Fallopian Tube Cancer

Fallopian tube cancer is an extremely rare disease that develops inside one or both of a woman’s fallopian tubes, the thin ducts that transport eggs from the ovaries to the uterus. This type of cancer accounts for only about 1% of all female gynecologic cancers. It’s estimated that only a few hundred cases are diagnosed in the United States each year.

The vast majority of fallopian tube cancers are papillary serous adenocarcinoma, which begin in cells in the lining of the fallopian tubes. A small percentage are sarcomas, which develop from connective tissue.

Our patients with fallopian tube cancer are treated in the Gynecologic Cancer Unit. See the Gynecologic Cancer Unit for more information.

You can also review the tabs at top of this page for information on fallopian tube cancer symptoms and risks, diagnosis, and treatment.

Symptoms

The most common symptoms of fallopian tube cancer are:

• Irregular or heavy vaginal bleeding (especially after menopause)
• Abdominal or pelvic pain
• Vaginal discharge
• A pelvic mass at the time of diagnosis (in up to two-thirds of patients)
• One particular symptom associated with fallopian tube cancer is called “hydrops tubae profluens.” This occurs when fluid that has collected in the fallopian tube is suddenly released through the uterus, causing a large amount of watery or pink-tinged fluid to come from the vagina.

Risks

Because of its rarity and the relative lack of research about it, the causes and risk factors for fallopian tube cancer are largely unknown. Studies have shown a correlation between this type of cancer and having a mutation of the BRCA1 or BRCA2 gene, which is also a genetic factor in ovarian and breast cancers.

Additional risk factors may include:

• Age: Most women with this type of cancer are between 50 and 60
  
• Ethnicity: This disease appears more frequently in Caucasians than women of other races
  
• Medical History: Having a history of unexplained infertility, chronic infection and/or inflammation of the fallopian tubes

Due to the difficulty of viewing inside the fallopian tubes, diagnosing this cancer can be difficult. Your physician may perform one or more of the following:

• Blood tests to measure for cancer antigen 125 (CA-125), a tumor marker.
• Laboratory tests to look for cancer cells in cervical and vaginal fluids and to examine tissue biopsies from the uterus.
• Imaging tests such as ultrasound or computed tomography (CT) scans to detect masses.

Occasionally, a laparoscopy (minimally invasive surgery) will be performed to view the affected area.

Staging

A process known as staging is used to determine whether the cancer has spread and if so, to what extent. Staging helps to determine the best course of treatment.

Stages of fallopian tube cancer are:

• Stage I: The tumor is limited to the fallopian tubes
• Stage II: The cancer has spread outside the fallopian tubes to the pelvic area.
• Stage III: The cancer includes peritoneal implants outside of the pelvis, and/or spread to the lymph nodes.
• Stage IV: The cancer has spread distantly to other organs, such as the liver.

Treatment options for fallopian tube cancer can depend on several factors, including the type and stage of the tumor, as well as the patient's age and desire to have children in the future.

Surgery is the primary treatment the type depends on the exact location and spread of the cancer. Surgical options include:

• Salpingo-oophorectomy: Removal of the diseased fallopian tube and its ovary. The layer of fat that covers the abdomen, called the omentum, is also generally removed on the affected side.
• Bilateral salpingo-oophorectomy: Removal of both fallopian tubes and ovaries, as well as the entire omentum.
• Hysterectomy: Removal of the fallopian tubes, ovaries and uterus. The omentum is also removed.

In most cases, surgery is followed by chemotherapy, the use of anticancer drugs to destroy any remaining cancer cells. Fallopian tube cancer in its very earliest stages may be treated by surgery alone. Generally, radiation therapy is not used in this type of cancer.