Fallopian tube cancer

What is fallopian tube cancer?

Fallopian tube cancer is a rare cancer affecting the fallopian tubes (the tubes that connect the ovaries to the uterus). This type of cancer can affect one or both of the fallopian tubes. There are two types of fallopian tube cancer:

• More than 95% of fallopian tube cancers grow from the lining cells of the fallopian tubes (Papillary serous adenocarcinomas).
• Sometimes cancer can form in the smooth muscle in the fallopian tubes (leiomyosarcomas) or in other cells that line the fallopian tubes (transitional cell carcinomas).

Each year around 70 women in Australia are diagnosed with fallopian tube cancer. Primary fallopian tube cancer accounts for less than half of 1% of all cancers in Australian women.

What increases your risk of fallopian tube cancer?

The exact cause of fallopian tube cancer isn’t known, but known risk factors include:

• age (most women with fallopian tube cancer are over 50)
• hereditary factors
  • family history of ovarian, breast, uterine, or bowel cancer
  • having the BRCA1 or BRCA2 gene
  • having a genetic condition such as Lynch syndrome
• never having children.

Just because you have risk factors, doesn’t mean you will get fallopian tube cancer. However, some women who develop this type of cancer don’t have any risk factors at all. If you’re concerned about your risk, speak to your doctor.

What are the signs and symptoms of fallopian tube cancer?

Fallopian tube cancer can be difficult to detect as it usually has no symptoms in the early stages. If symptoms arise, some can be similar to other health issues, including digestion and bowel issues. These may include:

• swelling in your lower abdomen not associated with weight gain
• a lump in the lower abdomen
• abdominal or back pain
• a feeling of pressure against the bowel or bladder, or that you need to go to the toilet quickly
• feeling like you can’t fully empty your bowel or bladder
• loss of appetite or feeling full quickly
• indigestion or heartburn
• feeling tired
• watery or blood-stained vaginal discharge
• unusual bleeding not associated with menstruation.

These symptoms may be due to other conditions and not related to fallopian tube cancer. However, if you notice any of them, visit your doctor.

How is fallopian tube cancer diagnosed?

Most cases of fallopian tube cancer are difficult to detect during a routine gynaecological check unless the cancer is advanced and is felt as a mass either on abdominal or vaginal examination, or during tests for other conditions. However, if your doctor suspects you may have a cancer, they will ask questions about your health and your family health history, and perform both an abdominal and pelvic examinations.

Tests used to diagnose fallopian tube cancer include an ultrasound of your pelvis, preferably a transvaginal ultrasound.

If it is abnormal and shows a pelvic mass around the areas of the fallopian tubes, your doctor will refer you to a gynaecological oncologist for any further tests and treatment. It is usually difficult to differentiate between fallopian tube and ovarian cancers.

Referral to a gynaecological oncologist

If your assessment and investigations suggest a cancer, ask your doctor for an immediate referral to a gynaecological oncologist. Gynaecological oncologists are specialist gynaecologists who treat cancers such as fallopian tube cancer.

Other tests and treatment may include:

• computerised tomography (CT) and magnetic resonance imaging (MRI) scans can be used to check if cancer has spread outside the uterus
• laparotomy, an abdominal operation, to look at the fallopian tubes and surrounding organs for signs of cancer. If cancer is found, the doctor will remove as much of the cancer as possible during the procedure. All of the tissues removed will be sent away to pathology for testing of the cells. Sometimes the diagnosis of fallopian tube cancer is only made after the pathology results are completed.

Treatment for fallopian tube cancer

Treatment for fallopian cancer depends on the extent of the cancer. It may include any of, or a combination of, the following:

• surgery
• radiotherapy
• chemotherapy
• hormonal therapy.

Prevention of fallopian tube cancer

There are no proven ways to prevent fallopian tube cancer, and there are no screening tests available. In most cases, early detection and diagnosis lead to good outcomes, which is why it’s important to see your doctor if you feel something isn’t quite right. Studies have shown that some ovarian cancers actually originate in the fallopian tubes.

When to see your doctor

It’s important to see your doctor if you notice any of the symptoms listed above, or anything else that is unusual.

Further information about fallopian tube cancer can be found at:

• Cancer Australia
• Australian Cancer Research Foundation.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at July 2021.