What is fallopian tube cancer
Fallopian Tube Cancer is a type of cancer that develops in the tubes that connect the ovaries and uterus. It is very rare and accounts for only 1% to 2% of all gynecologic cancers. The tubes are more often sites of metastasis of tumors originating in the ovaries or endometrium than the primary site of neoplasm development. This type of cancer usually affects women over the age of 50, although it can occur at any age. It is more common in Caucasian women who have had few or no children.
Cancer of the fallopian tubes, like ovarian and primary peritoneal cancer, forms in the epithelial cells that line the organ. They are therefore treated in the same way. Cancer sometimes starts at the end of the fallopian tube, near the ovary, and spreads to the ovary.
It is usually an adenocarcinoma (more than 95% of cases) that develops from glandular cells and manifests as an adnexal mass or with vague symptoms.
Symptoms and signs of fallopian tube cancer
Symptoms of fallopian tube cancer can be similar to those of other gynecological problems, which makes early diagnosis of the disease difficult, with potential impact on treatment. Also, some women do not show any signs of this type of cancer.
The most common, when they occur, are:
- Abnormal vaginal bleeding, especially after menopause;
- Abdominal pain or feeling of pressure in the abdomen;
- Abnormal vaginal discharge that is white, clear, or pink; and
- Pelvic mass, present in up to two thirds of patients.
There are several tests that can be performed for the diagnosis of the disease, as well as its staging and choice of the best clinical management:
- CA125 test – blood test that checks levels of a blood protein known as CA125, which is a tumor marker for gynecological conditions such as cancer of the fallopian tube. It is estimated that 85% of women with gynecological disease have high levels of CA125. However, it is important to note that increased levels of CA125 may not necessarily mean that a woman has cancer, as they may be higher during pregnancy, menstruation, in the presence of other non-neoplastic gynecological diseases, or cancers that affect other parts of the body;
- Imaging tests and surgery – Imaging tests such as CT scan, MRI and ultrasound of the pelvic region are regularly used tests. In many cases, as cancer of the fallopian tubes does not always cause symptoms, the diagnosis can occur during imaging tests routinely ordered by the doctor or to investigate another health problem.
A surgical procedure can also have the purpose of confirming the diagnosis and staging the neoplasm, that is, helping to define the best clinical approach to treat that cancer.
Treatment usually involves surgery, followed by chemotherapy. In the therapeutic decision, factors such as the patient’s age, as well as the type and stage of the tumor are evaluated.
- Surgery – This is usually the first step in the treatment of fallopian tube cancer. Treatment for this neoplasm may consist of removal of the uterus (hysterectomy) and removal of the ovaries and fallopian tubes (salpingo-oophorectomy), adjacent lymph nodes and surrounding tissues;
- Chemotherapy – may be recommended in conjunction with surgery. It is usually indicated after the surgical procedure so that any presence of cancer cells in the body is fought. Chemotherapy is a systemic treatment, acting throughout the body, which makes it a very useful therapy to prevent malignant cells that may have spread from surviving.
As this type of cancer is very rare, little is known about its cause and there is no clear and safe approach to its prevention. Research is moving towards associating an important role of genetics in the development of this neoplasm. There is evidence that women who have inherited the gene linked to breast and ovarian cancer, called BRCA1 or 2, are also at increased risk of developing fallopian tube cancer.
Even though we don’t know exactly how fallopian tube cancer occurs, some factors increase the risk of developing the disease:
- Not having given birth;
- Not having breastfed;
- Not having used birth control pills;
- Having a close relative (mother, sister, daughter) with ovarian or breast cancer;
- Age over 50 years.