Fallopian tube cancer
- Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
What is fallopian tube cancer?
The fallopian tubes connect the ovaries and the uterus. Fallopian tube cancer occurs when cells in the lining of a fallopian tube multiply out of control and form a tumor. As the tumor grows, it presses on the tube, stretching it and causing pain. Over time, the cancer can spread throughout the pelvis and abdomen.
Statistically, fallopian tube cancer has been described as being very rare. However, scientists have discovered that the most aggressive forms of ovarian cancer actually start in the part of the fallopian tube closest to the ovary. Precancerous and cancerous fallopian tube cells spill out in the small space between the two structures.
Because the cancer most often appears to primarily involve the ovary, it has been classified as ovarian cancer.
Scientists don't know whether environmental or lifestyle factors increase the risk of this cancer. Some researchers think certain women might inherit a tendency to develop fallopian tube cancer.
Women who inherit a mutation in their BRCA1 or BRCA2 genes have a greater risk of developing fallopian tube cancer, as well as breast and ovarian cancer. If a woman is diagnosed with fallopian tube cancer, she should be tested for it. If present, family members may be genetically tested as well. Women will also need to be evaluated for the simultaneous presence of ovarian and breast cancer as well. Emerging research suggests that the most common type of ovarian cancer, called epithelial ovarian cancer, likely begins in the fallopian tube.
Symptoms of fallopian tube cancer
Symptoms of fallopian tube cancer may include:
- abnormal vaginal bleeding, especially after menopause
- abdominal or pelvic pain
- a feeling of pressure, swelling, or bloating in the abdomen
- abnormal vaginal discharge (white, clear, or pinkish).
Although these symptoms can happen in a woman with fallopian tube cancer, they are much more likely to be caused by something else.
Diagnosing fallopian tube cancer
Fallopian tube cancer historically has been considered so rare, doctors usually suspect another gynecological problem and evaluate your risk for gynecological infections, ovarian tumors, or endometrial cancer. (Endometrial cancer affects the endometrium, the lining of the uterus.) These conditions have symptoms similar to fallopian tube cancer.
A doctor may suspect fallopian tube cancer if he or she feels a mass during a pelvic exam. Ultrasound or a computed tomography (CT) scan may show an abnormal growth in the area of the tube.
Your doctor may recommend a needle biopsy for confirmation of the diagnosis. This can be done through the skin, using ultrasound or CT scan to guide the needle or during laparoscopic surgery.
Women often learn that they have this cancer when a fallopian tube is removed to treat another problem. Doctors discover the cancer when they examine it in a laboratory.
If you are diagnosed with fallopian tube cancer, consider getting tested for the BRCA gene mutations. If you have these mutations, you should be tested for breast and ovarian cancers. You should also consider genetic counseling.
Expected duration of fallopian tube cancer
Fallopian tube cancer continues to grow until it is removed. Without surgery, it can spread to other organs.
Preventing fallopian tube cancer
Because fallopian tube cancer previously had been considered so rare, it seemed that there was no way to prevent it. As with ovarian and breast cancers, women with BRCA mutations are at greater risk of developing this cancer and may consider surgery to remove both ovaries and fallopian tubes before cancer can develop.
Now that most ovarian cancers appear to start in the fallopian tubes, women may be offered the opportunity to have their fallopian tubes removed during abdominal surgery done for another reason, such as gallbladder or appendix removal, at the same time.
Treating fallopian tube cancer
Treatment for fallopian tube cancer can include surgery, chemotherapy, and/or radiation therapy.
The extent of surgery depends on the how far the tumor has spread. If the tumor is contained in the fallopian tube, the surgeon will remove the fallopian tubes, ovaries, and uterus. This procedure is called a hysterectomy. If the tumor has spread beyond the tube, pelvic lymph nodes and other tissues may need to be removed.
Following surgery, some doctors recommend radiation therapy. Patients may receive chemotherapy, too, either with or without radiation. The chemotherapy drugs are similar to those used to treat ovarian cancer. In addition, newer drugs that specifically target cancer cells in women with the BRCA mutation(s) may be used.
When to call a professional
Call your doctor if you have abnormal vaginal bleeding, persistent or severe abdominal or pelvic pain, or abnormal vaginal discharge. If you have started menopause, call your doctor right away if you notice vaginal bleeding or a pinkish discharge.
Prognosis
The outlook depends on how far the cancer has advanced. If the cancer is limited to the tube's inner lining, the prognosis is excellent. However, if the cancer has gone into the wall of the fallopian tube or spread to its outer surface, the prognosis is less favorable.
Additional info
National Cancer Institute (NCI)
https://www.nci.nih.gov/
American Cancer Society (ACS)
https://www.cancer.org/
American College of Obstetricians and Gynecologists (ACOG)
https://www.acog.org
About the Reviewer
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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