early detection improves outcomes

Fallopian tube cancer, once thought to be relatively uncommon, is managed and treated much the same as ovarian cancer. Because fallopian cancers don’t always present with early symptoms, the disease is often advanced upon diagnosis.

Symptoms

Symptoms

Pelvic pain, discharge, and a pelvic mass are the most common symptoms present when women are diagnosed with fallopian tube cancer. Rarely do these symptoms present all together, however.

Menopausal status can play a role in how symptoms are managed and in the diagnostic process of fallopian tube cancer.

Post-menopausal women who are experiencing abnormal vaginal bleeding warrant a thorough and timely evaluation.

Diagnosis

Diagnosis

Cancer can begin in any of the different cell types that make up the fallopian tubes.

The most common type is adenocarcinoma (a cancer of cells from glands). Leiomyosarcoma (a cancer of smooth muscle cells) and transitional cell carcinoma (a cancer of the cells lining the fallopian tubes) are less common.

In addition to a physical examination, the following tests may be used to diagnose fallopian tube cancer:

Pelvic examination

The doctor feels the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to check for any unusual changes.

Ultrasound

An ultrasound uses sound waves to create a picture of internal organs. In a transvaginal ultrasound, an ultrasound wand is inserted into the vagina and aimed at the uterus to obtain the pictures.

Biopsy

A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease).

Molecular testing of the tumor

Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. Results of these tests will help decide whether your treatment options include a type of treatment called targeted therapy. Often times this is done as part of a clinical trial.

Computed tomography (CT or CAT) scan

A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.

Combined PET/CT Scanning

Combined PET/CT scanning joins two imaging tests, CT and positron emission tomography (PET), into one procedure. A PET scan creates colored pictures of chemical changes (metabolic activity) in tissues. Because cancerous tumors usually are more active than normal tissue, they appear different on a PET scan.

Combining CT with PET scanning may provide a more complete picture of a tumor’s location and growth or spread than either test alone. The combined procedure can improve health care professionals’ ability to diagnose cancer, determine how far it has spread, and follow patients’ responses to treatment. The combined PET/CT scan may also reduce the number of additional imaging tests and other procedures a patient needs.

Magnetic resonance imaging (MRI)

An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. A contrast medium may be injected into a patient’s vein to create a clearer picture.

Treatment

Treatment

Treatment options generally involve surgery and chemotherapy. Radiation therapy is rarely used.

Surgery

The stage of the tumor determines the type of surgery used.

Early stage fallopian tube cancer, when the tumor is limited to the fallopian tubes, is treated by surgical removal of the fallopian tubes and ovaries (called a salpingo-oophorectomy).

If the cancer has spread, the surgeon may remove the uterus (called a hysterectomy) and other structures in the abdomen and pelvis, including a fat pad called the omentum and nearby lymph nodes, to biopsy and conduct tests for the presence of cancer cells.

Chemotherapy

Chemotherapy is usually given after surgery for fallopian tube cancer.

A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.

The most common types of chemotherapy to treat fallopian tube cancer are paclitaxel (Taxol) and carboplatin (Paraplat, Paraplatin).

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Targeted Therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells. Targeted agents are often used along with standard chemotherapy agents to enhance their effectiveness. A number of agents are being used secondarily as a part of active ongoing clinical trials.