Fallopian Tube Cancer

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 a similar clinical presentations and have similar staging and treatment. Studies have shown that the origin for ovarian cancer starts from the fimbrial end of the fallopian tube

Where are the fallopian tubes situated in the body?

Every woman has two fallopian tubes; these are fine tubular structures, which starts from 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. 

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 a family history of ovarian or breast cancer (genetic BRCA1 and BRCA2) the risk of developing fallopian cancer is high.

  • Hereditary breast and ovarian cancer syndrome (HBOC): women with HBOC are characterized by a high risk of breast and ovarian cancers and they tend to develop cancer of the ovary, fallopian tube, and primary peritoneal cancer at an earlier age than the general population.

Hereditary breast and ovarian cancer syndrome 

What are the symptoms?
  • Pain in the tummy

  • Swollen abdomen

  • Feel lump in your tummy

  • Feeling full even with a small meal

  • Loss of appetite

  • Loss of weight

  • Frequency of passing urine

  • Constipation

  • Heartburn

What tests will be required to diagnosis?

1.  To confirm the diagnosis:

  • Doctor will usually do a vaginal examination (internal examination) if you have symptoms that may possibly be like cancer.

 

2.  Assessing the extent and spread:

  • 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.

 

  • 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?

Fallopian tubes cancers are treated like ovarian cancer.

Surgery:

  • Surgery is the mainstay of treatment. The type of surgery will depend on the stage of cancer and the age of the patient.

  • The guideline is to remove womb with the 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 fallopian tube cancer depending on the stage of cancer and other considerations. Aim of the surgery is – no gross tumor left behind.

  • HIPEC (Hyperthermic intraperitoneal chemotherapy): is an intra-operative procedure that may be offered on a case to case basis. The principle of this procedure is that after complete removal of the tumor the tummy is washed with heated chemotherapy.











     

  • When the cancer is in advance stages, you may be advised to have neoadjuvant chemotherapy (NACT) to shrink the tumor and then go for CRS this is sandwich therapy: neoadjuvant chemotherapy.

Chemotherapy:

In chemotherapy, treatment drugs are used to kill or slow the growth of cancerous cells. It’s usually given through an IV injection. Chemotherapy given after surgery is known as adjuvant chemotherapy.

Follow-up after treatment
  • You should strictly go for follow-up with your doctor as per their advice.

  • In addition to receiving treatment for fallopian tube cancer, your success of the treatment will depend only on when you have a regular follow-up.

Prevention of fallopian tube cancer

Though fallopian tube cancer is not preventable, women with the BRCA1 gene or a family history of this cancer should be monitored closely. Some women with genetic abnormalities choose to have prophylactic removal of the ovaries and fallopian tubes in order to prevent them from developing fallopian tube cancer.

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