Fallopian tube cancer

The fallopian tubes are part of your reproductive system. When you ovulate an egg passes from your ovaries along your fallopian tubes to your uterus. 

Each year about 70 Australian women find out they have fallopian tube cancer. About one in 200 Australian women with cancer have this type of cancer.

Causes

It is not usually possible to say what causes cancer in a particular woman. There are things that women with fallopian tube cancer have in common though. Known risk factors are:

• you are older (most women with fallopian tube cancer are over 50)
• you have never had children
• you have several close blood relatives who have had ovarian, breast, endometrial or colorectal cancer
• you have inherited a faulty gene (such as BRCA1 or BRCA2)
• you have Lynch syndrome (or hereditary non-polyposis colorectal cancer – HNPCC).

Symptoms

Fallopian tube cancer can be difficult to detect because its signs are often similar to the signs of many other conditions that can be part of everyday life, particularly around menopause when fallopian tube cancer often occurs.

Symptoms can include:

• swelling in your abdomen (stomach)
• pain in your abdomen and back
• lost appetite or feeling full quickly
• needing to wee often or urgently as well as other changes to your toilet patterns, such as changes to your bowel habits
• weight loss or gain that is hard to understand or explain
• indigestion or heartburn
• tiredness
• watery discharge from the vagina.

If you have any of these symptoms and they are unusual for you, or they persist, you should see your doctor.

Diagnosis

If you have symptoms that might be linked to fallopian tube cancer you should talk to a doctor, nurse or gynaecologist. You should tell them about any changes to your body that you have noticed. You should tell them if you or anybody in your family has had cancer or been tested for genetic faults.

If you have symptoms that might be linked to fallopian tube cancer your doctor will most likely:

• ask you questions about the history of the health of you and your family
• examine your pelvis by pushing on the outside of your abdomen and putting two fingers inside your vagina to feel the shape, size and position of your fallopian tubes and other pelvic organs
• do a blood test
• arrange for an MRI or CT scan of your abdomen and pelvis.

Depending on the results of these tests, it may be recommended that you have an operation called a laparotomy. In this operation, a cut is made in your abdomen so the surgeon can look at the organs inside your abdomen and pelvis. If they find cancer they will start treatment immediately by removing any cancer they find. Sometimes doctors will recommend that a sample of fluid (abdominal paracentesis) or tissue (core biopsy) – possibly from the ovary – is taken and tested.

All of these tests tell the medical team more about your cancer so you can be given the best kind of treatment for the particular cancer you have.

Treatment

The type of treatment you have will depend upon:

• the size of the cancer and where it is in your body (this is known as the stage of cancer)
• how quickly it is growing and how different it looks to normal cells (the grade of cancer)
• where in the fallopian tubes it started (the type of cancer)
• your age, health and medical history.

Your doctors will discuss these things with you and help choose the best possible treatment for your particular cancer, lifestyle and wishes.

Treatment options

• Surgery to remove one or both of your fallopian tubes. Your uterus and cervix may also be removed (known as a total hysterectomy) as well as your ovaries (known as an oophorectomy), some of the nearby lymph nodes (which filter and trap disease) and your omentum (the fatty tissue that covers the organs in your abdomen). These operations are sometimes done immediately after cancer is diagnosed in a laparotomy. If the cancer has spread to other parts of your body, further surgery may be considered to remove these areas.
• Chemotherapy is medication that aims to control or kill the cancer. Usually this involves being connected to an IV or drip for a few hours so the medicine can be released slowly into your body.
• Radiotherapy aims to control or kill the cancer. If you have external radiation you will lie or sit near a machine that directs radiation beams at your cancer.

Questions to ask

• How big is my cancer and where exactly is it?
• Is my daughter more likely to have fallopian tube cancer if I have it?
• What if I want to become pregnant?
• What will my abdomen look like after treatment?
• Will treatment stop my periods and start menopause?
• What are the side effects of the treatment you are recommending?
• Why is the treatment you are recommending best for me?
• Will I still be able to have sex?
• How often will I need to have checkups?
• Can you write down what you have told me so that I can read it again later?

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