Fallopian tube cancer is a rare gynecological cancer that develops in the tubes connecting the ovaries to the uterus. Symptoms include pelvic pain, bloating, and changes in bowel or bladder habits. Diagnosis involves exams, imaging, blood tests, and biopsies. Treatment includes surgery, chemotherapy, and sometimes targeted therapies, depending on the cancer’s stage. Early detection is important for better outcomes, and managing risk factors, like family history and genetic mutations, is advised.
How common is fallopian tube cancer?
It is rare and accounts for a small percentage of all female cancers. Its prevalence is much lower than more common cancers such as ovarian, uterine, and cervical cancers. Because of its rarity, collecting comprehensive statistics on its occurrence can be challenging. However, awareness and early detection efforts are important in improving outcomes for those affected by this rare type of cancer. Less than 1% of women’s cancers start in the fallopian tubes.
Symptoms
Symptoms can be vague and easily missed. You should see your healthcare provider anytime you notice a change in your health, especially if you have cancer risk factors. Symptoms of cancer include:
- Frequent urination
- Painful intercourse
- Pelvic pain or mass
- Chronic back pain
- Constipation
- Fatigue
- Feeling full quickly
- Abdominal pain or bloating
- Abnormal menstruation
- Upset stomach (indigestion)
- Watery or bloody vaginal discharge
Risk factors
While the exact cause of fallopian tube cancer is not fully understood, several risk factors have been identified that may increase the likelihood of its development.
Age
Fallopian cancer is more commonly diagnosed in women over 50, with the risk increasing as women get older.
Family history
A history of ovarian or breast cancer in close relatives (such as mother, sister, or daughter) may increase the risk of fallopian tube cancer. Mutations in the BRCA1 or BRCA2 genes, associated with a higher risk of breast and ovarian cancers, can also elevate the risk.
Inherited genetic mutations
Certain inherited genetic mutations, such as those associated with Lynch syndrome and hereditary nonpolyposis colorectal cancer (HNPCC), can also increase cancer risk.
Personal history of gynecological cancers
Women previously diagnosed with ovarian, uterine, or breast cancer may have a slightly higher risk for fallopian tube cancer.
Infertility or no pregnancy
Some studies suggest that women who have never been pregnant or have experienced infertility may have a slightly increased risk of fallopian tube cancer.
Hormone replacement therapy
Long-term estrogen-only hormone replacement therapy (HRT) after menopause may slightly elevate the risk.
Tubal Ligation
Some research suggests that women who have had tubal ligation (surgical sterilization) might have a reduced risk of fallopian tube cancer, possibly due to the disruption of the path that cancer might take to develop.
Endometriosis
Although the association is not fully understood, some studies have suggested a potential link between endometriosis and an increased risk of certain gynecological cancers, including fallopian tube cancer.
It’s important to note that having one or more of these risk factors does not necessarily mean that an individual will develop fallopian tube cancer. Conversely, some women without these risk factors may still develop the disease. Regular health check-ups and discussions with healthcare providers can help assess individual risk and determine appropriate screening and preventive measures.
What is the cause of fallopian tube cancer?
For most people with fallopian tube cancer, the cancer starts somewhere else in the body and then spreads to the fallopian tubes. Cancer that spreads is metastatic.
When cancer originates in the fallopian tubes, nine times out of 10, it develops in glandular cells (adenocarcinoma). The rest of the fallopian tube cancers start from connective tissue (sarcoma).
Recent research suggests that the most common type of ovarian cancer may start as fallopian tube cancer. The cancer starts at the end of the tube, where eggs enter the ovary, then spread to the surface of the ovary.
The cancer may account for up to 70% of all epithelial ovarian cancers. Most ovarian, fallopian tube and peritoneal cancers are grouped for diagnosis, treatment, and management.
Diagnosis
Diagnosing typically involves a series of medical evaluations and tests to determine whether a woman has the disease. The diagnostic process may include the following steps.
Medical history and physical examination
The initial step involves discussing the patient’s medical history, including any symptoms they are experiencing and their family history of cancer. A thorough physical examination, including a pelvic exam, is performed to assess the presence of any abnormalities or signs of disease.
Imaging tests
Imaging tests such as ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI) may be conducted to visualize the pelvic area and assess the extent of any potential tumors.
Blood tests
A blood test to measure the levels of the CA-125 tumor marker may be performed. While elevated CA-125 levels can indicate various gynecological conditions, including cancer, they are not specific to fallopian tube cancer and must be interpreted with other diagnostic findings.
Biopsy
The most definitive way to diagnose fallopian tube cancer is through a biopsy, in which a small tissue sample is taken from the suspected tumor. This tissue sample is then examined under a microscope by a pathologist to determine whether cancer cells are present and to identify the type and stage of cancer.
Surgery
In some cases, if a tumor is detected and other diagnostic methods are inconclusive, surgical exploration (laparoscopy or laparotomy) may be recommended. During surgery, the surgeon can visually inspect the pelvic region, take tissue samples for biopsy, and potentially remove the tumor for further analysis.
Staging
If cancer is confirmed, further tests, such as additional imaging or biopsies, may be performed to determine the cancer stage. Staging helps determine the extent of the cancer’s spread and guides treatment decisions.
Genetic testing
Given the association between fallopian tube cancer and genetic mutations, genetic testing may be recommended to assess for mutations in genes such as BRCA1 and BRCA2. This information can influence treatment decisions and may also affect family members.
It’s important to consult with a gynecologic oncologist, a specialist in treating gynecological cancers if fallopian tube cancer is suspected. Timely diagnosis is crucial for determining the appropriate treatment plan and improving the chances of successful outcomes.
How is fallopian tube cancer staged?
Healthcare providers use staging to describe the location and spread of cancer. This information helps providers choose the most effective treatment.
Staging is often by surgery or possibly by imaging (CT or PET) scan. Often, a biopsy is part of surgery for fallopian tube cancer. Your surgeon will remove the fallopian tube and nearby lymph nodes. A specialist examines tissue samples from the ducts and lymph nodes to check for cancer cells. The stages of fallopian tube cancer are:
- Stage 1: Cancer affects one or both fallopian tubes.
- Stage 2: Cancer affects the fallopian tube and adjacent tissues in the pelvic area.
- Stage 3: Cancer has spread outside the pelvic area, affecting lymph nodes or organs.
- Stage 4: Cancer affects the liver or distant organs such as the lungs or brain.
Treatment
Treatment typically depends on factors such as the stage of cancer, the patient’s overall health, and the individual’s preferences. Options may include:
- Surgery: Surgery is usually the primary treatment for fallopian tube cancer. The extent of the surgery depends on the stage of the cancer and whether it has spread to nearby tissues or organs. Surgical options may include a hysterectomy (removal of the uterus), bilateral salpingo-oophorectomy (removal of both fallopian tubes and ovaries), and removal of nearby lymph nodes.
- Chemotherapy: Chemotherapy is often recommended after surgery to destroy any remaining cancer cells and reduce the risk of recurrence. It may also be the primary treatment for advanced or metastatic fallopian tube cancer. Chemotherapy drugs are typically given in cycles, allowing the body time to recover between treatments.
- Radiation Therapy: Radiation therapy uses high-energy rays to target and kill cancer cells. It is less commonly used for fallopian tube cancer but might be recommended in certain cases, such as when cancer has spread to nearby tissues.
- Targeted Therapy: Targeted therapies are drugs that specifically target certain molecules or pathways involved in the growth and spread of cancer cells. These therapies can be used in cases where specific genetic mutations or abnormalities are present in the cancer cells.
- Clinical Trials: Clinical trials involve testing new treatments or treatment combinations to determine their effectiveness and safety. Participating in a clinical trial can provide access to cutting-edge treatments that may not be widely available.
It’s important for individuals diagnosed with fallopian tube cancer to work closely with a multidisciplinary team of healthcare professionals, including gynecologic oncologists, medical oncologists, and radiation oncologists. They can help determine the most appropriate treatment plan based on the individual’s situation.
Prevention
Preventing cancer, like other types, involves a combination of healthy lifestyle choices, regular screenings, and understanding your risk factors. While it’s not always possible to completely prevent cancer, you can take steps to reduce your risk.
Regular check-ups
Schedule regular check-ups with your healthcare provider. They can help you monitor your reproductive health and identify potential issues early.
Know your risk factors
Understand your personal and family medical history. Some genetic mutations and family history of certain cancers can increase your risk.
Healthy diet
Maintain a balanced diet of fruits, vegetables, whole grains, and lean proteins. A diet high in antioxidants and fiber may help reduce cancer risk. Limit processed foods, sugary drinks, and excessive red meat consumption.
Maintain a healthy weight
Being overweight or obese can increase the risk of various cancers, including those affecting the reproductive organs. Aim for a healthy weight through a balanced diet and regular physical activity.
Physical activity
Engage in regular physical activity. Aim for at least 150 minutes of moderate or 75 minutes of vigorous-intensity exercise per week.
Limit alcohol consumption
Excessive alcohol consumption is associated with an increased risk of various cancers. If you drink alcohol, do so in moderation.
Avoid smoking
Smoking is linked to numerous types of cancer, including ovarian and fallopian tube cancer. If you smoke, seek support to quit.
Oral contraceptives
Some studies suggest that long-term use of oral contraceptives (birth control pills) can lower the risk of ovarian and fallopian tube cancers. Discuss the potential benefits and risks of oral contraceptives with your healthcare provider.
Consider surgical options
Suppose you have a high genetic risk for ovarian or fallopian tube cancer due to inherited mutations (such as BRCA1 or BRCA2). In that case, you might consider preventive surgeries like a prophylactic bilateral salpingo-oophorectomy. However, these decisions should be carefully considered in consultation with healthcare professionals.
Educate yourself
Understand the symptoms of the fallopian tube and ovarian cancers, such as bloating, pelvic pain, changes in bowel or bladder habits, and feeling full quickly. Early detection and treatment can make a significant difference in outcomes.
Remember that risk reduction strategies can vary based on individual circumstances. If you’re concerned about your risk of fallopian tube cancer or any other health issue, it’s important to consult with a qualified healthcare provider. They can provide personalized advice based on your medical history and risk factors.
The bottom line
Fallopian tube cancer is a rare female cancer. People who have a BRCA gene mutation may be more likely to develop fallopian tube cancer. It’s easy to dismiss symptoms like bloating, abdominal pain, and indigestion as something else. If symptoms persist or interfere with daily life, see your doctor. The prognosis is good for people who find fallopian tube cancer early before the cancer has spread outside the pelvic area.
Additional questions
- What is the prognosis of fallopian tube cancer?
If ovarian and fallopian tube cancers are detected and treated before they spread beyond the ovaries and tubes, the 5-year relative survival rate is 93 percent. Approximately 20% of women with epithelial ovarian and fallopian tube cancer are diagnosed at this stage.
- How to prevent fallopian tube infection?
Timely treatment prevents blockage or ulceration of the fallopian tubes. The doctor prescribes oral antibiotics to treat a minor infection. If the infection is severe and causes blockage or scarring, the doctor will perform surgery to remove the affected areas.
- What happens to the woman after closing the tubes?
After the operation, you will have some pain in your stomach and feel tired. The type of anesthesia used and how the surgery is performed can also affect your symptoms. The most common side effect of tubal ligation is shoulder pain.
- Is adenocarcinoma serious?
Yeah. Adenocarcinoma can spread to other parts of the body. This happens when cancer cells break away from the tumor and travel throughout the body through the bloodstream or lymphatic system. This is called invasive adenocarcinoma.
- What is the tumor marker CA-125?
CA-125 is a biomarker or substance in the blood that may indicate a disease. A high level of CA-125 can be a sign of ovarian cancer. The ovaries are a pair of reproductive glands that store and release eggs and produce hormones.
References
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fallopian-tube-cancer
https://my.clevelandclinic.org/health/diseases/21540-fallopian-tube-cancer
https://www.mountsinai.org/care/cancer/services/gynecologic/conditions/fallopian-tube
