Fallopian tube cancer

Fallopian tube cancer is one of the rarest gynecological cancers. Older women who have been through the menopause are the most commonly affected group, for reasons that are not understood. Growing evidence suggests that many ovarian cancers actually begin in the fallopian tubes, so the risk factors for fallopian tube cancer are similar to those for ovarian cancer. They include inherited (gene) risks and not having children.

The fallopian tubes are part of the female reproductive system. The two tubes extend from the uterus (womb), one on each side, and each opens near an ovary. The tubes carry the ova (eggs) from the ovaries to the uterus.

Symptoms of fallopian tube cancer#

In its early stages, fallopian tube cancer often has no symptoms and may be discovered by chance during tests for other conditions. Symptoms tend to appear once the cancer has reached its later stages, and may include:

• Unusual vaginal bleeding that is not related to menstruation
• Watery or blood-stained vaginal discharge
• Swelling of the lower abdomen that is not related to weight gain
• A lump in the lower abdomen
• Pain in the lower abdomen
• A sensation of pressure against the bowel or bladder
• A feeling that the bowel or bladder cannot be fully emptied

Causes and risk factors#

The cause of fallopian tube cancer is not known, but suspected risk factors include:

• Advancing age. Most women with this type of cancer are diagnosed between 50 and 60 years of age.
• Inherited gene mutations, such as BRCA.
• Having been through the menopause.
• Not having children.

Diagnosis of fallopian tube cancer#

Fallopian tube cancer may be diagnosed using a number of tests, including:

• Medical history and physical examination, including a pelvic examination
• Blood tests
• Ultrasound of the pelvis
• Other scans, such as CT and MRI
• Keyhole surgery (laparoscopy) or exploratory abdominal surgery (laparotomy)
• Biopsy of the suspected cancer tissue

Treatment for fallopian tube cancer#

Treatment depends on several factors, including the woman’s general health, whether she wants to have children, and the size and stage of the cancer (whether it has spread to other parts of the body). Treatment may include:

• Surgery. This may involve a salpingo-oophorectomy (removal of the affected fallopian tube and its ovary), a bilateral salpingo-oophorectomy (removal of both tubes and both ovaries), or a hysterectomy (removal of the internal reproductive organs, including the fallopian tubes, ovaries and uterus). The omentum (an apron of fat that hangs down from the stomach) is often removed, and multiple biopsies are usually taken to fully stage the cancer and check for any spread outside the tube. A bowel resection may be needed if the cancer has spread to the bowel.
• Chemotherapy. The use of cancer-killing drugs, often in combination. Because the whole body is treated, chemotherapy can help control secondary cancers. It is usually required after surgery.
• Radiation therapy. The use of precisely targeted x-rays to kill cancer cells. This is not commonly used for fallopian tube cancer.

Long-term monitoring#

Regular check-ups are needed to make sure you remain free of cancer. Generally, you will need to see your doctor every three months for the first two years, then twice a year for the next three years.

Your long-term outlook depends on the stage of the cancer at the time of diagnosis, such as whether it had spread to other parts of the body. If the cancer is diagnosed and treated in its early stages, the survival rate at five years is about 84 per cent.

Key points#

• Older women who have been through the menopause are the most commonly affected group, for reasons that are not understood.
• Because the whole body is treated, chemotherapy can help control secondary cancers.
• Radiation therapy is not commonly used for fallopian tube cancer.

Where to get help#