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Fallopian Tube Cancer


Fallopian tubes are the pair of ducts through which a woman’s eggs travel from the ovaries to the uterus, either to be fertilized or expelled during menstruation.

 

Primary carcinoma of the fallopian tube is one of the rarest gynecological cancers. Secondary cancers due to metastasis from the ovaries, endometrium, gastrointestinal tract or breast are more common.

The most common types of fallopian tube cancer are serous and endometrioid adenocarcinomas. Leiomyosarcomas, which form in the smooth muscle of the fallopian tube, and transitional cell carcinomas, have also been reported.

Sometimes women with fallopian tube cancer may be asymptomatic or experience vague symptoms resembling other gynecologic or gastrointestinal problems. Because fallopian tube cancer is so rare, it can be difficult to diagnose and an evaluation by a physician is essential.

 

The more common symptoms include:

  • Abnormal vaginal bleeding, especially after menopause
  • Abdominal pain or feeling of pressure
  • Unusual vaginal discharge that is white, clear or tinged with pink
  • A pelvic mass at the time of diagnosis, present in up to two-thirds of patients with fallopian tube cancer
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At the moment there are no courses of Fallopian Tube Cancer

Clinical trials
Estudio doble ciego, fase III, aleatorizado, controlado por placebo, multicentrico, de Olaparib en retratamiento de mantenimiento en pacientes de cáncer ovario epitelial tratados previamente con un inhibidor de PARP, y que respondan a una quimioterapia basada en platino.
Ensayo de fase 1a/2a, abierto y multicéntrico, para investigar la seguridad, tolerabilidad y actividad antitumoral de dosis repetidas de Sym015, una mezcla de anticuerpos monoclonales dirigida frente al receptor MET, en pacientes con tumores malignos sólidos en fase avanzada
Estudio de fase ib para evaluar la seguridad, tolerabilidad y farmacocinética de mirvetuximab soravtansina (imgn853) en combinación con bevacizumab, carboplatino o doxorubicina liposomal pegilada en adultos con cáncer de ovario epitelial avanzado, cáncer peritoneal primario, cáncer de las trompas de falopio o cáncer endometrial positivos para el receptor de folato alfa.
PRIMER ESTUDIO EN EL SER HUMANO DE LA ADMINISTRACIÓN REPETIDA DE REGN2810, UN ANTICUERPO MONOCLONAL, TOTALMENTE HUMANO FRENTE A LA PROTEÍNA DE MUERTE CELULAR PROGRAMADA 1 (PD-1), EN MONOTERAPIA Y EN COMBINACIÓN CON OTROS TRATAMIENTOS ANTINEOPLÁSICOS, EN PACIENTES CON TUMORES MALIGNOS AVANZADOS
Estudio fase IIIB, prospectivo, randomizado, abierto que evalúa la eficacia y seguridad de Heparina/Edoxaban versus Dalteparina en tromboembolismo venoso asociado con cáncer.
Tumores sólidos. Antiemesis Estudio fase III, multicéntrico, aleatorizado, doble ciego, con control activo para evaluar la seguridad y eficacia de Rolapitant en la prevención de náuseas y vómitos por la quimioterapia (NVIQ) en pacientes que reciben quimioterapia altamente emética (QAE). A phase III, multicenter, randomized, double blind, placebo controlled study of the safety and efficacy of Rolapitant for the treatment of Chemotherapy-induced nausea and vomiting in subjects receiving highly Emetogenic Chemotherapy (HEC)
Ensayo clínico en fase I de determinación de dosis del antiangiogénico multidiana Dovitinib (TKI258) más paclitaxel en pacientes con tumores sólidos.

Because of its rarity, the causes and risk factors for developing primary fallopian tube cancer are not clearly understood. Researchers are, however, investigating the roles of genetics and hormones.

 

Factors that may affect a woman’s risk of developing fallopian tube cancer include:

 

Age: While this cancer can occur in women of any age, it most often occurs in Caucasian postmenopausal women between age 50 and 60, who have had few or no children. The peak incidence is in women aged 60 to 66 years.

 

Family History: A family history of fallopian tube cancer has been shown to increase a woman’s risk of developing this cancer.

 

Genetic Mutations: There is evidence that women who carry BRCA mutations – linked to high risk of breast and ovarian cancer – or one of the genes that cause HNPCC (hereditary nonpolyposis colorectal cancer) have a higher risk of developing fallopian tube cancer. BRCA mutations, particularly BRCA1, have been identified in 16-43% of women with primary fallopian tube cancer.

 

There is a decreased risk of developing fallopian tube cancer among women who have used hormonal contraception, as well as among those who have delivered and breast-fed children, with the protective effect increasing with the number of children a woman has delivered.

 

Having one or more of the symptoms listed above does not necessarily mean you have fallopian tube cancer. However, it is important to discuss any symptoms with your doctor, since they may indicate other health problems.

The first step in making a diagnosis is a pelvic examination, in which the physician examines the uterus, ovaries, fallopian tubes and vagina. It is during this examination that the pelvic mass or lump may be discovered. However, the presence of this mass is not enough to make a diagnosis of fallopian tube cancer.

The physician may use several tests to make the diagnosis. Tests for fallopian tube cancer may include:

 

Ultrasound of the pelvis: High-frequency sound waves are used to create a pattern of echoes, called a sonogram, in which images of healthy tissues, cysts and tumors can be differentiated.

 

Computed tomography (CT) scan: A computer linked to an X-raymachine takes a series of detailed images of areas inside the body. Sometimes a contrast dye is injected or swallowed to make organs or tissues show up more clearly.

 

Magnetic resonance imaging (MRI): Magnetic fields, rather than X-rays, produce detailed images of the body.

 

Surgical biopsy: The only way to confirm a diagnosis of fallopian tube cancer is for a pathologist to look at the fallopian tube tissue. A sample of tissue is usually obtained during surgery.

 

CA125 test: This blood test checks levels of CA125, a protein known as a tumor marker for gynecological diseases. About 85% of women with such diseases have increased levels of CA125. An abnormally high reading adds support to the diagnosis, but on its own does not prove that a woman has this cancer.

 

Staging
 

Staging is the process used to determine if, where and to what extent the cancer has spread, and if it is affecting the function of other organs in the body. The Federation Internationale de Gynecologie et d’Obstetrique (FIGO) and the American Joint Committee on Cancer (AJCC) have designated staging for fallopian tube cancers as follows:

 

Stage I: The tumor is limited to one or both fallopian tubes.

Stage II: The tumor involves one or both tubes and has spread to the pelvic area and/or has metastasized to the uterus, ovary or other pelvic tissues.

Stage III: The tumor involves one or both tubes and the pelvis, and has spread to the abdominal cavity and/or regional lymph nodes.

Stage IV: The cancer has spread to the lung, liver or other distant organs.

Treatment for fallopian tube cancer depends on the size, location and stage of the tumor, as well as the woman’s age, overall health and desire to have children. Treatment outcomes for fallopian tube cancer depend on diagnostic procedures, the tumor stage and how much cancer remains after surgery. Because fallopian tube cancer is so rare, there have been few controlled studies from which to obtain accurate data for prognosis.

 

Surgery
 

Surgery, followed by chemotherapy, is the most common treatment for fallopian tube cancer. The type of surgery is determined by the stage of the tumor, and may involve removal of the fallopian tubes, ovaries, uterus and cervix, as well as nearby lymph nodes.

 

Chemotherapy
 

Generally, the follow-up treatment to surgery for fallopian tube cancer is systemic chemotherapy, the use of powerful drugs to kill cancer cells. These drugs may be given through a vein or directly into the peritoneal space, where it will come in direct contact with the cancer. The most common drugs used to treat fallopian tube cancer are cisplatin, paclitaxel (Taxol), and carboplatin. The physician will develop the chemotherapyregimen according to the patient’s individual needs.

 

Radiation Therapy
 

Radiation therapy is generally not used to treat fallopian tube cancerexcept in special circumstances for palliation of localized disease.

 

Clinical Trials
 

New treatments are currently being tested in clinical trials and women diagnosed with fallopian tube cancer may want to consider participating in one of these research studies. Women with fallopian tube cancer are usually eligible to participate in clinical trials designated for ovarian cancer patients. If interested, patients should search for both fallopian tube trials as well as ovarian cancer trials and check the eligibility criteria for participation.