Fallopian Tube Cancer

Overview

Fallopian tube cancer is a rare cancer that starts in one of the two fallopian tubes. The fallopian tubes are the thin, tube-shaped organs that carry an egg from the ovary to the womb (uterus). Cancer begins when cells lining the tube start to grow out of control and form a lump, called a tumour. Because the tubes sit so close to the ovaries and the lining of the belly, this cancer is often grouped together with ovarian cancer and treated in a very similar way. Many experts now believe that some cancers called 'ovarian' actually begin in the fallopian tube.

No, it is uncommon. Fallopian tube cancer is one of the rarest cancers of the female reproductive system. Because it is rare, general awareness of it is low, and it is often discovered during tests or surgery for another reason.

It mostly affects people who have a fallopian tube, usually after the menopause. Most cases are diagnosed in people in their 50s to 70s. People with a strong family history of breast, ovarian or related cancers, or who carry a gene change such as BRCA1 or BRCA2, have a higher chance of developing it. It can occasionally affect younger people, but this is uncommon.

Symptoms

Common symptoms

• A bloated or swollen feeling in the tummy (abdomen) that does not go away
• Pain or discomfort in the lower tummy or pelvis
• Feeling full very quickly when eating, or losing your appetite
• Needing to pass urine more often or more urgently than usual
• A change in bowel habits, such as constipation or loose stools
• Watery or blood-stained vaginal discharge
• Vaginal bleeding after the menopause, or bleeding between periods
• Unexplained tiredness, or weight loss without trying
• A lump or swelling you can feel in the lower tummy

Symptoms in children

• This cancer is extremely rare in children and teenagers. When it does occur, the signs would usually be tummy pain, a swelling in the tummy, or changes in bowel or bladder habits.
• Any child with ongoing tummy pain, a growing swelling, or unexplained weight loss should be checked by a doctor. In children, these symptoms are far more likely to have a common and treatable cause.

Symptoms in older adults

• Most cases are diagnosed after the menopause, so new bloating, pelvic discomfort, or bleeding after the menopause should always be checked.
• Older adults may put symptoms down to 'getting older' or a passing bug, which can delay a diagnosis. It is always reasonable to ask for a check-up.
• Some older adults may also have other health conditions that make symptoms harder to notice, so it helps to keep a simple note of what has changed and for how long.

Causes

Main causes

• Fallopian tube cancer happens when the DNA inside cells lining the tube changes in a way that lets them grow and divide out of control. Doctors do not fully understand why this happens in any one person.
• Research suggests that many cancers thought to start in the ovary actually begin in the far end of the fallopian tube and then spread to nearby organs.
• In most cases there is no single clear cause, and nothing you did or did not do is to blame.

Risk factors

• Age — it is more common after the menopause
• Inherited gene changes, especially BRCA1 and BRCA2, which also raise the risk of breast and ovarian cancer
• A strong family history of breast, ovarian, fallopian tube or prostate cancer
• Never having been pregnant
• Some inherited conditions that run in families and raise cancer risk (your doctor can explain these)
• Having had breast cancer in the past

When to see a doctor

See a doctor urgently if:

• Bleeding from the vagina after the menopause
• A swollen, bloated tummy that has lasted more than two to three weeks
• Pelvic or tummy pain that is getting worse or waking you at night
• Painful swelling, redness or warmth in one leg
• Vomiting that will not stop, or a tummy that is swollen and tender

Book a routine appointment if:

• Bloating, fullness or a change in bowel habits that keeps coming back
• Needing to pass urine more often than usual, with no infection found
• Unexplained weight loss or ongoing tiredness
• A family history of breast, ovarian or fallopian tube cancer that you would like to discuss
• Any symptom that is new for you and has not settled after a few weeks

Diagnosis

Your doctor will start by asking about your symptoms, your periods and your family history, and will usually examine your tummy and pelvis. If anything seems unusual, or if your symptoms do not settle, you may be referred to a specialist (often a gynaecologist or a cancer team) for scans and tests. Sometimes fallopian tube cancer is only found during surgery for another reason, because it is hard to see on scans when it is small.

Tests that may be done

• A pelvic examination, where the doctor feels the womb and ovaries
• An ultrasound scan of the pelvis, using a small probe on the tummy or inside the vagina
• A CT scan or MRI scan to look at the tubes, ovaries and nearby organs
• Blood tests, including a test called CA125, which can be raised in cancers of the ovary and tube (but can also be raised for other, harmless reasons)
• A biopsy, where a small sample of tissue is taken and checked under a microscope — this is the test that confirms a diagnosis
• Surgery to look inside the tummy and take samples, which also helps work out how far any cancer has spread (called staging)
• Genetic testing, offered to many people with this diagnosis, to look for gene changes such as BRCA1 and BRCA2

What to expect at your appointment

Being tested can feel like a lot of waiting. Some tests happen on the same day, while results for scans and biopsies usually take one to two weeks. You are welcome to bring someone with you, to write down your questions, and to ask for things to be explained again. Nothing is decided without your agreement, and you can ask what each test is for and what the results might mean.

Treatment

Treatment is planned by a specialist team and depends on the type of cancer, how far it has spread, your general health and what matters to you. The main treatments are surgery and chemotherapy, and sometimes targeted therapy (drugs that aim at specific features of the cancer cells) or radiotherapy. You will usually be given a chance to ask questions and to talk through options with your team before anything starts.

Self-care at home

• Keep a simple diary of symptoms, appointments and questions — it helps you feel more in control
• Ask a friend or family member to come to appointments with you and take notes
• Rest when your body asks for it, and build gentle activity back in when you feel able
• Tell your team about any side effects early, so they can help you manage them
• Ask your pharmacist before taking any new medicines, supplements or herbal products, as some can interfere with treatment
• Keep up with routine vaccinations and check with your team first about any that are live

Medical treatments

Surgery is usually the first step, aiming to remove the cancer and check whether it has spread. After surgery, chemotherapy is commonly offered — these are medicines, usually given through a drip into a vein, that travel around the body and target fast-growing cancer cells. Some people are also offered targeted therapy, which works on particular features inside cancer cells; your team will explain whether this is suitable for you. Radiotherapy (high-energy X-rays) is used less often for this cancer but can help in certain situations. Clinical trials may also be an option, and it is fine to ask about them. Your specialist team will explain the benefits, the possible side effects and the choices open to you.

When is surgery considered?

Surgery is usually the main treatment and is often done soon after diagnosis. The operation typically removes the fallopian tubes, ovaries and womb, along with any visible cancer, and samples are taken to see how far it has spread. For people who hope to have children in the future, fertility-sparing options may sometimes be possible if the cancer is found very early — this is something to discuss with your specialist team as soon as you can.

Living with this condition

Life during and after treatment often settles into a new rhythm. There will be good days and harder days. Many people find it helps to plan around their energy levels, to accept offers of help with practical things, and to keep some gentle routines that feel normal — a short walk, a chat with a friend, a favourite meal. Follow-up appointments will be regular at first, then spaced out over time.

Lifestyle tips

• Pace yourself and rest before you feel completely drained
• Stay connected with people you trust — isolation makes hard days harder
• Ask your team about work, driving and travel advice for your situation
• Avoid smoking and keep alcohol within recommended limits
• Keep a list of your medicines and bring it to every appointment
• Ask about support with money, travel to hospital and caring responsibilities — help is often available

Diet and exercise

There is no special diet that treats this cancer, but eating well helps you cope with treatment and recover from surgery. Try regular small meals with plenty of vegetables, fruit, beans, whole grains and a source of protein such as eggs, fish, chicken or lentils. If your appetite is poor, ask to see a dietitian — they can suggest easy, nourishing options. Gentle movement, like short walks, can help with tiredness, mood and recovery, but always build up slowly and follow your team's advice after surgery.

Mental health and emotional wellbeing

A rare cancer diagnosis can bring shock, fear, anger and sadness. It is common to feel anxious before scans and results, and to worry about the future. These feelings are not a sign of weakness, and you do not have to manage them alone. Talking to a counsellor, a clinical psychologist, your specialist nurse or a support group often helps a great deal. If you ever feel you cannot cope or have thoughts of harming yourself, please reach out for crisis support straight away — you deserve help right away.

Prevention

There is no sure way to prevent fallopian tube cancer, and in most people there is no clear cause to target. The strongest known protective step is surgery to remove the fallopian tubes (and sometimes the ovaries) for people at high genetic risk, such as those with a BRCA1 or BRCA2 gene change — this is a big decision and should be discussed in detail with a specialist. Some studies suggest that removal of the tubes at the time of other pelvic surgery, such as a hysterectomy, may lower risk; ask your surgeon whether this applies to you. Being aware of your body and getting persistent symptoms checked is also genuinely worthwhile.

Vaccines

There is no vaccine that prevents fallopian tube cancer.

Screening programmes

There is no national screening programme for fallopian tube cancer, and no blood test or scan has been shown to reliably catch it early in people without symptoms. If you have a strong family history or a known gene change, you may be offered regular checks or advice about risk-reducing surgery through a specialist genetics or gynaecology service.

Complications

If left untreated

• The cancer can spread to nearby organs such as the ovaries, womb and the lining of the tummy (peritoneum)
• Fluid can build up in the tummy (called ascites), causing swelling and discomfort
• The cancer can press on the bowel, causing a blockage with pain, vomiting and constipation
• It can spread to lymph nodes or, less often, to other parts of the body
• Untreated cancer can cause weight loss, tiredness and a general decline in health

Long-term outlook

The outlook varies widely and depends on the type of cancer, how far it has spread at diagnosis, and how well it responds to treatment. When fallopian tube cancer is found early, many people live well for many years and some are cured. Even when it is found later, treatment can control the cancer, relieve symptoms and help people live longer and feel better. Because this cancer is rare, precise numbers are hard to give — your own specialist team can talk through what is known about your situation, and it is always fair to ask them.

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