Fallopian Tube Cancer: Comprehensive Health Information

Fallopian Tube Cancer: A Comprehensive Guide

This information is intended to provide a general overview of Fallopian Tube Cancer. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health.

General Information

Fallopian tube cancer primarily develops in the cells that line the inside of the fallopian tubes, which are the two slender ducts connecting the ovaries to the uterus. In women who have not yet reached menopause, the ovaries release eggs (ova) that travel through these tubes to the uterus.

Types of Fallopian Tube Cancer

The most common form of primary fallopian tube cancer is high-grade serous adenocarcinoma. These cancers begin in the cells that line the fallopian tubes.

Due to the advanced stage at which women often present, primary fallopian tube cancers are frequently difficult to distinguish from primary ovarian cancers. In fact, research suggests that the majority of high-grade serous ovarian cancers may have originated in the epithelium (lining) of the fallopian tube.

Risk Factors

The risk factors for fallopian tube cancer are similar to those for ovarian cancer and may include:

Age and Family History

It can affect women of any age, but it is most frequently diagnosed in women between 60 and 66 years old. A family history of fallopian tube or ovarian cancer is also a risk.

Gene Mutations

Women with certain gene mutations face a higher risk. These include:

  • BRCA Gene Mutations: Especially BRCA1, which significantly raises the risk of breast and ovarian cancer.
  • Hereditary Nonpolyposis Colorectal Cancer (HNPCC): Also known as Lynch syndrome, caused by mutations in one of the related genes.

Factors That May Lower Risk

Some factors appear to lower a woman's risk of developing fallopian tube cancer. These include:

  • Using oral contraceptive pills.
  • Having delivered and breast-fed children. The risk is generally lower with a higher number of children.

If you have risk factors, it is advisable to discuss them with your healthcare provider. For concerns regarding inherited family syndromes that may predispose you to fallopian tube cancer, discuss genetic testing options with your care team at SSCHRC.

Symptoms

In some cases, women with fallopian tube cancer may not experience any symptoms. At other times, the signs can be vague and resemble those of other medical conditions, and they vary from person to person.

If fallopian tube cancer is present, you may experience:

  • Abnormal vaginal bleeding, particularly after menopause.
  • Pain or pressure in the abdominal or pelvic area.
  • Unusual vaginal discharge that is white, clear, or tinged with pink.
  • A palpable mass in the pelvic region.
  • Unexplained fatigue.
  • Unexplained weight loss or gain.
  • Bloating and/or a feeling of fullness, even after consuming a small meal.

It is important to remember that these symptoms do not automatically mean you have fallopian tube cancer. However, you must discuss any persistent symptoms with your doctor, as they may indicate other health problems.

Diagnosis

Obtaining a precise diagnosis as soon as possible is crucial for increasing the chances of successful treatment. However, diagnosing fallopian tube cancer can be challenging because:

It is a rare type of cancer.

Its symptoms are often vague and can mimic those of other conditions.

Locating cancer specifically inside the fallopian tube is difficult.

Diagnostic Tests and Procedures

If your doctor suspects fallopian tube cancer based on your symptoms, they will perform an examination and inquire about your health and family medical history. A pelvic examination will be performed to feel your uterus, ovaries, fallopian tubes, and vagina. Should a mass be detected, further tests will be conducted.

One or more of the following tests may be used to confirm a diagnosis, determine if the cancer has spread, and monitor the effectiveness of treatment.

Biopsy

Cells are removed from the fallopian tubes and examined under a microscope. This is the only definitive way to confirm fallopian tube cancer and typically requires a surgical procedure.

Imaging Tests

  • Pelvic ultrasound.
  • Transvaginal ultrasound (using a special internal wand).
  • CT or CAT (Computed Axial Tomography) scans.
  • MRI (Magnetic Resonance Imaging) scans.

CA125 Test

A blood test that measures the levels of CA125, a known tumour marker for gynaecologic diseases. An elevated level of CA125 may lead to further testing, but it does not exclusively confirm fallopian tube cancer.

Cancer Staging

If you are diagnosed with fallopian tube cancer, your doctor will determine the stage of the disease. Staging is the process of classifying how much disease is present in the body and how far it has spread at the time of diagnosis. This information is vital for your care team to plan the optimal treatment. The stages for fallopian tube cancer are set by FIGO (the International Federation of Gynaecology and Obstetrics), ranging from Stage I to Stage IV. Higher numbers indicate more advanced cancer, which is generally more complex to treat.

Fallopian tube cancer, ovarian cancer, and primary peritoneal cancer are related conditions and share a single set of staging criteria.

Stage I

Cancer is found in one or both ovaries or fallopian tubes.

Stage II

Cancer is found in one or both ovaries or fallopian tubes and has spread into other areas of the pelvis, or primary peritoneal cancer is confined within the pelvis.

Stage III

Cancer is found in one or both ovaries or fallopian tubes, or is primary peritoneal cancer, and has spread outside the pelvis to other parts of the abdomen and/or to nearby lymph nodes.

Stage IV

Cancer has spread beyond the abdomen to other distant organs and tissues of the body.

For women at an increased risk due to BRCA mutations, pre-cancerous lesions called Serous Tubal Intra-epithelial Carcinomas (STIC) have been found during risk-reducing surgery. STIC is an area of ongoing study at SSCHRC.

Treatment

Fallopian tube cancer treatment typically involves surgery and is most successful when performed by a specialist with extensive experience in treating this rare cancer.

SSCHRC surgeons are highly skilled and utilise advanced, minimally invasive techniques for their patients.

Fallopian Tube Cancer Treatment Options

Upon diagnosis, your care team will discuss the best treatment options based on several factors, including the size, location, and stage of the tumour, as well as your age, overall health, and desire to have children.

One or more of the following therapies may be used to treat the cancer or help alleviate symptoms:

Surgery

This is the main treatment, often followed by chemotherapy. The type of surgery depends on the stage of the tumour and may be performed during the same procedure as the biopsy. The fallopian tubes, ovaries, uterus, and cervix, along with nearby lymph nodes, are usually removed. In some cases, minimally invasive laparoscopic surgery may be possible.

Chemotherapy

Chemotherapy drugs are used to kill cancer cells, control their growth, or relieve disease-related symptoms. It may involve a single drug or a combination, depending on the cancer type and growth rate. For fallopian tube cancer, chemotherapy is generally administered after surgery. SSCHRC offers the most current and advanced chemotherapy options.

Radiation Therapy

This therapy uses focused, powerful beams of energy to destroy cancer cells while minimising damage to healthy tissue. Radiation therapy is not typically the primary treatment for fallopian tube cancer, but it may be used post-surgery and chemotherapy, or to manage symptoms if the cancer cannot be cured.

Targeted Therapy

These drugs are designed to interfere with specific molecules (often proteins) that cancer cells need to survive, multiply, and spread. Targeted therapies work at a cellular level to slow or stop the growth of the cancer. SSCHRC is one of the few cancer centres able to offer targeted therapy for certain types of fallopian tube cancer.

Immunotherapy

This treatment works by enhancing the body's immune system's natural ability to locate and eliminate cancer. Immune checkpoint inhibitors may be used in the treatment of fallopian tube cancer.

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