What is Fallopian Tube Cancer
Fallopian Tube Cancer is a type of cancer that develops in the tubes that connect the ovaries and the uterus. It is very rare and accounts for only 1% to 2% of all gynecological cancers. The tubes are more often sites of metastasis from tumors originating in the ovaries or endometrium than the primary site of neoplasia development.
This type of cancer usually affects women over 50 years old, although it can occur at any age. It is more common in Caucasian women who have had few or no children.
Fallopian tube cancer, like ovarian and primary peritoneal cancer, is formed 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
The symptoms of Fallopian tube cancer can be similar to those of other gynecological problems, which complicates the early diagnosis of the disease, with potential impact on treatment. Additionally, some women do not have any signs of this type of cancer.
The most common, when they occur, are:
- Abnormal vaginal bleeding, especially after menopause;
- Abdominal pain or a 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.
Diagnosis of Fallopian tube cancer
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 – a blood test that checks the levels of a blood protein known as CA125, which is a tumor marker for gynecological diseases, such as Fallopian tube cancer. It is estimated that 85% of women with gynecological disease have elevated levels of this marker. However, it is important to note that increased levels of CA125 may not necessarily mean that a woman has cancer, as they can 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 computed tomography, magnetic resonance imaging, and ultrasound of the pelvic region are regularly used exams. In many cases, since Fallopian tube cancer does not always cause symptoms, the diagnosis can occur during imaging tests requested as routine by the doctor or to investigate another health problem.
Surgical procedures can also aim to confirm the diagnosis and stage the neoplasm, i.e., they help define the best clinical approach to treat that cancer.
Treatment of Fallopian Tube Cancer
Treatment for Fallopian tube cancer usually involves surgery followed by chemotherapy. Factors such as the patient’s age, as well as the type and stage of the tumor, are evaluated in the therapeutic decision.
- Surgery – is usually the first stage of treatment for 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 can be 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.
Prevention
As this type of cancer is very rare, little is known about its cause and there is no clear and safe conduct for the prevention of Fallopian tube cancer. 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 ovarian and breast cancer, called BRCA1 or 2, also have an increased risk of developing Fallopian tube cancer.
Even not knowing exactly how Fallopian tube cancer occurs, some factors increase the risks 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.
