Fallopian tube cancer or tubal cancer is a type of cancer that develops in the fallopian tubes connecting the ovaries with the uterus. This rare cancer accounts for only 1 to 2 % of all gynecological cancers and often affects women between 50 to 60 years of age. For most people with this cancer, it doesn’t start from the fallopian tube itself but rather metastasizes to this site from other parts of the body. In other cases, it begins from the fallopian tube’s gland cells (adenocarcinomas) or connective tissues (sarcomas). Besides this, recent evidence suggests that cancers originating from this organ may be responsible for a significant subset of other cancers like ovarian cancers. While it may be challenging to diagnose, prompt treatment increases the patient’s survival rate once correctly identified.
Causes of Fallopian Tube Cancer
The exact etiology behind fallopian tube cancer remains unknown. Some risk factors that increase the chances of getting this cancer have been identified. In recent years, growing evidence suggests that the most common type of ovarian cancer begins as fallopian tube cancer. Therefore, most risk factors associated with fallopian tube cancer overlap with that seen in ovarian cancer. These include:
- Advancing age – Women between 50 to 60 years of age are at a higher risk.
- Ethnicity – People of Northern European or Ashkenazi Jewish ancestry are at a higher risk.
- Infertility problems
- Having no pregnancies
- Family history of breast, ovarian, or fallopian tube cancer (Read Breast Cancer: What are the Symptoms and Treatment?)
- Inherited genetic mutations in the breast cancer gene (BRCA gene)
- Early menstruation (before 12 years of age) or late menopause
- Hormone replacement therapy after menopause
- Endometriosis
- ·Obesity (during early adulthood).
Symptoms
The symptoms of fallopian tube cancer are often vague and easily misidentified or dismissed. The commonly observed symptoms include:
- Abdominal pain or bloating
- Abnormal menstruation, especially after menopause
- Chronic back pain
- Constipation
- Fatigue
- Abnormal vaginal discharge that is white, clear, or pinkish
- Presence of pelvic mass
- Frequent urination
- Lump or swelling in the lower belly
- Painful intercourse
- Indigestion
Screening tests
The diagnosis begins with a general physical examination enabling the doctor to understand the symptoms better. If a malignancy is suspected, the physician recommends additional screening tests to confirm fallopian tube cancer. These include:
Ø Pelvic exam: The doctor will physically examine the abdomen externally and internally to look for lumps or tender areas. It helps to find out any abnormality in this area.
Ø Imaging tests: Imaging tests like transvaginal ultrasound, MRI, PET, and CT scans are done to produce images of the area where the tumor is suspected. These create images of the fallopian tubes and the ovaries. Healthy tissues, fluid-filled cysts, and tumors look different in this picture.
Ø CA125 test: A blood sample is taken and analyzed to measure the blood protein levels called CA125. People with fallopian tubes or ovarian cancer show elevated blood protein levels. However, it could also suggest other health conditions. It cannot be used as a stand-alone test for confirming fallopian tube cancer.
Ø Biopsy: In this procedure, a small sample of the abnormal tissue from the tumor is removed and examined by a pathologist. This helps to distinguish the type of tumor cells present in the malignancy.
Treatment for Fallopian Tube Cancer
The following approaches treat fallopian tube cancer:
- Surgery – Surgery is the first step in treating this cancer. A total abdominal hysterectomy removes the uterus, cervix, fallopian tubes, and ovaries. Another surgical procedure called salpingo-oophorectomy is also adopted for treating this cancer. It involves the removal of the fallopian tube and ovary only. It is recommended for treating early-stage fallopian tube cancer.
- Chemotherapy – This multimodality treatment is used in patients to shrink tumors and kill the lingering tumor cells after surgery. It is also used to control secondary cancers, given systemically to the patient.
- Radiation therapy – High-powered beams such as x-rays or protons are used to kill cancer cells. It is not commonly used for treating fallopian tube cancer.
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