At the hospital you will see a doctor who is a specialist in women’s health (a gynaecologist). They will ask you about your symptoms and general health. They will carry out some tests and talk to you about any other tests you may need. You may see a specialist nurse before or after you have your tests.
There are several tests that may be used to diagnose fallopian tube cancer.
Internal (vaginal) examination
Your doctor will do an internal examination to check for any lumps or swelling in the ovaries or womb. It takes about five minutes and shouldn’t be painful but may be uncomfortable. You can ask for a female doctor to examine you if you prefer.
You lie on a couch, with your feet drawn up and knees apart. The doctor places one or two gloved fingers into your vagina and gently presses on your lower tummy with their other hand. They may put a speculum (which holds the vaginal walls apart) into the vagina to check that your cervix looks normal.
Blood tests
You will usually have a blood test to check for raised levels of a protein called CA125. The level of this protein may be higher in women with fallopian tube cancer or ovarian cancer. But it can also be raised by non-cancerous conditions.
You will also have blood tests to check your general health.
Ultrasound scan
This test uses sound waves to build up a picture of the organs inside the tummy (abdomen) and pelvis. A computer converts the sound waves into pictures that you can see on a screen. There are two types of ultrasound that can be used:
Pelvic ultrasound
You will be asked to drink plenty of fluids before this ultrasound so that your bladder is full. This helps to give a clearer picture. The person doing the scan spreads a gel on to your tummy (abdomen). They then gently go over the area with a small handheld device, which produces the sound waves.
Vaginal ultrasound
The tip of an ultrasound probe (the size of a tampon) is gently inserted into your vagina. The probe produces sound waves. Although this may sound uncomfortable, you may find it easier than a pelvic ultrasound, as you don’t need a full bladder.
CT (computerised tomography) scan
A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless and takes about 10-30 minutes. CT scans use a small amount of radiation, which would be very unlikely to harm you or anyone you come into contact with. You'll be asked to not eat or drink for at least four hours before the scan.
You may be given a drink or injection of a dye that allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.
MRI (magnetic resonance imaging) scan
This test uses magnetism 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 it is safe for you to have the MRI scan. Before the scan, you will be asked to remove metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan to show up more clearly. During the test, you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It is also noisy, but you will be given earplugs or headphones.
Removing fluid from the tummy
If you have a build-up of fluid in the tummy (called ascites) your doctor may take a sample to check for cancer cells. They numb the skin over the area first with a local anaesthetic. The doctor then passes a needle through the skin into the fluid and draws some into a syringe.
If you have a lot of fluid it can be uncomfortable so your doctor may remove it by putting a short tube (a cannula) into the tummy (abdomen). The tube attaches to a bag that collects the fluid as it drains.
We have more information about ascites.
Laparoscopy
Sometimes, you need a simple operation called a laparoscopy (keyhole surgery) to see inside the tummy (abdomen). While you are under general anaesthetic, the surgeon makes a small cut (about 1cm in length) in the lower abdomen. They put a thin tube with a light and camera (called a laparoscope) through the cut and use this to look at the fallopian tubes. The surgeon may take a small sample of tissue (a biopsy) from areas that don’t look normal. A pathologist (a doctor who specialises in analysing cells) then looks at the tissue under the microscope for signs of cancer.
During the operation, the surgeon pumps some carbon dioxide gas into the tummy. This helps them to see clearly and to move the laparoscope around safely. You may have wind and/or shoulder pains for several days after because of the gas. If you’re uncomfortable your nurse will give you painkillers and advice to help.
Guided biopsy
You may have a sample of tissue (biopsy) removed from the tumour using a CT scan to guide the surgeon to the right place. The doctor numbs the skin over the area using a local anaesthetic injection. You may also be given a sedative to help you relax.
They pass a needle through the skin of your tummy. A CT scan guides them to the right place. They take a biopsy from the tumour which they check for cancer cells.