Fallopian Tube Cancer

Fallopian tube cancer forms in your fallopian tubes. It’s curable if it’s treated early because surgery removes all of the cancer cells. The challenge of this cancer is that it doesn’t often cause symptoms in the early stages, and it spreads fast. Most women aren’t diagnosed until fallopian tube cancer has spread and is harder to treat.

Fallopian tube cancer is rare compared to other types of gynecological cancer. But research shows that the most common type of ovarian cancer — epithelial ovarian cancer — may start in the fallopian tube.

Symptoms of fallopian tube cancer

Symptoms can be hard to notice, especially in the early stages. You may not notice symptoms until the cancer has spread.

Signs and symptoms of fallopian tube cancer include:

• Pelvic pain or a lump in your pelvic area
• Abdominal pain, swelling or bloating
• Loss of appetite, feeling full quickly or nausea
• Changes in your pooping habits, like constipation or diarrhea
• Peeing more often
• Irregular periods or bleeding after menopause
• Watery or bloody vaginal discharge

You should see a healthcare provider anytime you notice a change in your health, especially if you have a family history of cancer or other risk factors.

Fallopian tube cancer causes

Researchers aren’t sure what causes fallopian tube cancer. They do know that most of the time, it develops in glands that line your organs (epithelial tissue). These are the same type of cells where most ovarian cancers start. Most fallopian tube and ovarian tumors are high-grade serous tumors. This means they spread fast.

The remaining fallopian tube cancers start in connective tissue (sarcomas).

Risk factors

Factors that increase your chances of developing fallopian tube cancer include:

• Age: Most women are between 60 and 64 years old.
• Family history: Your risk is greater if you have a first-degree biological relative (parent, sibling or child) who’s had breast cancer, ovarian cancer or fallopian tube cancer.
• Genetic mutations: Changes (mutations) to the breast cancer (BRCA) gene increase your risk.
• Health conditions: Conditions like Lynch syndrome and Peutz-Jeghers syndrome increase fallopian cancer risk. Endometriosis is also a risk factor.
• Pregnancy and childbirth history: You’re more likely to develop fallopian tube cancer if you’ve never been pregnant or if you had your first full-term pregnancy after 35.
• Menstrual cycle history: Getting your first period before age 12 and going through menopause after age 51 are both risk factors.
• Obesity: Having a body mass index (BMI) above 30 can increase your risk.

How to lower your risk

If you have a family history of breast, ovarian or fallopian tube cancer, your healthcare provider may recommend a BRCA test. The test can show if you have a BRCA mutation or a syndrome that increases your risk of gynecological cancers.

If you have the mutation, removing your ovaries and fallopian tubes (a salpingo-oophorectomy) can lower cancer risk by as much as 96%.

To reduce your risk of fallopian tube cancer, you can also:

• Take hormonal birth control.
• Have a tubal ligation.
• Have your fallopian tubes removed.
• Cut back on how much alcohol you drink and quit smoking (if you do).
• Eat nutritious foods and stay physically active.
• Maintain a weight that’s healthy for you.
• Breastfeed (if possible).

How doctors diagnose fallopian tube cancer

You may not know you have fallopian tube cancer until a healthcare provider notices a lump or mass during a pelvic exam.

Your provider may order one or more of these tests to learn more about your condition:

• Blood tests: A CA-125 blood test measures the amount of cancer antigen 125 (CA-125). You may have higher levels of CA-125 if you have fallopian tube cancer.
• Imaging tests: You may get a transvaginal ultrasound, CT scan, MRI or PET scan. These scans create images of your fallopian tubes and ovaries and can show cysts and tumors.

To make a diagnosis, your provider will need to remove fluid or tissue so a pathologist can test for cancer cells in a lab. Procedures include:

• Exploratory surgery: Surgery allows your provider direct access to your organs, so they can check for suspicious-looking tissue. They may remove all or part of your fallopian tubes, ovaries and nearby lymph nodes for testing.
• Paracentesis: Your provider uses a needle to collect a sample of fluid that’s built up in your abdomen for testing.
• Biopsy: A biopsy removes a tissue sample from a tumor for testing.

How is fallopian tube cancer staged?

Imaging scans and procedures that remove and test tissue allow providers to stage fallopian tube cancer. Cancer staging describes where fallopian tube cancer is located and how much it’s spread. Staging helps your provider plan treatment.

Stages of fallopian tube cancer include:

• Stage I (1): Cancer affects one or both fallopian tubes.
• Stage II (2): Cancer affects one fallopian tube or both and nearby tissues in your pelvis.
• Stage III (3): Cancer has spread outside your pelvis to lymph nodes or nearby organs.
• Stage IV (4): Cancer has spread to your liver or distant organs like your lungs or brain.

You may also hear your provider describe cancer as:

• Local: Cancer hasn’t spread beyond your fallopian tubes.
• Regional: Cancer has spread to nearby abdominal organs or lymph nodes.
• Distant: Cancer has spread to distant organs.

Your provider can help you understand what these terms mean for your health.

How is it treated?

Your treatment will depend on the cancer stage. Treatments include:

• Surgery: Exploratory surgery to diagnose fallopian tube cancer is often also the first stage of treatment. Most women have surgery to remove their uterus, both fallopian tubes and ovaries.
• Chemotherapy: You may need chemotherapy to shrink the tumor before surgery or destroy lingering cancer cells after surgery.
• Targeted therapy: Targeted therapy stops the growth of certain cancer cells with minimal damage to healthy cells.
• Immunotherapy: If you have cancer cells with a specific genetic mutation, your provider may consider immunotherapy drugs.
• Clinical trials: Your provider may recommend you take part in a study to try promising new cancer treatments.
• Palliative care: Palliative care can help you manage cancer symptoms and treatment side effects.

When should I call my healthcare provider?

You should call a healthcare provider if you have:

• A lump or mass in your pelvic area
• Severe abdominal, pelvic or back pain that interferes with sleep or daily activities
• Unexplained weight loss
• Unusual vaginal discharge

What can I expect if I have fallopian tube cancer?

About 8 in 10 people experience remission (no signs or symptoms of fallopian tube cancer) after treatment. Early-stage cancers return (recur) 1 in 4 times. Advanced-stage cancers return up to 8 in 10 times.

You’ll need to see your healthcare provider regularly, especially within the first five years. You’ll likely need lifelong checkups to make sure the cancer doesn’t come back.

Talk to your provider about any new symptoms you’re experiencing during these visits. In addition to striving to keep you cancer-free, your healthcare provider can offer resources and advice to help you manage lasting side effects or refer you to support groups for people living with a cancer diagnosis.

What’s the prognosis?

Survival rates depend on the cancer stage and other factors, like age. The prognosis is best when providers catch the cancer before it spreads.

The five-year survival rates (odds of being alive five years after the initial diagnosis) are:

• Local: About 9 in 10
• Regional: About 5 in 10
• Distant: About 4 in 10