Detecting fallopian tube cancer can be challenging as its symptoms often overlap with those of various common conditions experienced during menopause, which is a time when this type of cancer commonly occurs.

Symptoms may include:

• Abdominal swelling
• Abdominal and back pain
• Loss of appetite or feeling full quickly
• Frequent or urgent need to urinate, along with changes in toilet patterns, such as alterations in bowel habits
• Unexplained weight loss or gain
• Indigestion or heartburn
• Fatigue
• Watery discharge from the vagina.

The specific cause of fallopian tube cancer remains unknown; however, certain factors are suspected to increase the risk, including: cost like 600

• Advancing age (most cases are diagnosed in women between 50 and 60 years old).
• Post-menopausal status.
• Nulliparity (having no children).
• Family history of ovarian or breast cancer, particularly among close relatives (mother, sister, daughter).
• Increased risk associated with inherited mutations in the BRCA gene, which are linked to higher incidences of ovarian and breast cancers.
• Never having breastfed a child.
• Never having used birth control pills.
• Presence of endometriosis, a benign (non-cancerous) condition that can elevate the risk of ovarian and fallopian tube cancers.

Various factors contribute to different types of cancer, and researchers are actively investigating the causes and prevention of ovarian and fallopian tube cancer. While there is no definitive way to completely prevent these cancers, it may be possible to lower one’s risk. Consulting your healthcare team can provide valuable insights into your individual cancer risk.

Studies have indicated that certain factors may reduce the risk of developing ovarian and fallopian tube cancer:

• Taking birth control pills: Individuals who have used oral contraceptives for three or more years have shown a 30% to 50% lower likelihood of developing ovarian and fallopian tube cancer. This decreased risk might persist for up to 30 years after discontinuing the pills. Additionally, intrauterine devices (IUDs) have been associated with a reduced risk of ovarian cancer.
• Breastfeeding: Prolonged breastfeeding after childbirth is linked to a decreased risk of ovarian and fallopian tube cancer.
• Pregnancy: The number of full-term pregnancies a person has experienced is inversely related to their risk of ovarian and fallopian tube cancer.
• Surgical procedures: People who have undergone a hysterectomy or tubal ligation tend to have a lower risk of developing ovarian and fallopian tube cancer. A hysterectomy involves removing the uterus and sometimes the cervix. Tubal ligation is a surgical procedure where the fallopian tubes are tied or closed to prevent pregnancy. For individuals at high risk of ovarian and fallopian tube cancer, doctors might recommend bilateral salpingo-oophorectomy, which involves removing both ovaries and fallopian tubes. Some individuals choose to have their fallopian tubes removed during abdominal surgery for other purposes or during a caesarean section after completing their desired number of childbirths.
• High-risk genetic mutations: Individuals with genetic mutations like BRCA1, BRCA2, and genes associated with Lynch syndrome are advised to consider removing their ovaries and fallopian tubes after completing childbearing. This preventive measure can reduce the risk of ovarian and fallopian tube cancers by up to 96%. Furthermore, if the surgery is performed before natural menopause, there may be a 40% to 70% decrease in the risk of developing breast cancer, especially for individuals with BRCA2 mutations.

Due to the rarity of fallopian tube cancer and its symptoms resembling other conditions, diagnosing it can be challenging. Sometimes, women only discover they have fallopian tube cancer when a tube is surgically removed during treatment for another health issue.

However, several tests can aid in definitively diagnosing the condition. Your doctor will begin by inquiring about any symptoms you may be experiencing, reviewing your medical history, and conducting a thorough physical examination. Additional tests that may be performed include:

• Pelvic Exam: This involves the examination of the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to detect any abnormalities in size or shape.
• CA125 Test: A blood test to measure CA125 levels, a tumor marker associated with gynecological diseases, including fallopian tube cancer. While approximately 85 percent of women with gynecological diseases have elevated CA125 levels, it’s crucial to note that increased CA125 levels may not necessarily indicate cancer. Levels can also rise during pregnancy, menstruation, and other non-cancerous gynecological diseases or cancers affecting different parts of the body.
• Computed Tomography (CT) Scan: This imaging test captures detailed pictures of the body’s internal areas. A computer, linked to an X-ray machine, generates these images. To enhance organ or tissue visibility, a special dye may be injected into a vein or swallowed.
• Ultrasound: Pelvic ultrasound uses high-frequency sound waves to create images of organs and systems within the body. These sound waves, inaudible to humans, produce a pattern of echoes called a sonogram, which can differentiate between healthy tissues, fluid-filled cysts, and tumors.
• PET (Positron Emission Tomography): PET scans involve the use of a radioactive sugar (glucose) to identify cancer cells. This test is sometimes employed to detect the spread of fallopian tube cancer.

These tests collectively aid in achieving an accurate diagnosis and better understanding the extent of fallopian tube cancer if present.

The stages of fallopian tube cancer are determined by the extent of its spread, ranging from the earliest (Stage I) to the most advanced (Stage IV):

• Stage I: Cancer is confined to one or both fallopian tubes.
• Stage II: Cancer has extended to the uterus or nearby tissues within the pelvic region (which includes internal reproductive organs, bladder, and rectum), or it is localized on the peritoneum.
• Stage III: Cancer has progressed beyond the pelvic region and spread to lymph nodes and/or other abdominal areas (such as the surface of the liver or spleen).
• Stage IV: Cancer has metastasized to distant locations, such as the lungs.

Surgery plays a crucial role in the treatment of ovarian and fallopian tube cancers, and it is typically carried out by a gynecologic oncologist, a specialist in treating gynecologic cancers, including surgical procedures and chemotherapy (see “Chemotherapy” below).

As mentioned earlier in the Diagnosis section, surgery is often necessary to fully assess the extent of the disease and establish an accurate stage. Minimally invasive surgery is commonly employed to confirm the diagnosis and determine whether a debulking procedure (see below) should be performed immediately after diagnosis or after administering chemotherapy first. This step is essential because imaging tests may not always reveal the complete extent of the disease.

For patients with localized cancer in the ovary, a debulking procedure includes a staging process, involving the removal of various tissues, including lymph nodes, to determine if the cancer has spread. In advanced cases, the primary objective is to remove as much cancer as possible. This procedure has been shown to be most effective when combined with chemotherapy after the surgery.

There are several surgical options for ovarian and fallopian tube cancer, and the recommended surgeries depend on the tumor’s stage. In some cases, multiple procedures may be performed during the same surgery:

• Salpingo-oophorectomy: This surgery involves the removal of the ovaries and fallopian tubes. When both ovaries and both fallopian tubes are removed, it is referred to as bilateral salpingo-oophorectomy. For individuals with early-stage cancer who desire future pregnancy, it may be possible to remove only one ovary and one fallopian tube if the cancer is limited to one ovary. This type of surgery is known as unilateral salpingo-oophorectomy. For patients with a germ cell type of ovarian tumor, it is often sufficient to remove only the ovary containing the tumor, preserving the ability to conceive.
• Hysterectomy: This procedure involves the removal of the uterus and surrounding tissue if necessary. If only the uterus is removed, it is called a partial hysterectomy. A total hysterectomy includes the removal of both the uterus and the cervix.
• Lymphadenectomy/lymph node dissection: During this surgery, the surgeon may remove lymph nodes in the pelvic and paraortic regions.
• Omentectomy: This surgery aims to remove the thin tissue covering the stomach and intestines.
• Cytoreductive/debulking surgery: Used for advanced ovarian and fallopian tube cancers, the goal of this surgery is to remove as much tumor as safely possible. It may involve removing tissue from nearby organs, such as the spleen, liver, and parts of the small bowel or colon. This can alleviate symptoms caused by masses pressing on other organs and enhance the effectiveness of subsequent treatments, such as chemotherapy, to control any remaining disease. If the cancer has spread beyond the ovaries, fallopian tubes, or peritoneum, doctors may use neoadjuvant chemotherapy to shrink the tumor before cytoreductive or debulking surgery. Neoadjuvant chemotherapy involves 2 to 3 cycles of chemotherapy before the surgery to make the debulking procedure safer and more effective. Hyperthermic intraperitoneal chemotherapy (HIPEC), a newly described method, is being studied in clinical trials and is not yet the standard of care. Sometimes, chemotherapy may be administered during surgery.

It is advisable to have debulking surgery performed by a board-certified gynecologic oncologist if possible. Before undergoing surgery, discuss the risks and benefits of the procedure with your doctor. Inquire about the surgeon’s experience with debulking surgery and whether it will be conducted minimally invasively, through an open incision, or robotically. Make sure to explore the various surgical options with your doctor.