Fallopian tube cancer is a rare cancer that starts in the fallopian tubes – the pair of slender tubes that connect your ovaries to your uterus (womb). Each month, an egg travels from the ovary through the fallopian tube to the uterus, where it may meet sperm for fertilisation.
More than 95% of cases develop in the cells that line the inside of the fallopian tubes (the epithelium). The most common type is high-grade serous carcinoma, which is very similar to the most common type of ovarian cancer. In fact, some cancers previously thought to start in the ovaries may actually begin in the fallopian tubes.
How Common Is It?
Fallopian tube cancer is very rare, accounting for less than 1% of all gynaecological cancers. However, recent research suggests that a significant number of ovarian cancers may actually originate in the fallopian tubes. It is most commonly diagnosed in women between the ages of 50 and 70, with the average age at diagnosis being around 60.
Causes and Risk Factors
- Age – the risk increases with age, especially after menopause.
- Genetic mutations – particularly BRCA1 and BRCA2 gene mutations. Women with BRCA1 have a lifetime risk of around 5% for fallopian tube/ovarian cancer; for BRCA2, it is around 3–5%.
- Lynch syndrome (HNPCC) – a hereditary condition linked to several cancers.
- Strong family history of breast, ovarian, or fallopian tube cancer.
- Never having been pregnant (nulliparity) – women who have never carried a full-term pregnancy have a slightly higher risk.
- Endometriosis – may slightly increase the risk.
- Chronic pelvic inflammation – in rare cases.
Symptoms
- Abnormal vaginal bleeding – especially bleeding after menopause or bleeding between periods.
- Watery, pink, or blood-stained vaginal discharge.
- Pelvic or abdominal pain – a dull ache or pressure.
- A feeling of fullness or bloating in the abdomen.
- A noticeable pelvic mass or lump – sometimes felt during a pelvic examination.
- Changes in bowel or bladder habits – such as constipation or needing to urinate more often.
- Loss of appetite or feeling full quickly after eating.
Diagnosis
- Pelvic examination – to feel for any masses or tenderness.
- Transvaginal ultrasound – to visualise the tubes, ovaries, and uterus.
- CA-125 blood test – a tumour marker that is often raised in fallopian tube and ovarian cancers.
- CT scan or MRI – to look for spread to other organs.
- Biopsy – a tissue sample is taken to confirm the diagnosis. This is usually done during surgery, as taking a biopsy without surgery can be difficult.
Treatment
Surgical Treatment
Treatment for fallopian tube cancer is very similar to that for ovarian cancer and usually involves a combination of surgery and chemotherapy. The main treatment is surgery to remove as much of the cancer as possible. This typically includes:
- Removal of both fallopian tubes and both ovaries (bilateral salpingo-oophorectomy).
- Removal of the uterus (hysterectomy).
- Removal of the omentum (a layer of fatty tissue covering the abdomen).
- Removal of any visible tumour deposits.
- Sampling of lymph nodes in the pelvis and abdomen.
Chemotherapy
After surgery, most women will receive chemotherapy to destroy any remaining cancer cells. This is typically given intravenously in cycles.
Radiotherapy
This is rarely used but may be considered for localised recurrence or symptom control.
eGynaecologist Advice
- You should not ignore persistent pelvic or abdominal symptoms especially if you are over 50 or postmenopausal. Symptoms like bloating, pelvic pain, or unusual vaginal bleeding lasting more than 2 weeks warrant a gynaecological review.
- If you have a close relative with breast, ovarian, or fallopian tube cancer, inform your gynaecologist. You may be eligible for genetic screening.
- You must discuss the timing and benefits of risk-reducing surgery with your gynaecologist if you carry a BRCA mutation.
- You should regularly attend all follow-up appointments with your gynaecologist to detect any recurrence early.
Frequently Asked Questions
Is fallopian tube cancer the same as ovarian cancer?
They are very similar. Both are treated in the same way, and many ovarian cancers are now thought to actually start in the fallopian tubes
Will I lose my fertility?
In almost all cases, yes. The standard surgery removes both fallopian tubes, both ovaries, and the uterus, which means you will no longer be able to conceive naturally.
Should I have genetic testing for BRCA?
Yes – all women diagnosed with fallopian tube cancer should be offered genetic counselling and testing for BRCA1/BRCA2 and Lynch syndrome mutations. This is important for your family members, as they may also be at risk, and it can guide your treatment options.
What happens if I am premenopausal – will I go through menopause?
Yes. Removing both ovaries will cause immediate surgical menopause. Your gynaecologist can discuss whether Hormone Replacement Therapy (HRT) is safe for you, depending on your cancer type.
Can it be prevented?
For women at high genetic risk (BRCA carriers), surgery to remove the fallopian tubes and ovaries (risk-reducing salpingo-oophorectomy) can significantly reduce the risk.
