Fallopian Tube Cancer: Symptoms, Diagnosis & Treatment

What is fallopian tube cancer?

Fallopian tube cancer is not common and starts in the fallopian tubes which join the ovaries to the uterus. During ovulation, tubes help carry the eggs during the ovulation.

Stages of Fallopian Tube Cancer

For fallopian tube cancer, as with ovarian and peritoneal cancer, the FIGO (International Federation of Gynaecology and Obstetrics) staging system is used. Staging is done according to how far the cancer has travelled from where it started in the fallopian tubes.

These are the 4 main stages:

Stage I – Cancer is found only in the fallopian tubes

• Stage IA means the cancer is only found on a fallopian tube without breaking through it and with no sign it has spread.
• Stage IB: The cancer affects only the fallopian tubes and it has not spread outside or burst.
• During stage IC, cancer exists in one or both fallopian tubes and it can come with any of the following:

IC1: A spillage of cancerous tissue might happen during removal.

IC2: Before surgery was performed, the fallopian tube has already ruptured.

IC3: Surgical exam reveals the presence of cancer cells in the fluid around the abdomen.

Stage II – Cancer is found in the pelvis

• At Stage IIA, the cancer is found in the uterus and/or ovaries (adnexa).
• Stage IIB: The cancer continues to grow in other pelvic organs such as the bladder or rectum.

Stage III - cancer is in the belly or close to the lymph nodes

• Stage IIIA1: The cancer is found in retroperitoneal lymph nodes without having left the area.
• IIIA1 (i): The lymph node is no larger than 10 mm.
• IIIA1 (ii): The lymph nodes with metastatic spread measure more than 10 mm
• Stage IIIA2 means cancer cells have moved to the peritoneum (abdomen), although they cannot be seen during surgery.
• Stage IIIB: The spread of cancer is seen in the abdomen or on the omentum and it is no more than 2 cm.
• Stage IIIC includes cancer that measures at least 2 centimeters in the abdomen or appears on the outside of the liver or spleen (not inside).

Stage IV – Distant metastasis

• Stage IVA: Cancer cells are detected inside the pleural fluid (the fluid surrounding the lungs).
• Stage IVB: Growth in the liver, lungs or additional organs or lymph nodes far from the abdomen.

Fallopian Tube Cancer Symptoms

Signs of fallopian tube cancer can be mild and similar to the symptoms of related gynaecological cancers, mainly ovarian cancer. The following are some of the most prevalent symptoms to observe:

Early signs of fallopian tube cancer:

• Abnormal vaginal bleeding or discharge
• Pelvic or abdominal pain
• Pelvic mass or pressure
• Abdominal bloating or swelling
• Changes in urinary or bowel habits
• Pain during intercourse (dyspareunia)
• Unexplained fatigue or weight loss

Causes of Fallopian Tube Cancer

It is unknown exactly why fallopian tube cancer happens, though some risk factors and genetic links can lead to it.

Risk factors for fallopian tube cancer:

Genetic Mutations

• Having BRCA1 or BRCA2 mutations greatly raises your chances of getting these cancers: fallopian tube, ovarian and breast cancers.
• Lynch syndrome makes a person more likely to develop cancers, for example, of the uterus and fallopian tube.

Family History

• Learning that your mother or sister has ovarian, breast or fallopian tube cancer gives you a greater risk of getting these cancers.

Age

• Most cases happen to women between 50 and 60 and this group is mainly made up of postmenopausal women.

Reproductive History

• If a person is not able to have kids (nulliparous), it might increase their chances of developing heart disease.
• Exposure to estrogen lasts for more years than normal when puberty and menopause arrive too early or too late, respectively.

Hormonal Factors

• Taking only estrogen once menopause has occurred might increase your health risks.

Inflammation and Infection

• When there is ongoing inflammation in the reproductive organs (for instance, because of pelvic inflammatory disease or endometriosis), it might have an effect.

Fallopian Tube Cancer Diagnosis

A clinical examination, imaging studies, laboratory tests and surgeries are all part of diagnosing fallopian tube cancer. Its symptoms sometimes line up with those of ovarian cancer which means it needs careful review.

Diagnosis Steps:

Taking a Medical History & Performing a Physical Exam

• The doctor may enquire about unusual problems like bleeding, lower abdominal pain or discharge.
• Do a pelvic exam to look for lumps or any discomfort.

Imaging Tests

• Transvaginal ultrasound is the main test used to look at fallopian tubes and ovaries and find any masses or fluid.
• CT scan or MRI: This imaging is done to check how much disease has spread in the pelvis and abdomen.
• Chest X-ray: To find if there is cancer in the lungs.

Blood Tests

• Fallopian tube cancer: Raised CA-125 is seen, though the marker is not specific for it.
• Further blood testing that helps check your general well-being.

Diagnostic Procedures

• Endometrium or cervical biopsy or Pap smear is usually done just in case there is an unusual finding.
• If there is fluid in the abdomen, a sample can be taken to see if cancer cells are present.

Surgical Evaluation

• Surgically checking and taking a tissue sample from a suspicious area is done by exploratory laparotomy or laparoscopy.
• For a complete diagnosis and staging, the surgeon may take out the fallopian tubes, ovaries, uterus and lymph nodes.
• Pathologist studies tissue to uncover the type of cancer involved.

Chemotherapy for Fallopian Tube Cancer

After surgery for fallopian tube cancer or if it can’t be performed right away, chemotherapy is an important treatment method. Administration of the treatment works to kill any cancer cells that might be left, lower tumor size and help prevent the cancer from coming back.

Schedule:

• The treatment is repeated every 3 weeks (each cycle).
• Most patients have to go through 6 rounds of chemotherapy.

When Chemotherapy is given?

• If cancer cells were not completely removed during surgery, chemo is given to seek out and destroy any tiny pieces left.
• Doctors may use neoadjuvant chemotherapy before surgery if the tumor is too big, to help reduce its size and keep surgery risk-free.
• If the disease comes back, the doctor may repeat chemotherapy or might use a different type of drug according to how the patient responded before.

Fallopian Tube Cancer Treatment Options

Most of the treatments for fallopian tube cancer are established for ovarian cancer and they involve surgery, chemotherapy and at times, targeted treatments.

Surgery (Primary Debulking Surgery)

• Antibiotics are the initial medication prescribed most of the time. 
• Operate to take out as much cancer as can be removed safely (cytoreduction).
• Figure out if the cancer is in the early stages or has travel to other areas.

Common procedures:

• Removing the uterus during total hysterectomy
• Removal of the ovaries and fallopian tubes from both sides (bilateral salpingo-oophorectomy)
• The operation to remove fatty tissue located in the abdomen is called an Omentectomy.
• Surgery to remove (pelvic and para-aortic) lymph nodes
• Performing biopsies or taking fluid samples from the peritoneum

Chemotherapy

• Chemo is generally given after surgery, though it may be started beforehand if the tumor cannot be operated on easily (neoadjuvant chemo).

Targeted Therapy

• In particular, used when cases is complex or repeat, for those with BRCA changes or issues involving homologous recombination deficiency (HRD).

Radiation Therapy

• Used only occasionally, but could be useful when cancer is localized and surgery cannot be done or for palliative treatment.

Clinical Trials

• In some cases, mainly with advanced or recurring disease, patients can access new treatments in clinical trials.
• Immunotherapy
• Mixing more than one chemotherapy medication
• Researchers work on experimental drugs that attack certain genetic mutations.

Fallopian Tube Cancer Survival Rate

Patient outcome with fallopian tube cancer varies mostly according to the stage of cancer at diagnosis, the grade of the tumor and the person’s general health. Since reproductive cancer is rare and detected late by most, stats on survival are limited and usually associated with ovarian and peritoneal malignancies.

• For Stage I (limited to a tube), treating with radiation has a 75% to 95% chance of success.
• Spread to the pelvis (Stage II): The disease affects around 60-80% of patients.
• Stage III (cancer spreads to the abdomen or lymph nodes): Approximately 40-60%
• For people with Stage IV (distant metastasis), the survival rate ranges from 20% to 40%.

Is fallopian tube cancer curable?

Yes, fallopian tube cancer is often curable if it is identified when still in the early stages. Cure rates are highest when the cancer affects only the fallopian tubes or the nearby structures in the pelvis (Stages I and II).

How rare is fallopian tube cancer?

Less than 1–2% of all gynaecologic cancers are fallopian tube cancers.

Rarity by Numbers

• About one woman out of every 500,000 per year gets a diagnosis worldwide.
• It is less common than ovarian, cervical or endometrial cancer.
• Most cases happen in women who have passed menopause (between the ages of 50 and 60).

Fallopian Tube Cancer vs Ovarian Cancer

Fallopian Tube

• Fallopian tube cancer starts in the lining of the fallopian tubes which are small ducts leading from the ovaries to the uterus. 
• Fallopian tube cancer is unusual, being seen in less than 1–2% of all gynecologic cancers. 
• It occurs in about 1 in every 500,000 women every year. 
• Unlike ovarian cancer, fallopian tube cancer often leads to abnormal vaginal bleeding and watery discharge, mainly for postmenopausal women and at times pain when having sex. 
• Fallopian tube cancer usually gets detected earlier than ovarian cancer, often because bleeding can tip doctors off.

Ovarian Cancer

• The most common places for ovarian cancer to start are on the outer surface (epithelium) or in rare cases in the germ or stromal parts of the ovary. 
• One in 78 women has a lifetime chance of developing ovarian cancer. 
• General symptoms of ovarian cancer are bloating, discomfort in the abdomen or pelvis and altered habits with bowel or bladder functions which usually start in the late stages of the disease. 
• Most patients with ovarian cancer are diagnosed late which causes the survival rate to remain low, even if the treatment is similar.

Best Hospital for Fallopian Tube Cancer Treatment in India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket
• Apollo Hospital, Delhi

Best Doctors for Fallopian Tube Cancer Treatment 

• Dr. Rupinder Sekhon
• Dr. Sabhyata Gupta
• Dr. Rama Joshi
• Dr. Kanika Batra Modi
• Dr. Amita Mahajan

Why Choose GetWellGo for Fallopian Tube Cancer Treatment?

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