What is Fallopian Tube Cancer?
Like most cancers, Fallopian Tube Cancer starts when abnormal cells are rapidly produced, causing tumors. Some tumors are harmless, which are known as benign tumors. Cancerous tumors are called malignant and can be spread to other parts of the body.
The fallopian tubes are two narrow ducts that extend out from either side of the uterus, reaching towards the ovaries. They provide a pathway for eggs to travel from the ovary to the uterus.
In the United States, fewer than 1% of gynecologic cancers are fallopian tube cancers. Cancer that starts in the fallopian tubes is rare. Most cancers that affect the fallopian tubes originate elsewhere in the body.
Fallopian Tube Cancer and Other Cancers
Fallopian tube cancer is fairly rare. It occurs in about 1% of cancers in the female reproductive system. It is more common for malignant cancers to start elsewhere, such as in the uterus, ovaries, endometrium, colon, or appendix, and then spread to the fallopian tubes.
However, new research suggests that some ovarian cancers are linked to fallopian tube cancer. When fallopian tube cancer affects the fimbriae (the fringe-like fingers at the end of the fallopian tubes), the cancerous cells could travel to the ovaries, causing ovarian cancer.
Types of Fallopian Tube Cancer
Carcinomas can grow from any of the three types of cells that comprise the fallopian tubes.
- Adenocarcinoma – This type of cancer begins in the glands. It is the most common form of fallopian tube cancer.
- Transitional cell carcinoma – This is a cancer of the fallopian tube lining.
- Leiomyosarcoma – This cancer affects the smooth muscle tissue of the fallopian tubes.
Risk Factors for Fallopian Tube Cancer
Because this type of cancer is so rare, risk factors are not well understood. However, as with most cancers of the reproductive system, the risk of fallopian tube cancer may increase with:
- Fallopian tube cancer most often occurs in women between the ages of 50-70.
- A family history of fallopian tube cancer. There may be a hereditary component to developing this type of cancer.
- Gene mutation. A mutation in the BRCA1 gene has been linked to ovarian and breast cancer, and studies have shown it may increase the risk of fallopian tube cancer as well.
When fallopian tube cancer is advanced, the abdominal cavity may fill with fluid, and women may feel a large lump in the pelvis.
Having a close relative (mother, sister, daughter) with ovarian or breast cancer also raises your risk. You’re more likely to get fallopian tube cancer if you inherited a change (mutation) to the BRCA gene, which makes ovarian and breast cancers more likely.
Preventing Fallopian Tube Cancer
Women at increased risk of developing fallopian tube cancer may wish to talk to their doctor about a salpingo-oophorectomy. In this procedure, the surgeon removes the fallopian tubes and the ovaries as a preventative measure against cancer, even if cancer has not been diagnosed. If you have a history of breast or ovarian cancer in your family, you should discuss your concerns with a genetic counselor.
Fallopian Tube Cancer Symptoms
The key to a good prognosis for patients with fallopian tube cancer is to catch it in its early stage. Unfortunately, many patients do not report any symptoms at all, or their symptoms are confused with an unrelated medical condition. Some common symptoms of fallopian tube cancer include:
- Abnormal vaginal bleeding
- Clear, white, or bloody vaginal discharge
- Heavy or irregular bleeding, especially post-menopause
- Abdominal pain or pressure
- A pelvic mass or lump
- Pelvic pain or cramping
- Lump or swelling in your lower belly
Diagnosing Fallopian Tube Cancer
If you are experiencing symptoms, visit your gynecologist right away. Your gynecologist will provide you with a pelvic examination and order imaging and blood tests to make a diagnosis. Some tests that you may receive include:
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Blood/CA-125 array tests
Your doctor will check your blood for a chemical called CA-125. The presence of CA-125 may indicate the presence of a fallopian tube tumor. This test is most helpful for post-menopausal patients. In younger women, the presence of CA-125 more often indicates endometriosis or pelvic inflammatory disease.
Ultrasound
Your doctor may conduct a transvaginal ultrasound to detect a mass in the fallopian tubes. In this procedure, a slender wand is inserted into the vagina – the wand emits ultrasonic waves to create a picture of the pelvic organs.
Genetic testing
A genetic specialist can examine your DNA to detect a mutation of the BRCA1 gene. Detecting this mutation can help your doctors understand more about your risk for fallopian tube cancer and related cancers.
CT scan (Computed Tomography)
This is an imaging technique that uses X-rays to create a 3D projection of the inside of your body.
MRI (Magnetic Resonance Imaging)
This technology can create detailed images of your internal organs using magnetic waves.
Fallopian Tube Cancer Treatment
The treatment for fallopian tube cancer will take into account the patient’s stage of the disease, medical history, current health and personal preference, and other health care factors. The goal of treatment of fallopian tube cancer is to get rid of cancer completely with minimal side effects. A doctor specializing in gynecologic oncology typically treats this type of cancer, which is a doctor who specializes in treating gynecologic cancers. These providers typically perform the surgery and manage the chemotherapy treatments, which is different from most cancer care providers for other types of cancer.
If your gynecologist believes you have fallopian tube cancer, you will be referred to an oncologist for further evaluation and treatment. In some cases, chemotherapy may be recommended as a follow-up treatment to surgery. Your doctor will then discuss your treatment options and help you decide the best course of action for you.
Treatment of fallopian tube cancer almost always consists of removal of the uterus (hysterectomy) and removal of the ovaries and fallopian tubes (salpingo-oophorectomy for early-stage of cancer), adjacent lymph nodes, and surrounding tissues. These procedures are usually done when surgery to stage the cancer is done. Sometimes surgery to stage and treat fallopian cancer can be done using a laparoscope.
For advanced stages of cancer, such as stage III, or stage IV, that has spread to other parts of the body, doctors usually remove as much of the cancer as possible. This type of surgery is called cytoreductive surgery. Depending on where cancer has spread, you may be treated with chemotherapy instead of or before surgery.
Chemotherapy for cancer patients is usually necessary after surgery. Chemotherapy may be used to destroy any small areas of cancer cells that may remain. The most commonly used chemotherapy drugs are carboplatin plus paclitaxel. Radiation therapy is rarely useful. For cancer that has spread to other parts of the body, removing as much of cancer as possible improves your prognosis.
After treatment for fallopian tube cancer, your health care team will monitor you for the recurrence of the disease and to monitor and treat any side effects you may be experiencing from your treatment. Your provider will do a physical exam at each follow-up appointment and will do blood tests to monitor for tumor markers. If you are exhibiting any symptoms of recurrence your provider may order further imaging tests. It is important to be open and honest with your doctor regarding any new or recurring symptoms you may be experiencing.
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If you believe you are experiencing symptoms of, or suffering from Fallopian Tube Cancer, or have questions about it, please see your doctor.
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