Fallopian Tube Cancer

Every woman has two fallopian tubes; these are fine tubular structures, which connect ovaries to the uterus (womb). During a woman’s childbearing years, the ovaries produce an egg each month. The egg travels through the fallopian tubes to reach the womb. Cancer of the fallopian tubes is an abnormal growth of malignant cells in one or both of a woman’s fallopian tubes. Ovarian, fallopian tube and primary peritoneal cancer have similar clinical presentation and have similar staging and treatment.

What are the causes?
  • Risk increases with age
  • Obesity or being overweight
  • Risk is slightly higher in women who have not had children and in women who have had early menarche (first menstruation) and late menopause
  • If there is family history of ovarian or breast cancer (genetic BRCA1 and BRCA2). 1% of ovarian cancers may be due to hereditary
What are the symptoms?
  • Pain in the tummy
  • Abdominal swelling.
  • Swollen abdomen
  • Feeling full even with small meal
  • Loss of appetite
  • Loss of weight
  • Watery discharge sometimes could be blood tinged
  • Sudden gush of watery discharge
  • Frequency of passing urine
  • Constipation
What test will be required for diagnosis?
  • 1.  To confirm the diagnosis
    • Doctor will usually do a vaginal examination (internal examination) if you have symptoms that may possibly be like
      cervical cancer.
  • 2.  Assessing the extent and spread
    • Once you have been diagnosed then further tests may be advised to assess if the cancer has spread to other organs such as, an ultrasound scan, a CT scan, PET CT an MRI scan, a chest X-ray, blood tests like CA125 tumor marker or other tests.
    • This assessment is called staging of the cancer, done to asses the extent of the spread and to know the stage.
    • If your tummy is swollen with fluid (called ascites) of mass, you may be advised to have this fluid drained or have biospy of the mass. This is usually done with the help of ultrasound (ultrasound guidance). The removed fluid or biopsy of the mass may be checked for cancer cells.
What are the treatment options available?
  • Surgery is the mainstay of treatment. The type of surgery will depend on the stage of cancer and age of the patient.
  • Guideline is to remove womb with cervix (total hysterectomy), both ovaries and fallopian tubes (bilateral salpingo-oophorectomy), fatty apron near the stomach (omentum) and fatty tissue (lymph glands) and to remove all the visible tumor, this surgery is known as cytoreductive surgery (CRS). There are various surgical treatment for ovarian cancer depending on the stage of the cancer and other considerations. Aim of the surgery is – not gross tumor left behind.
  • When the cancer is in advance stages, you may be advised to have neo-adjuvant chemotherapy (NACT) to shrink the tumor and then go for CRS.
  •  Chemotherapy
    • In chemotherapy treatment drugs are used to kill or slow the growth of cancerous cells. It’s usually given through an IV injection.

Though fallopian tube cancer is not preventable, women can lower the risk by having children or with hormonal birth control. Women with the BRCA1 gene or a family history of this cancer should be monitored closely. Some women with genetic abnormalities choose to have a prophylactic removal of the ovaries and fallopian tubes.

Follow-up after treatment
  • You should strictly follow-up with your doctor as per their advice.
  • In addition to receiving treatment for cervical cancer your success of treatment will depend only when you have regular follow-up.