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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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This information is about fallopian tube cancer.
The fallopian tubes are part of a woman's reproductive system. This system is made up of the parts of the body involved in having sex, producing and fertilising eggs, carrying a baby and giving birth. It also includes the ovaries, womb (uterus) and the vagina.
The two fallopian tubes come out from the sides of the womb. The tubes are very fine and about 10cm long. An egg is released from an ovary during the menstrual cycle every month. The egg moves through the fallopian tube and down to the womb.
The fallopian tubes and their surrounding structures View a large copy of the image of the fallopian tubes and their surrounding structures|
Fallopian tube cancer is rare. Only about 1 in 100 of all cancers of the female reproductive system (1%) are fallopian tube cancers.
This information is about primary fallopian tube cancer. The primary cancer is the area of the body where the cancer first starts to grow. Sometimes cancers that start in other areas, such as the ovaries|, womb| or cervix|, can spread to the fallopian tubes. This is known as a secondary fallopian tube cancer and is treated according to where it started (the primary cancer).
There are different types of fallopian tube cancer. The most common type is adenocarcinoma, which starts in the cells that form part of the lining of the fallopian tubes.
The exact cause of fallopian tube cancer is unknown. It’s more common in women in their 50s and 60s.
The only known risk factor is an inherited faulty gene. Our genes carry the information that’s passed on (inherited) from our parents. Doctors have identified two genes that may cause fallopian tube cancer. These are known as the BRCA genes. Doctors think that a faulty BRCA gene may cause around 15% of fallopian tube cancers. The BRCA genes are also linked to breast and ovarian cancer.
Your GP can refer you to a family cancer clinic if you have two or more close relatives (mother, sisters, daughters) with breast or ovarian cancer or one close relative with both cancers. We also have more information about genetics and cancer|.
Symptoms of fallopian tube cancer may include any or all of the following:
These symptoms can be caused by other conditions but it’s important to have them checked by your doctor. You should always see your GP about abnormal vaginal bleeding.
Usually you begin by seeing your GP, who will examine you and may arrange for you to have some tests. Your GP may refer you immediately to a gynaecologist (a specialist in the female reproductive system). The gynaecologist will do an internal vaginal examination to check for any lumps or swellings. You may also have an examination of your back passage (rectum). Your specialist will arrange for you to have some of the following tests:
You will usually have a blood test to check your general health and how well organs like your kidneys and liver are working.
You may have a blood test to check if you have higher than normal levels of a protein called CA125. CA125 is a protein that most women have in their blood. A raised level of CA125 is sometimes linked with fallopian tube cancer or ovarian cancer.
You may have an abdominal ultrasound or an internal vaginal ultrasound to check for any enlargement or abnormality of the fallopian tubes. For an abdominal ultrasound you’ll be asked to drink plenty of fluids so that your bladder is full. This helps to give a clearer picture. Once you’re lying comfortably on your back a gel is spread onto your abdomen. A small device, which produces sound waves, is then rubbed over the area. The sound waves are converted into a picture by a computer.
If you have an internal ultrasound scan, a probe with a rounded end is put into your vagina. Although this type of scan may sound uncomfortable, many women find it more comfortable than having an abdominal ultrasound, as you won’t need to have a full bladder.
This is a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless but takes longer than an x-ray (about 10-30 minutes).
Most people who have a CT scan are given a drink and/or injection to allow particular areas to be seen more clearly. For a few minutes, this may make you feel hot all over. Before having the injection or drink, it is important to tell your doctor and the person doing this test if you are allergic to iodine or have asthma.
Just before the scan begins, you may be asked to place a tampon into your vagina. This will ensure that the best possible picture is produced from the scan. Once you are lying in a comfortable position, the scan will be taken.
You will probably be able to go home as soon as the scan is over.
This test is similar to a CT scan but uses magnetism instead of x-rays to build up a detailed picture of areas of your body. Before the scan you may be asked to complete and sign a checklist. This is to make sure that it’s safe for you to have an MRI scan because the scanner is a powerful magnet. The checklist asks about any metal implants you may have, for example a pacemaker, surgical clips or bone pins.
Some people are given an injection of dye into a vein in the arm, which doesn’t usually cause discomfort. This can help the images from the scan to show up more clearly. You’ll be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. The scan is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It’s also noisy, but you’ll be given earplugs or headphones, and you can hear, and speak to, the person operating the scanner.
If you have a build-up of fluid in the tummy (abdomen) a sample of the fluid can be taken to check for any cancer cells.
The doctor will use a local anaesthetic to numb the area before passing a small needle through the skin. Some fluid is drawn off into a syringe and sent to a laboratory to be examined.
Sometimes the sample of fluid is taken while you are having an ultrasounds scan. The scan helps guide the doctor to the fluid.
This is a small operation that allows the doctor to look at the fallopian tubes and the surrounding area. The operation is done under a general anaesthetic and will mean a short stay in hospital.
The doctor makes a small cut (about 1cm in length) in the lower abdomen. A thin fibreoptic tube (laparoscope) is then inserted. The doctor can examine the fallopian tubes by looking through the laparoscope. A small sample of tissue is removed (this is called a biopsy) and is later examined for cancer cells.
During the operation, carbon dioxide gas is passed into the tummy (abdomen) and this can cause wind and/or shoulder pains for several days. You can often ease this pain by walking around or by taking sips of peppermint water.
An operation to examine the inside of the abdomen usually has to be done before a diagnosis of fallopian tube cancer can be confirmed. This operation is called a laparotomy. During the procedure the surgeon removes a small piece of tissue. This tissue is then examined to see if it contains cancer cells.
The stage of a cancer is a term used to describe its size and whether or not it has spread beyond its original site. Knowing the particular type and the stage of the cancer helps the doctors decide on the most appropriate treatment for you.
The most commonly used staging system is called the TNM system:
T refers to the tumour size.
N refers to whether or not lymph nodes are affected
M refers to whether or not the cancer has spread to other parts of the body (metastases).
The T, N and M will often have numbers attached to describe the detail. For example, a T1 tumour may be very small and just in one layer of tissue, whereas a T4 tumour may be a larger size and spread through several layers of tissue.
The exact details of the T, N and M will depend on the type of cancer.
In addition to TNM staging, you’ll probably hear the doctors use a number staging system. There are usually three or four number stages for each cancer type.
Stage 1 describes a cancer at an early stage when it's usually small in size and hasn’t spread, whereas stage 4 describes cancer at a more advanced stage when it has usually spread to other parts of the body. Stages 2 and 3 are in between these stages.
The number stages are made up of different combinations of the TNM stages. So a stage 1 cancer may be described as either T1, N0, M0 or T2, N0, M0.
Number stages may also be further subdivided to give more detailed information about tumour size and spread. For example, a stage 3 cancer may be subdivided into stage 3a, stage 3b and stage 3c. A stage 3b cancer may differ from a stage 3a cancer in either the tumour size or if the cancer has spread to lymph nodes.
In the last few years, staging systems have become increasingly complex and they now describe the size and spread of different types of cancer in much greater detail. This can be very helpful in planning the details of treatment or predicting outcomes.
However, doctors will often use a much simpler approach when talking about staging. They might use words like ‘early’ or ‘local’ if the cancer hasn't spread, ‘locally advanced’ if it has begun to spread into surrounding tissues or nearby lymph nodes, or ‘advanced’ or ‘widespread’ if it has spread to other parts of the body. Your doctors can give you more information about the stage of your particular cancer.
The main treatment for fallopian tube cancer is surgery. Both ovaries and fallopian tubes are removed (bilateral salpingo-oophorectomy) and also the womb and the cervix (total abdominal hysterectomy). The tissue that supports nearby organs (called the omentum) and the lymph nodes in the pelvis may also be removed.
You are likely to have an electrocardiogram or ECG (heart tracing) scan. You’ll also have blood and urine tests, and your blood pressure will be checked. Some women may also have a chest x-ray or a heart scan (echocardiograph). These tests can be done the day before your operation or a few days or weeks beforehand at a preassessment clinic.
The operation is carried out under a general anaesthetic. The surgeon usually makes a cut downwards from the belly button to the pubic hair. Sometimes they make a 10cm (4in) cut across your tummy (abdomen) just above the pubic hair instead.
The surgeon then removes fallopian tubes, the ovaries and other organs through the cut in your abdomen. The muscles and tissues are repaired and the wound is closed with staples or a continuous stitch.
You can expect to be in hospital for 3-7 days after your operation. You’ll be encouraged to start moving around as soon as possible. You will have been given support stockings to wear. These help prevent blood clots developing in the legs and you may be asked to wear them for up to six weeks after you go home.
It's normal to have some pain or discomfort for a few days, but this can be controlled effectively with painkillers. If the pain is not controlled, let your doctor or nurse know so that your painkillers can be changed.
It takes time to fully recover from this operation and you’re likely to feel tired for several weeks or more. It will also take a while for your tummy muscles (abdominal muscles) and skin to heal. So you will need to avoid strenuous activity or heavy lifting for at least 12 weeks. A little walk for a few minutes each day is a good idea to build up your strength. It’s usually safe to start gentle exercise, like swimming, about 6–8 weeks after your surgery.
There is more information about what to expect before and after your surgery in our section on having a hysterectomy|.
Getting back to a normal sex life after a hysterectomy is perfectly safe and healthy. To allow the wound to heal properly, most women are advised to wait at least six weeks after their operation before having sexual intercourse.
Any sexual problems usually settle with time as life begins to get back to normal after the surgery. If they don't improve your doctor or specialist nurse will be able to give you advice. They may be able to arrange for you to have counselling, which is often helpful.
In women who are still having periods, removing the ovaries will bring on an early menopause, so you will become infertile. Your doctor or specialist nurse can give you more information on how menopausal symptoms can be managed.
Being told that you have cancer and that treatment will make you infertile can be very difficult. Whatever your situation, the loss of fertility| can be overwhelming. Some women may find it helpful to talk things over with a trained counsellor.
Chemotherapy| (anti-cancer drugs) is usually given after surgery if it wasn’t possible to remove all of the cancer. It’s also given if there’s a high risk that some cancer cells that are too small to be seen have been left behind. Sometimes chemotherapy is given before surgery to shrink the cancer and make it easier to do the operation.
The most commonly used drugs to treat fallopian tube cancer are:
The drugs are usually given by injection into a vein (intravenously). Chemotherapy can often be given to you as an outpatient but it will sometimes mean spending a few days in hospital.
Chemotherapy can cause side effects, but they can often be well controlled with medicines. Most of these side effects will disappear once your treatment is over.
The drugs temporarily reduce the number of normal cells in your blood. When this happens you’re more likely to get an infection and may tire easily. If you have any signs of infection you will be given antibiotics. Occasionally people may need a blood transfusion if they become anaemic due to chemotherapy.
There are now very effective anti-sickness (anti-emetic) drugs to prevent or reduce nausea and vomiting|. Your doctor will prescribe these for you.
Cleaning your teeth carefully and regularly using mouthwashes are important. Your nurse will show you how to do this properly. If you don’t feel like eating| during treatment, try replacing some meals with nutritious drinks.
Some of the chemotherapy drug used can make your hair fall out|. If your hair does fall out, it will grow back over a period of 3-6 months, once the chemotherapy has finished.
This is due to the effect of some chemotherapy drugs on nerves and is called peripheral neuropathy|. Tell your doctor if you notice these symptoms.
Radiotherapy| uses high-energy rays that destroy the cancer cells while doing as little harm as possible to normal cells. It is occasionally used to reduce symptoms if the cancer comes back after surgery and chemotherapy.
The side effects will depend on how much treatment you have and your doctor will discuss this with you beforehand. Radiotherapy makes you feel tired and this can last for weeks after your treatment is over. Make sure you get enough rest. You may also get some diarrhoea| or feel that you want to pass urine more frequently. Your doctor can prescribe drugs to help relieve these side effects. The side effects will improve gradually when your treatment is over.
Occasionally doctors use a drug called Tamoxifen| as part of the treatment for fallopian tube cancer.
After your treatment has finished, you will have regular check-ups and possibly scans or x-rays. Let your doctor or specialist nurse know as soon as possible if you have any problems, or notice any new symptoms in between these times.
It takes time to come to terms with a cancer diagnosis. You’re likely to experience a number of different emotions|, from shock and disbelief to fear and anger. Everyone has their own way of coping with difficult situations. Some women find it helpful to talk to family or friends, while others prefer to get help from people outside their situation. Counselling can usually be arranged by the hospital or your GP. Our cancer support specialists| can give you information about counselling.
This information has been compiled using information from a number of reliable sources including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.