Fallopian tube cancer

Fallopian tube cancer is similar to ovarian cancer and doctors treat it in much the same way. It starts in the fallopian tubes which connect the ovaries to the womb. 

What is fallopian tube cancer?

It can sometimes be difficult for doctors to tell the difference between fallopian tube cancer and ovarian cancer that has spread to the fallopian tube.

Doctors classify your cancer as fallopian tube cancer if:

• the cancer is in the fallopian tube rather than the ovaries
• they find precancerous cells on the inside surface of the fallopian tube  - these are called STIC lesions (serous tubal intraepithelial carcinomas)

Although figures show that fallopian tube cancer is rare, doctors now think that many of the most common type of epithelial ovarian cancers (high grade serous type) actually start in the far end of the fallopian tube, rather than the surface of the ovary.

The fallopian tubes

The fallopian tubes link the ovaries to the womb. During a woman’s childbearing years, the ovaries produce an egg each month. The egg travels through the fallopian tubes to the womb. A baby will begin to develop in the womb if the egg is fertilised by a sperm.

The diagram below shows where the fallopian tubes are.

Risks and causes

We don’t know the exact cause of fallopian tube cancer.

Risk factors are things that might increase a person’s risk of developing a cancer. Some possible risk factors have been suggested for fallopian tube cancer, including a family history of ovarian or breast cancer.

A family history of ovarian or breast cancer

Having 2 or more of your very close relatives who have had ovarian cancer could increase your risk of fallopian tube cancer.

A very close relative means your:

• mother
• sister
• daughter

Doctors have identified 2 genes that cause ovarian and fallopian tube cancer. These are the BRCA genes.

Symptoms

The symptoms of cancer of the fallopian tube are similar to the symptoms of ovarian cancer. They are often quite vague, particularly if the disease is in its early stages.

The symptoms might include:

• vaginal bleeding not related to your periods
• a watery vaginal discharge that may contain blood
• abdominal pain which is often colicky (comes in spasms)
• a swollen abdomen

Tests to diagnose

Fallopian tube cancer can be hard to diagnose. If you have symptoms your doctor will examine you and may use the following tests to help make a diagnosis.  

Pelvic examination

If you have symptoms of pain or abnormal bleeding, the first thing your doctor is likely to do is to examine your abdomen. They will press gently on the outside of your abdomen to feel for any lumps, or tender areas.

Your doctor may also want to examine you internally. This is to see if your womb and ovaries feel normal. Your doctor will ask you to lie on your back on the couch with your feet drawn up and your knees apart. They will then put one or two gloved fingers into your vagina at the same time as pressing down on your abdomen with the other hand. If any part of your reproductive system is swollen, or if a mass of any kind is there, your doctor may be able to feel it.

Scans

You might need to have an ultrasound scan to help diagnose your cancer. An ultrasound uses sound waves to build up a picture of a part of the body. You might have an abdominal ultrasound or a transvaginal ultrasound.

Your doctor may want you to have a CT scan or MRI scan to check if the cancer has spread within your abdomen.

Blood tests

Fallopian tube cancers often produce chemicals that show up in a blood test. Doctors call these tumour markers.

The marker that doctors look for in fallopian tube cancer is called CA125. A raised level of CA125 can suggest either fallopian tube cancer or ovarian cancer. But it can be raised for other reasons, such as:

• fibroids
• pregnancy
• pelvic inflammatory disease

Treatment and trials

Doctors treat fallopian tube cancer in a very similar way to ovarian cancer. The main treatments are surgery and chemotherapy. 

Surgeons try to remove all of the cancer, or as much of it as possible. If your surgeon can't remove all of the cancer, your specialist is likely to suggest that you have chemotherapy after your surgery.

You might also have chemotherapy if they remove all of the cancer. This is to reduce the chance of the cancer coming back.

The chemotherapy drugs used are generally the same as for ovarian cancer. Common drugs include carboplatin and paclitaxel.

Fallopian tube cancers are usually included in ovarian cancer trials. If you are interested in finding out about trials for this type of cancer, you can look at the ovarian cancer trials in our clinical trials database.

Coping

Coping with a rare condition can be difficult, both practically and emotionally. Being well informed about your condition and its treatment can help you to make decisions and cope with what happens.

It can also help to talk to other people who have the same thing. But it can be hard to find people who have had a rare type of cancer. 

Cancer Research UK’s discussion forum is a place for anyone affected by cancer. You can share experiences, stories and information with other people who know what you are going through.

You may also find it helpful to contact the Rare Cancer Alliance, who offer support and information to people who have rare cancers.