A part of a woman's reproductive system, the fallopian tubes are small ducts that link a woman's ovaries to her uterus. Fallopian tube cancer may begin in any of the different cell types that make up the fallopian tubes, and the most common type is adenocarcinoma (a cancer of cells from glands). Rarer types of fallopian tube cancer include leiomyosarcoma (a cancer of smooth muscle cells) and transitional cell carcinoma (a cancer of the cells lining the fallopian tubes).
As the cancer in the fallopian tube grows, it can push against the walls of the tube and cause abdominal pain. If untreated, the cancer can spread into and through the walls of the fallopian tubes and eventually into the pelvis (lower abdomen) and stomach areas.
Statistics
Fallopian tube cancer accounts for about 1% of all cancers of a woman's reproductive system. It is more common for other cancers to spread to the fallopian tubes rather than for cancer to begin there. For example, the fallopian tubes are a common site of metastasis (spread) of cancers that started in the ovaries, uterus, endometrium, appendix, or colon.
If detected early, fallopian tube cancer can often be successfully treated. At its earliest stage, where the cancer is contained in the lining of the fallopian tube, the five-year relative survival rate (the percentage of patients who survive at least five years after the cancer is detected, excluding those who die from other diseases) is 95%. The relative survival rate decreases as the cancer spreads. If cancer has invaded the walls of the fallopian tube, the five-year relative survival rate is about 75%; if it has spread outside of the fallopian tube; the five-year relative survival rate is 45%.
Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a woman how long she will live with fallopian tube cancer. Because the survival statistics are measured in five-year (or sometimes one-year) intervals, they may not represent advances made in the treatment or diagnosis of this cancer.
A risk factor is anything that increases a person’s chance of developing cancer. Some risk factors can be controlled, such as smoking, and some cannot be controlled, such as age and family history. Although risk factors can influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and communicating them to your doctor may help you make more informed lifestyle and health-care choices.
Because fallopian tube cancer is so rare, not much is known about its risk factors. However, the following factors may increase a woman’s risk of developing fallopian tube cancer:
Age. Fallopian tube cancer occurs mostly in postmenopausal women between the ages of 50 and 60.
Family history. A family history of fallopian tube cancer can increase a woman's risk of developing this cancer.
Genetic mutations. Recent studies have suggested that a mutation in the BRCA1 gene, which is linked to breast and ovarian cancers, may also increase the risk of developing fallopian tube cancer.
Because there are no certain risk factors for fallopian tube cancer, there is no known way to prevent the disease from occurring.
Women with fallopian tube cancer may experience the following symptoms. Sometimes, women with fallopian tube cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.
Irregular or heavy vaginal bleeding, especially after menopause
Occasional abdominal or pelvic pain or feeling of pressure
Vaginal discharge, which may be clear, white, or tinged with blood
Doctors use many tests to diagnose cancer and determine if it has metastasized. Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:
Age and medical condition
The type of cancer
Severity of symptoms
Previous test results
In addition to a physical examination, the following tests may be used to diagnose fallopian tube cancer:
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 of fallopian tube cancer. 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).
Ultrasound. An ultrasound uses sound waves to create a picture of internal organs, such as the uterus.
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.
Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body.
Staging is a way of describing a cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis (chance of recovery). There are different stage descriptions for different types of cancer.
One tool that doctors use to describe the stage is the TNM system. This system uses three criteria to judge the stage of the cancer: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to the rest of the body. The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer so doctors can work together to plan the best treatments.
TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:
How large is the primary tumor and where is it located? (Tumor, T)
Has the tumor spread to the lymph nodes? (Node, N)
Has the cancer metastasized (spread) to other parts of the body? (Metastasis, M)
Tumor. Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe a woman's condition in more detail. This helps the doctor develop the best treatment plan for each individual. Specific tumor stage information is listed below:
TX: The primary tumor cannot be evaluated.
T0: There is no tumor.
Tis: The tumor is carcinoma in situ (cancer that has not spread to nearby tissue).
T1: The tumor is limited to the fallopian tube(s).
T1a: The tumor is contained within one fallopian tube. No part of the tumor has spread to the surface of the tube, and no cancer cells are found in abdominal fluid.
T1b: An encapsulated (self-contained) tumor is in both fallopian tubes, but no tumor is touching a tube surface. No cancer cells are found in abdominal fluid.
T1c: The tumor is in one or both fallopian tubes, but the capsule has ruptured or the tumor has spread to the tube surface, or cancer cells are found in the abdominal fluid.
T2: The tumor involves one or both fallopian tubes and has extended to the pelvis.
T2a: Tumor extensions (implants) are found on the uterus and/or ovaries but no cancer cells are found in the abdominal fluid.
T2b: There is cancer in other pelvic tissue, but no cancer cells are found in the abdominal fluid.
T2c: Tumor extensions in the pelvis are present, such as in T2a or T2b, but cancer cells are also detected in the abdominal fluid.
T3: The tumor involves one or both fallopian tubes and has spread microscopically into the abdominal area outside the pelvis.
T3a: Microscopic metastasis is present in the peritoneal area (the area around the organs in the abdomen) beyond the pelvis.
T3b: Metastasis measuring 2 centimeters (cm) (a little smaller than 1 inch) or smaller is discovered outside the pelvis.
T3c: Metastasis larger than 2 cm is present in areas outside the pelvis.
Nodes. The "N" in the TNM staging system stands for lymph nodes, the tiny, bean-shaped organs that help fight infection. Lymph nodes near the pelvis are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.
NX: The regional lymph nodes cannot be assessed.
N0: No cancer was found in the regional nodes.
NI: The cancer has spread to the pelvic nodes.
Metastasis. The "M" in the TNM system indicates whether the cancer has spread to other parts of the body.
MX: Distant metastasis cannot be assessed.
M0: There is no cancer beyond the peritoneal area.
MI: The cancer has spread beyond the peritoneal area.
Cancer stage grouping
Doctors assign the stage of the cancer by combining the T, N, and M classifications.
Stage 0: Refers to carcinoma in situ.
Stage I: Tumor is limited to the fallopian tubes (T1, N0, M0).
Stage IA: An encapsulated tumor is limited to one fallopian tube with no spread to pelvic nodes or other parts of the body (T1a, N0, M0).
Stage IB: An encapsulated tumor is in both fallopian tubes, with no spread to pelvic nodes or other parts of the body (T1b, N0, M0).
Stage IC: Cancer is in one or both fallopian tubes with either a ruptured capsule or tumor spread to the ovarian surface, or cancer cells are in the abdominal fluid (T1c, N0, M0).
Stage II: Cancer is in one or both fallopian tubes and has grown into the pelvis (T2, N0, M0).
Stage IIA: Cancer has extended to the uterus or ovaries, but not to the pelvic nodes or distant organs (T2a, N0, M0).
Stage IIB: Cancer has spread to other pelvic tissue, but not to lymph nodes or distant organs (T2b, N0, M0).
Stage IIC: Cancer has spread into the pelvic area and is shedding cancer cells into abdominal fluid (T2c, N0, M0).
Stage III: Cancer is in one or both fallopian tubes and the pelvis, and has spread into the peritoneum (T3, N0, M0).
Stage IIIA: Cancer has spread microscopically throughout the pelvis (T3a, N0, M0).
Stage IIIB: Cancer has spread into the peritoneal area with implants that are 2 cm or smaller (T3b, N0, M0).
Stage IIIC: Describes any cancer that has spread into the peritoneal area in implants larger than 2 cm (T3c, N0, M0), or the tumor has spread to lymph nodes and/or the pelvis, but not to other parts of the body (any T, N1, M0).
Stage IV: Describes any cancer that has spread to distant organs (any T, any N, M1).
Histologic grade (G). A tumor's grade uses the letter "G" and a number, and describes how closely the cancer cells resemble normal tissue under a microscope. Cells that look like healthy cells are low grade, and those that look like cancer cells are higher grade.
GX: The tumor grade cannot be identified.
G1: Describes cells that look more like normal tissue cells (well differentiated).
G2: The cells are somewhat different (moderately differentiated).
G3: The tumor cells look very much unlike normal cells (poorly differentiated).
G4: The cells barely resemble normal cells (undifferentiated).
Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Sixth Edition (2002) published by Springer-Verlag New York, www.springer-ny.com.
The treatment of fallopian tube cancer depends on the size and location of the tumor, whether the cancer has spread, and the woman’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan.
Surgery
The stage of the tumor determines the type of surgery. 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. If the cancer has spread, the surgeon may remove the uterus (hysterectomy) and other structures in the pelvis, including nearby lymph nodes, to evaluate them for the presence of cancer cells.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.
Chemotherapy is generally given after surgery for fallopian tube cancer. The most common types of chemotherapy to treat fallopian tube cancer are paclitaxel (Taxol) and carboplatin (Paraplatin).
The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications you've been prescribed, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.Net's Drug Information Resources, which provides links to searchable drug databases.
Radiation therapy
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. Radiation therapy may be used before surgery to shrink the size of the tumor or after surgery to destroy any remaining cancer cells.
Side effects from radiation therapy include tiredness, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.
Doctors and scientists are always looking for better ways to treat patients with fallopian tube cancer. A clinical trial is a way to test a new treatment in order to prove that it is safe, effective, and possibly better than a standard treatment. Patients who participate in clinical trials are among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.
Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that finding new drugs and other therapies is the only way to make progress in treating fallopian tube cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with fallopian tube cancer.
To join a clinical trial, patients must complete a learning process known as informed consent. During informed consent, the doctor should list all of the patient's options, so the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment. Learn more about clinical trials, including patient safety, phases of a clinical trial, deciding to participate in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.
Because fallopian tube cancer is so rare, specific trials for this cancer are uncommon, but some clinical trials on ovarian cancer may be open to people with fallopian tube cancer.
Cancer and cancer treatment can cause a variety of side effects; some are easily controlled, and others require specialized care. Below are some of the side effects that are more common to fallopian tube cancer and its treatments. For more detailed information on managing these and other side effects of cancer and cancer treatment, visit the Cancer.Net Managing Side Effects section.
Diarrhea. Diarrhea is frequent, loose, or watery bowel movements. It is a common side effect of chemotherapy or radiation therapy to the pelvis. It can also be caused by certain types of cancer, such as pancreatic cancer.
Fatigue (tiredness). Fatigue is extreme exhaustion or tiredness, and is the most common problem that people with cancer experience. More than half of patients experience fatigue during chemotherapy or radiation therapy, and up to 70% of patients with advanced cancer experience fatigue. Patients who feel fatigue often say that even a small effort, such as walking across a room, can seem like too much. Fatigue can seriously affect family and other daily activities, can make patients avoid or skip cancer treatments, and may even affect the will to live.
Fluid in the arms or legs (lymphedema). Lymphedema is the abnormal buildup of lymph (fluid) in the lymphatic system, the series of channels and nodes (small sacs that hold fluid) that carries lymph through the body and helps fight infection and disease. When cancer metastasizes, cancer cells first move to the lymph nodes and then to other parts of the body. Lymphedema can develop immediately after cancer surgery or radiation therapy, or it can develop months or years later. The most common causes of lymphedema includes surgery to remove the lymph nodes; radiation therapy to the lymph nodes; metastatic cancer; bacterial or fungal infection; injury to the lymph nodes; and other diseases involving the lymph system.
Hair loss (alopecia). Radiation therapy and chemotherapy may cause hair loss by damaging the hair follicles responsible for hair growth. Hair loss may occur throughout the body, including the head, face, arms, legs, underarms, and pubic area. The hair may fall out entirely, gradually, or in sections. In some cases, the hair will simply thin-sometimes unnoticeably-and may become duller and dryer. Losing one's hair can be a psychologically and emotionally challenging experience and can affect a patient's self-image and quality of life. However, the hair loss is usually temporary, and the hair often grows back.
Infection. An infection occurs when harmful bacteria, viruses, or fungi (such as yeast) invade the body and the immune system is not able to destroy them quickly enough. Patients with cancer are more likely to develop infections because both cancer and cancer treatments (particularly chemotherapy and radiation therapy to the bones or extensive areas of the body) can weaken the immune system. Symptoms of infection include fever (temperature of 100.5°F or higher); chills or sweating; sore throat or sores in the mouth; abdominal pain; pain or burning when urinating or frequent urination; diarrhea or sores around the anus; cough or breathlessness; redness, swelling, or pain, particularly around a cut or wound; and unusual vaginal discharge or itching.
Mouth sores (mucositis). Mucositis is an inflammation of the inside of the mouth and throat, leading to painful ulcers and mouth sores. It occurs in up to 40% of patients receiving chemotherapy treatments. Mucositis can be caused by chemotherapy directly, the reduced immunity brought on by chemotherapy, or radiation treatment to the head and neck area.
Nausea and vomiting. Vomiting, also called emesis or throwing up, is the act of expelling the contents of the stomach through the mouth. It is a natural way for the body to rid itself of harmful substances. Nausea is the urge to vomit. Nausea and vomiting are common in patients receiving chemotherapy for cancer and in some patients receiving radiation therapy. Many patients with cancer say they fear nausea and vomiting more than any other side effects of treatment, but nausea and vomiting are preventable. When it is minor and treated quickly, nausea and vomiting can be quite uncomfortable but cause no serious problems. Persistent vomiting can cause dehydration, electrolyte imbalance, weight loss, depression, and avoidance of chemotherapy.
Skin problems. Skin contains many nerves, making skin problems painful. Skin protects the inside of the body from infection, and skin problems can often lead to other serious problems. Because the skin is on the outside of the body and visible to others, many patients have difficulty coping with skin problems. As with other side effects, prevention or early treatment is best. In other cases, treatment and wound care can often improve pain and quality of life. Skin problems can have many different causes, including chemotherapy leaking out of the intravenous (IV) tube or burned skin caused by radiation therapy.
After treatment for fallopian tube cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. Although there are no specific guidelines defined for follow-up care for women who have finished fallopian tube cancer treatment, the plan may include x-rays, CT scans, ultrasound studies, or MRI scans. Discuss any new symptoms with your doctor.
Women recovering from fallopian tube cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about Healthy Living After Cancer.
Research for fallopian tube cancer is ongoing. Advances may still be under investigation in clinical trials and may not be approved or available at this time. Always discuss all diagnostic and treatment options with your doctor.
Because fallopian tube cancer is so rare, fallopian tube cancer-specific clinical trials may be hard to find. However, because it is similar to ovarian cancer, researchers are trying to determine if it can be treated similarly. Therefore, many clinical trials may include patients with either ovarian or fallopian tube cancer.
Genetic research has shown that mutations to the BRCA1 gene may increase the risk of developing fallopian tube cancer. Further research into this area may help clarify the risk and also result in better patient counseling for women who carry a mutation to this gene.
Regular communication with your doctor is important in making informed decisions about your health care. Consider asking the following questions of your doctor:
What is the exact type of fallopian tube cancer that I have?
What is the stage of my cancer?
What are the treatment options?
What clinical trials are open to me?
What type of side effects from treatment can I expect?
Will this treatment affect my fertility (ability to have children)?
What is my prognosis?
What are the chances that the cancer will recur?
How can I keep myself as healthy as possible during treatment?
Does my diagnosis mean that my close relatives are at a higher risk for fallopian tube cancer?
Printer-Friendly
E-mail this page