fallopian tube cancer

Fallopian Tube Cancer: A Rare Gynecologic Cancer

Fallopian tube cancer, also known as tubal cancer, is a rare and aggressive form of gynecologic cancer that affects the fallopian tubes in women. The fallopian tubes are two long, slender tubes that connect the ovaries to the uterus, playing a crucial role in the reproductive process by transporting eggs from the ovaries to the uterus.

What is Fallopian Tube Cancer?

Fallopian tube cancer starts in the cells of the fallopian tubes and can grow into and destroy surrounding tissues. It is similar to ovarian cancer in terms of its origin, treatment, and management. Most cases of fallopian tube cancer are diagnosed at an advanced stage, making it challenging to treat.

Symptoms of Fallopian Tube Cancer

The symptoms of fallopian tube cancer may include:

• Watery or blood-stained vaginal discharge
• Swelling of the lower abdomen that is not associated with weight gain
• A lump in the lower abdomen
• Pain in the lower abdominal area

Causes and Risk Factors

Fallopian tube cancer risk factors are similar to ovarian cancer risk factors. They may include:

• Age: Fallopian tube cancer can occur in women of any age, but it most often is found in women between 60 to 66 years old.
• Family history of fallopian tube or ovarian

Common Signs and Symptoms of Fallopian Tube Cancer

Fallopian tube cancer can be challenging to diagnose in its early stages, as the symptoms may be similar to those of other gynecological problems. However, there are some common signs and symptoms that may indicate the presence of this type of cancer.

• Abdominal or pelvic pain: This is one of the most common symptoms of fallopian tube cancer, often described as a dull ache or sharp pain in the lower abdomen.
• Abnormal vaginal bleeding: Women with fallopian tube cancer may experience irregular vaginal bleeding, especially after menopause. This can include spotting, light bleeding, or heavy bleeding.
• Unusual vaginal discharge: Some women may notice a watery or blood-stained vaginal discharge, which can be a sign of the cancer.
• Swelling in the abdomen: As the tumor grows, it can cause swelling in the lower abdomen, which may not be associated with weight gain.
• Pelvic mass: In some cases, a pelvic mass (a lump) may be felt during a physical examination.

Other Possible Symptoms

In addition to these common symptoms, women with fallopian tube cancer may also experience:

• Back pain: Pain in the back can occur as the tumor grows and puts pressure on surrounding tissues.
• Indigestion: Some women may experience indigestion or feeling full quickly after eating due to the tumor's impact on digestion.
• Fatigue: As with many cancers, fatigue is a common symptom of fallopian tube cancer.

Important Note

It's essential to note that these symptoms can also be caused by other conditions, such as ovarian or peritoneal cancer. If you're experiencing any of these symptoms, it's crucial to consult your doctor for proper evaluation and diagnosis.

References:

• [1] Symptoms of fallopian tube cancer can be hard to notice and easy to ignore, especially in the early stages.
• [2] Abnormal vaginal bleeding, especially after menopause; is a symptom of fallopian tube cancer.
• [3] Signs and symptoms often appear as the tumour grows and causes changes in the body.
• [4] Symptoms of fallopian tube cancer include: Watery or blood-stained vaginal discharge; Swelling of the lower abdomen that is not associated with weight gain; A lump in ...
• [5] Fallopian tube cancer symptoms vary, but often include: Abnormal vaginal bleeding; Abdominal or pelvic pain or pressure; Unusual vaginal discharge;
• [8] Patients with fallopian tube cancer may have symptoms that include irregular vaginal bleeding or discharge, lower abdominal pain, bloating, and pelvic pressure.
• [9] Signs and Symptoms of Fallopian Tube Cancer · Abdominal pain · Abnormal vaginal bleeding · Bloating · Pelvic mass · Watery vaginal discharge ...
• [12] Symptoms vary from woman to woman. If you have fallopian tube cancer, you may have: Abnormal vaginal bleeding, especially after menopause; Abdominal or pelvic pain or pressure
• [14] Symptoms that may indicate fallopian tube cancer include: Back, pelvic or abdominal pain Pain during intercourse; Indigestion, including feeling full quickly after eating Fatigue Bloating or abdominal swelling

Diagnostic Tests for Fallopian Tube Cancer

Fallopian tube cancer is a rare and aggressive form of cancer that affects the female reproductive system. Diagnosing this type of cancer can be challenging, but various tests can help identify it. Here are some diagnostic tests used to detect fallopian tube cancer:

• Pelvic Exam: A pelvic exam is usually the first step in diagnosing fallopian tube cancer. During this exam, a healthcare provider inserts gloved fingers into the vagina and feels the uterus, ovaries, fallopian tubes, and vagina for any abnormalities [8].
• CA-125 Blood Test: The CA-125 blood test measures the level of a protein called CA-125 in the blood. High levels of CA-125 can indicate uterine, ovarian, fallopian tube, or peritoneal cancer, as well as less serious conditions like endometriosis or abdominal inflammation [12].
• Ultrasound Exam: An ultrasound exam uses sound waves to create images of the internal organs. This test can help identify any abnormalities in the ovaries, uterus, and fallopian tubes [9].
• Transvaginal Ultrasound (TVUS): TVUS is a type of ultrasound that uses a probe inserted into the vagina to get a closer look at the ovaries and fallopian tubes. This test can help identify any abnormalities in these areas [9].
• Blood Tests: Blood tests, such as the CA-125 test, can be used to check for tumor markers, which are substances produced by cancer cells that can be detected in the blood [5].
• Surgery: In some cases, surgery may be necessary to remove a sample of tissue from the fallopian tube or ovary to examine under a microscope. This is usually done after other tests have indicated the presence of cancer [1].

It's essential to note that no single test can definitively diagnose fallopian tube cancer. A combination of these tests, along with a thorough medical history and physical exam, can help healthcare providers make an accurate diagnosis.

References:

[1] Exploratory surgery: ... Surgery: Exploratory surgery to diagnose fallopian tube cancer is often also the first stage of treatment [1].

[5] Tumor marker tests: Blood tests, such as the CA-125 test, look for tumor markers. These are biomarkers found in blood, produced by cancer cells [5].

[8] May 9, 2023 — Tests and procedures used to diagnose ovarian cancer include infection, blood loss, bowel injury, and heart and blood vessel problems [8].

[9] Jul 11, 2022 — Screening tests for ovarian, fallopian tube, and primary peritoneal cancers are being studied in clinical trials [9].

[12] High amounts of CA-125 may indicate uterine, ovarian, fallopian tube or peritoneal cancer, as well as less serious conditions such as endometriosis or abdominal inflammation [12].

Treatment Options for Fallopian Tube Cancer

Fallopian tube cancer treatment typically involves a combination of surgery, chemotherapy, and targeted therapy. The specific treatment plan depends on the stage and severity of the cancer.

• Surgery: Surgery is usually the main treatment for fallopian tube cancer. The type of surgery required depends on the stage of the cancer. [13] It may involve removing the affected fallopian tube, ovary, uterus, or other surrounding tissues.
• Chemotherapy: Chemotherapy uses powerful drugs to kill cancer cells and control their growth. It can be used alone or in combination with other treatments. [2]
• Targeted Therapy: Targeted therapy involves using medications that specifically target the cancer cells. Examples of targeted therapies for fallopian tube cancer include:
  • Bevacizumab: This medication was approved by the FDA and EMA to treat epithelial ovarian, fallopian tube, or primary peritoneal cancer stage III or IV in combination with carboplatin and paclitaxel. [14]
  • Niraparib (Zejula): This medication may be used as a maintenance therapy for women with recurrent fallopian tube cancer that has responded to chemotherapy with a platinum drug such as carboplatin or cisplatin. [15]

Additional Treatment Options

Other treatment options for fallopian tube cancer include:

• PARP Inhibitors: PARP inhibitors, such as olaparib (Lynparza), can be used to treat high-grade ovarian cancer that has spread, including people with high-grade fallopian tube cancer and peritoneal cancer. [8]
• Combination Chemotherapy: Combination chemotherapy involves using more than one anticancer drug to treat the cancer. The way the chemotherapy is given depends on the type and stage of the cancer. [6]

Important Considerations

It's essential to note that treatment options for fallopian tube cancer are often based on the standard management of ovarian cancers, as data regarding the treatment of fallopian tube cancers are limited and extrapolated from the ovarian cancer literature. [3]

The differential diagnosis for fallopian tube cancer involves considering various conditions that can present similarly to this type of cancer. Some of the key points to consider are:

• Adnexal masses: These can be caused by a range of benign and malignant processes, including pelvic inflammatory disease (hydrosalpinx and pyosalpinx), isolated tubal torsion, and ovarian torsion [10].
• Ovarian cancer: This is often indistinguishable from primary fallopian tube cancer in the early stages, as women may present with advanced-stage disease [4].
• Peritoneal cancer: This can also be a differential diagnosis for fallopian tube cancer, particularly if the cancer has spread to the peritoneum [12].
• Tubal ectopic pregnancy: This is a condition that can mimic fallopian tube cancer in women of childbearing age, especially if there are elevated levels of beta-hCG [6].
• Primary ovarian cancer: Some studies have suggested that primary ovarian cancer and primary fallopian tube cancer may share similar morphological and immunophenotypical features, making differential diagnosis challenging [15].

It's also worth noting that the diagnosis of fallopian tube cancer often involves a combination of blood tests, medical imaging, and pathologic assessment of fallopian tissue [12]. A wide range of conditions can affect one or both fallopian tubes, so familiarity with and recognition of characteristic imaging features are crucial for accurate diagnosis and prompt patient management [10].

References:

[4] Primary fallopian tube cancers are often indistinguishable from primary ovarian cancers because women present at very advanced stages.

[6] Tubal ectopic pregnancy: women of childbearing age and elevated β-hCG

[10] A wide range of benign and malignant processes can affect one or both fallopian tubes. Familiarity with and recognition of the characteristic imaging features of these diseases and conditions are imperative for accurate diagnosis and prompt patient management.

[12] Differential diagnosis: Ovarian cancer, peritoneal cancer [1]

[15] The most difficult differential diagnosis in the ovarian cancer field concerns mucinous tumours since both morphological and immunophenotypical features are shared between primary and metastatic tumours.