during the initial stages of vulvar cancer, you may not experience any symptoms. In a lay mans term, I usually call it the younger brother of cervical cancer. Sarcoma A rare type that starts in cells in muscle, fat and other tissue under the skin. For years after treatment ends, you will see your cancer doctor. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The only thing is that the man can get HPV but usually, it is men that are the reservoir for human papillomavirus and they spread it. About half the cases are caused by human papillomavirus and half are caused by lichen sclerosus. Skin changes in the vulva, including what looks like a rash or warts. Be sure to ask the doctor about the cancer stage and what it means for you. The 10 Best Air Purifiers for Allergies of 2023, Everything to Know About Epilepsy Service Dogs, Detection canine program- Borne IED initiative fact sheet and video, Sniffer dogs can identify lung cancer patients from breath and urine samples, Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia, Review and comparison of cancer biomarker trends in urine as a basis for new diagnostic pathways, The mechanisms by which polyamines accelerate tumor spread, Safe and effective deodorization of malodorous fungating tumors using topical metronidazole 0.75% gel (Gk567): a multicenter, open-label, phase III study. Vulvar intraepithelial neoplasia (VIN): VIN occurs when there are abnormal cells on the surface layer of vulvar skin. Cancer Information, Answers, and Hope. In general, doctors know that cancer begins when a cell develops changes (mutations) in its DNA. Pain during sex. Humans average a paltry 6 million. Why do people smell cancer? Increasing Receipt of Ovarian Cancer Care from a Gynecologic Oncologist, U.S. Department of Health & Human Services. Does vulvar cancer have an odor? You know, generally, we say that cancer is a global epidemic. Any type of surgery can have risks and side effects. Scientists are still trying to determine exactly what causes cancer to have a smell. These two particular ones are important and that is why you have them in the available HPV vaccines. Vaginal cancer is a very rare cancer that's found anywhere in the vagina. Vulvar cancer is a type of cancer that occurs on the outer surface area of the female genitalia. They will say that someone caused it or what someone in the past caused it. There are precancerous lesions which cannot be called cancer. 7. Also, later in life, every five years. A diagnosis involves tissue biopsy and histology. Are there any myths about cervical cancer? Based on the stage of the cancer, how long do you think Ill live? Removal of the uterus, cervix and surrounding . Accessed Sept. 30, 2020. See a GP if: you have any symptoms of vaginal cancer your symptoms are new and do not go away Important Abdominal bloating. Its not just every developing country; its those that are very poor including Sub-Saharan Africa, where Nigeria belongs. When a woman with VIN does have a symptom, it is most often itching that does not go away or get better. The lower the number, the less the cancer has spread. Ovarian cancer is a type of cancer found in the ovaries. Cancers. What does it take to outsmart cancer? (401) 651-2622. In these studies, dogs were trained to detect the scent of cancer, often using breath or urine samples. Symptoms depend on whether it is a cancer or pre-cancer and what kindof vulvar cancer it is. Occasionally, it also affects the skin of the genitals. Color: The color over the mole is not the same. This is called a skin graft. CLICK HERE! In Enugu, where I stay out of 100 female genital cancer, about 67 of them are cervical cancer. Vulvar cancer treatment usually involves surgery to remove the cancer and a small amount of surrounding healthy tissue. Due to the nature of cancer and the fact that the cells are uncontrollable, the person can develop the late stage within months. The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. The American Cancer Society offers programs and services to help you during and after cancer treatment. Soreness and a red, scaly area are symptoms of Paget disease of the vulva. Some signs of vulvar cancer are skin changes in part of the vulva, a new bump, skin feeling thick or rough, itching, burning, an open sore, and new bleeding, spotting, or discharge from the vagina. Why not? Then skin must be taken from another part of the body to cover the wound. Thickened skin. So, because developed countries have cancer screening programmes, cervical cancer is no longer a problem to them. Gagandeep Brar, MD, is a board-certified hematologist and medical oncologist in Los Angeles, California. In the early stage of the disease where there might not be any symptoms, a woman could get pregnant. What causes vaginal dryness? The most common symptom associated with vulvar tumors . If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. They are the best way for doctors to find better ways to treat cancer. If youre living with cancer and have concerns about any odor changes in your body, be sure to talk to your cancer care team. Chemo is given in cycles or rounds. The surrounding tissue may contract and pucker. Because women do not screen often for cervical cancer, they present late to the clinic. Surgery is the main treatment for most women. Most vulvar cancers are squamous cell carcinomas. These can include: Verrucous carcinoma, a subtype of invasive squamous cell vulvar cancer, looks like cauliflower-like growths similar to genital warts. It is more common in older . Cancer diagnosis what is it and how to live with it? Sometimes, however, this kind of discharge can also mean cervical, ovarian, uterine, or vaginal cancer. Help us end cancer as we know it,for everyone. The treatment plan thats best for you will depend on: Most women with vulvar cancer have some type of surgery. The bleeding may be abnormal because of how heavy it is, or when it happens, such as bleeding after you have gone through menopause; bleeding between periods; or any other bleeding that is longer or heavier than is normal for you. Although it isn't exactly known which VOC in the cancer the dogs are able to smell, they've been successful in detecting cancer. Call Directions. Cancer? Cervical cancer has pre-invasive stage and the invasive stage precancerous lesions and then, the invasive cancer. Diet and your level of hydration can affect the appearance and smell of urine, says Dr. Adelstein, but so can food, infection, medications, and medical conditions. Cribriform Carcinoma of the Breast Ductal Carcinoma In Situ (DCIS) HER2 Enriched Inflammatory Breast Cancer (IBC) Invasive Ductal . Learn more about how vaginal cancer is diagnosed. Some side effects of chemotherapy and other cancer treatments are unavoidable. How will I know if they are safe? Allscripts EPSi. Lichen sclerosus is a chronic inflammatory skin disease that affects five to ten times as many women (most frequently postmenopausal) as men. Accessed Sept. 30, 2020. Double-blind tests showed 100% sensitivity and 97.5% specificity. punchng.com 1971- 2023 Punch Nigeria Limited, Workplace bullying can affect employees mental health Expert, Cervical cancer vaccine available soonPfizer, Yes Daddy: Obi admits phoning Oyedepo, denies 'religious war' allegation, May Day: Assent research funding bill - ASURI, coalition urge Buhari, [JUST IN] Sudan: Azman Air receives FG's approval to evacuate stranded Nigerians, APC group defends Lukman, asks Adamu to render party account, May Day: Lecturers, doctors, others to benefit from pay rise, says FG, Reps invite telecom companies over poor network coverage, Infidelity: Edo farmer hacks wife with cutlass, commits suicide, JAMB begins release of UTME results Tuesday, Oppositions rigging claim fraudulent, FG insists, Dont attack embassy staff, ambassador warns stranded Nigerian students, Presidency lists Buharis achievements, highlights economic landmark, Man hangs self in Lagos, traditionalists perform cleansing rites. Genital HPV infection Fact sheet. Here you'll find in-depth information on specific cancer types including risk factors, early detection, diagnosis, and treatment options. This is the most common type of hysterectomy. Help us end cancer as we know it,for everyone. Our team is made up of doctors andoncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing. Cancer of the vulva is a rare disease, accounting for 0.6 percent of all cancers in women, and it may form slowly over many years. To be most effective, one of the vaccines should be given before a person becomes sexually active. Rotten like a decaying organism. They can be found throughout the vulva, but most are in the area around the clitoris or on the labia majora or minora. Its not called bladder cancer unless it starts from cells in the bladder. If your sense of smell is sensitive, and possibly causing nausea, avoiding being around smells that you're sensitive to can be helpful. Vaginal cancer is even . In terms of death, it seems cervical cancer is number one. Watanabe K, Shimo A, Tsugawa K, et al. URGENT NEWS: Earn US Dollars directly paid to your account; Nigerians can now earn up to $14,000- $17,000 (12 million+) profiting from premium domain names. More often, however, a lump in this area is from a Bartholin gland cyst, which is much more common (and is not a cancer). Evolving: The mole is changing in size, shape, or color. Rarely, but importantly, vaginal odor can be a sign of a serious health problem, like cancer, according to the Cleveland Clinic. Cauliflower-like wart. They are the ones that can cause cervical cancer especially the high-risk ones. These are the usual. Then, the longer youre cancer-free, the less often the visits are needed. In vulvar specialty clinics, lichen simplex chronicus is frequently encountered. Click here for an email preview. Accessed Oct. 2, 2020. Treatments include surgery, radiation and chemotherapy. 2016;24:2583-2590. There is also the diagnosis of the cancer itself when a woman presents any of the symptoms like post-coital bleeding or foul smelling discharge. But what if? It starts as abnormal cells. AND it was!! Do you think it could cure the cancer? It can lead to it in other genital areas as well, including the vagina, vulva, and penis. Let me paint a picture. 6th ed. Identifying it: The Candida albicans fungus causes an infection in roughly 75% of women at some point. pain and irritation. This compound is often produced at higher levels in cells that are dividing quickly, which cancer cells do. 2011;30(1):95. More from Health Magazine. Research. The cell and its offspring go on living when other normal cells would die. Our team is made up of doctors andoncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing. Together, were making a difference and you can, too. A bump or lump, which could be red, pink, or white and could have a wart-like or raw surface or feel rough or thick, Bleeding or discharge not related to the normal menstrual period, An open sore (especially if it lasts for a month or more). Vulvar cancer usually causes unusual lumps or flat, smooth or rough, red, or flesh-colored sores that can be seen and felt and that do not heal. American Cancer Society medical information is copyrightedmaterial. The earlier cancer is detected and treated, the better your outlook. bleeding after sex or pain during sex smelly or bloodstained vaginal discharge bleeding between periods an itch in your vagina that will not go away pain when you pee, or needing to pee a lot Vaginal cancer is rare, especially in women under 40. This treatment may be given along with chemo to help shrink a tumor so its easier to take it out with surgery. Sometimes infections are to blame for vaginal discharge that is bloody, heavy, and foul smelling. Surgery Most women with vulvar intraepithelial neoplasia (VIN) have no symptoms at all. It is often thicker and lighter than the normal skin around it. Side effects of chemotherapy can lead to alterations in the senses of taste and smell. Biopsy (BY-op-see): Taking out a small piece of tissue to see if there are cancer cells in it. We're improving the lives of cancer patients and their families through advocacy, research, and patient support to ensure that everyone has an opportunity to prevent, detect, treat, and survive cancer. Sometimes doctors might not even recognize the condition at first. An area on the vulva that looks different from normal it could be lighter or darker than the normal skin around it, or look red or pink. Why Does My Scalp Smell and How Do I Treat It? Chemois short for chemotherapy, the use of drugs to fight cancer. It looks like the neck, (the cervix) and when there is cancer, a wound will be seen there they call it lesions and that may be suggestive. Though it can occur at any age, vulvar cancer is most commonly diagnosed in older adults. Diameter: The mole is wider than 6 mm (about 1/4 inch). Also known as a . Squamous cell carcinoma of the vulva: Staging and surgical treatment. However, some (for example, melanomas) grow quickly. Cancer of the vulva is a rare disease, accounting for 0.6 percent of all cancers in women, and it may form slowly over many years. Vulvar cancer commonly forms as a lump or sore on the vulva that often causes itching. Ramirez PT, et al., eds. 2023 American Cancer Society, Inc. All rights reserved. Symptoms of vulvar cancer We hypothesized that if ovarian carcinoma emits a specific odor, dogs may be trained to detect it. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). pain during . Vulvar cancer (squamous cell carcinoma). The average person is not able to detect the smell of cancer, but they may notice changes in the odor of body fluids when they're receiving treatment for cancer. We also partner with CaringBridge, a free online tool that helps people dealing with illnesses like cancer stay in touch with their friends, family members, and support network by creating their own personal page where they share their journey and health updates. It's very important that your particular findings be put into context by an expert. We couldnt do what we do without our volunteers and donors. Mayo Clinic; 2019. It starts in the cells that give the skin its colour (melanocytes), also found in the moist lining of the vulva. In advanced stages, you may experience vaginal discharge with a foul smell. Weve invested more than $5 billion in cancer research since 1946, all to find more and better treatments, uncover factors that may cause cancer, and improve cancer patients quality of life. Skin of the vulva looks white and feels rough. It is a cancer of the cervix. Karam A, et al. It may also be used alone to treat nearby lymph nodes. This combination of fluid and bacteria that make up the vaginal discharge that can, at times, emit certain odors. Cancer cells in the vulva can sometimes travel to the bladder and grow there. Sometimes a lot of skin is removed. While as many as 30 types of bacteria can be found in normal vaginal discharge, about 95% of a healthy vaginal bacteria population consists of lactobacilli. Some signs of vulvar cancer are skin changes in part of the vulva, a new bump, skin feeling thick or rough, itching, burning, an open sore, and new bleeding, spotting, or discharge from the vagina. Lumps, bumps, sores, thickening, and areas of color change should be reported to your HCP. When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. What does vulvar cancer smell like? A partial or modified radical vulvectomy removes part of the vulva, including the deep tissue. Men with lichen sclerosus on the penis may also have an increased risk. Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. I'm also a RN, and I believe cancer does have a "smell" I have often noticed it on pts who weren't diagnosed yet. The precancerous lesions can be identified and treated and that is where the pap smear comes in.

Bill Bellamy Related To Daniel Bellomy, Flexshopper Lease Termination, Articles D