Fallopian tube cancer

What is fallopian tube cancer?

Cancer of the fallopian tubes is a rare disease making up just one in a hundred (one per cent) of all female reproductive cancers.

Fallopian tube cancer is similar to ovarian cancer, but starts in the fallopian tubes; these are the two very fine 10 centimetre long tubes that connect the womb to the ovaries. 

The most common form of fallopian tube cancer is adenocarcinoma which begins in the epithelial cells which are part of the lining of the fallopian tubes. 

Other very rare forms are transitional cell cancer which develops in the stretchy cells within the tube lining, and sarcoma which occurs in the muscular parts of the fallopian tubes.

Fallopian tube cancer risks

The causes of fallopian tube cancer are unknown, but it is known to be linked to mutations in BRCA genes, which increase the risks of developing breast cancer and ovarian cancer.

Those with two or more close relatives such as a mother, sister or daughter who have been diagnosed with ovarian cancer may have an increased risk of fallopian tube cancer. Age is also a risk factor as fallopian tube cancer is most common in people in their 50s and 60s.

Fallopian tube cancer symptoms

Fallopian tube cancer symptoms may include one or more of the following:

• Vaginal bleeding that is not related to periods.
• Watery vaginal discharge that may contain blood.
• Abdominal pain.
• Abdominal swelling.

Tests for fallopian tube cancer

Your GP will probably examine your abdomen for any lumps or tenderness and may give you an internal pelvic examination to check for any abnormalities around your womb and ovaries. 

Your GP may also offer you a CA125 blood test. This tests for a protein in your blood which can act as a cancer marker; a normal level is under 35. CA125 levels can be raised by other health conditions as well as cancers. The blood test results should take about a week. 

Your GP may also refer you for an ultrasound scan, when sound waves give a picture of your internal organs. This may be followed by a referral for a CT scan when x-rays are used to build up a three dimensional image of the inside of the body. These scans can help in your diagnosis and in planning treatment.

Diagnosis

If you are suspected of having fallopian tube cancer you will be referred to a hospital gynaecological oncology team for further investigations. This team will discuss appropriate investigations and treatment options with you. 

Sometimes a biopsy is needed to help with diagnosis. This can be done by an imaging guided laparoscopy which is a small operation under general anaesthetic. A thin fibre optic tube is inserted into the abdomen to look at the fallopian tubes and take samples to check for cancer cells.

Or you may have a laparotomy when a surgical cut is made into the abdomen under general anaesthetic to examine internal organs and confirm a diagnosis.

If you are diagnosed with fallopian tube cancer it will be given a stage that describes how far it has spread.

Treating fallopian cancer

Those diagnosed with fallopian tube cancer should be treated by a gynaecological oncologist who will be part of a multi-disciplinary team that includes all the people who will plan and deliver their care. It is treated using surgery and chemotherapy in the same way as ovarian cancer.

Surgery

Treatment for fallopian tube cancer is usually to remove as much of the cancer as possible followed by chemotherapy to destroy remaining cancer cells. 

Sometimes you may be advised to have some chemotherapy before the surgery to shrink the cancer before operating. The gynaecological oncologist will discuss this with you. 

The operation is similar to ovarian cancer surgery. It will remove the fallopian tubes, the ovaries, womb, cervix and a fatty layer that lies over the organs in the abdomen called the omentum. This operation is called a total abdominal hysterectomy bilateral salpingo oophorectomy and omentectomy. 

You will be in hospital for about three to seven days after your operation. You can find out more about surgery here.

Chemotherapy

After a few weeks, when you have recovered from your operation, you will probably be offered chemotherapy by an oncologist. This is to treat any remaining cancer cells that the surgeon could not remove. 

Chemotherapy for fallopian tube cancer is usually the same as for ovarian cancer. The most commonly used drugs are carboplatin and paclitaxel (Taxol) which may be used together. You will probably be offered six cycles of these. You will be given the chemotherapy drugs intravenously through a vein as a hospital outpatient.

Chemotherapy can cause unpleasant side effects but these can usually be controlled with other medicines. 

Side effects can include nausea, tingling in your hands and feet, a sore mouth and loss of appetite, a lowering of your blood cell count making you vulnerable to infection, and hair loss. If you experience hair loss, it will grow back and within six months you should have a covering of hair. You can find out more about chemotherapy here.

Join Ovacome’s rarer ovarian cancer support group

Meet others in a similar situation to you in this online support group. Click here to read more and register.

Read more

Did you find this page helpful?

We welcome your feedback. If you have any comments or suggestions, please email r.grigg@ovacome.org.uk or call 0207 299 6653.