Fallopian tube cancer
What is fallopian tube cancer?
Fallopian tube cancer is a cancerous disease in which a malignant tumor originates from the epithelium of the fallopian tube.
Cancer of the fallopian tubes is considered a rare disease. The frequency of diagnosis is up to 1% among all oncologicpathologies and up to 1.18% in the structure of gynecologic oncologic diseases. Tumors of the fallopian tubes are more often detected in women over 50 years of age. The malignant process more often occurs on one side, but there are also bilateral lesions.
Malignant tumors of fallopian tubes arise as a result of malignization of epithelial areas. About 90% of neoplasms by histological type are adenocarcinomas. Gradually, the tumor blocks the lumen of the fallopian tube, provokes hemorrhages and necrotic changes, and may also cause its rupture.
With the flow of blood and lymph, malignant cells get into the lymph nodes and other organs (primarily reproductive). They can be implanted in the walls of the abdominal cavity, intestines, liver, spleen, etc.
Types
Depending on the origin of the tumor, the following types of fallopian tube cancer are distinguished:
- primary (malignant neoplasm is initially formed in the lumen of the tube);
- secondary (atypical cells get into the tubes from other genital organs – uterus, ovaries, vagina);
- metastatic (tubal lesions result from metastasis of a tumor from another location, such as the stomach or breast).
Taking into account the degree of prevalence of the pathological process, the following stages of cancer are distinguished:
- Null (preinvasive cancer). The neoplasm is localized in the epithelium of the fallopian tube.
- One. The tumor grows into other layers of the fallopian tube but does not go beyond it. Substage A corresponds to a unilateral lesion of the mucous and muscular layers. Substage B is characterized by bilateral localization of the process. Substage C implies unilateral or bilateral lesions involving the serous layer of the tubes and penetration of atypical cells into the abdominal cavity. Altered cells are detected by examination of ascitic fluid.
- Second. In this stage of cancer, the tumor is localized on one or both sides and has infiltrated the surrounding organs. Substage A involves the uterus and/or ovaries. Substage B is characterized by the invasion of the tumor into other pelvic organs.
- Third. In addition to fallopian tubes and pelvic structures, other organs are involved. At substage A, microscopic metastases are found in the abdominal cavity, B – secondary tumor formations up to 2 cm in diameter, and C – the size of metastases exceeds 2 cm. Most often, at this stage, metastasis to lymph nodes occurs.
- Fourth. Disseminated cancer. The tumor affects other structures of the small pelvis, metastases appear in distant organs and lymph nodes.
Symptoms
Symptomatology in fallopian tube cancer appears quite early. The first symptom is severe pain periodically on the side of the lesion. Often, there is also the pathological discharge of serous, purulent, or bloody character, as well as abundant watery discharge.
As the disease progresses, the pain becomes constant. Some patients quickly develop ascites, externally manifested by increased abdominal circumference. At later stages, symptoms typical of advanced cancer are observed: weakness, apathy, fatigue, lack of appetite, weight loss, enlargement of lymph nodes, etc.
Reasons
The exact causes of fallopian tube cancer have not been established. The following factors are considered predisposing:
- papillomavirus infection;
- Carrying herpes virus type 2;
- infertility;
- recurrent anovulatory cycles;
- inflammatory diseases of the uterine appendages;
- tobacco and alcohol abuse;
- exposure to stress.
Diagnosis
A suspicion of a cancerous tubal tumor may arise during a gynecological examination. The disease is indicated by deformation, irregular tube shape, or a sac-like formation on one or both sides of the uterus. The laboratory stage of diagnosis involves a general blood test, a test for markers, and the study of smears from the cervical canal and aspirate from the uterus. Visualization of the tube is possible during ultrasound, CT, or MRI of the pelvis.
General examination is aimed at detecting metastases in distant organs and lymph nodes. For this purpose, ultrasound, radiography, CT and/or MRI, diagnostic laparoscopy, etc. are performed.
Fallopian tube cancer treatment
Treatment of the disease is carried out in a complex manner. The main stage is surgery, during which the tumor is removed along with the affected organ. Antitumor therapy is carried out to destroy cancer cells that have managed to spread to the surrounding tissues.
Conservative treatment
Polychemotherapy is used in most cases to eliminate atypical cells. In modern oncology, preference is given to drugs that have a targeted effect on tumor cells and practically do not affect health in general.
One of the effective chemotherapeutic methods of HIPEC is applied directly during surgery. After the tumor is removed, a warm cytostatic solution is injected into the abdominal cavity. It increases the effectiveness of treatment.
In case of advanced forms of cancer in the postoperative period, radiotherapy of the pelvis and para-aortic zone is performed, which contributes to a more complete elimination of cancer cells and reduces the risk of metastases.
Surgical treatment
The stage of the disease, age, and reproductive plans of the patient determine the possibility of organ-preserving surgery. “The gold standard for the treatment of tubal cancer is total hysterectomy (removal of the uterus together with the appendages). During the operation, an urgent histological examination is performed, during which the structure of the tumor is studied, and regional lymph nodes are checked for the presence of metastases. Analysis of abdomen flushes reflects the risk of secondary tumors in the abdominal cavity. If necessary, lymphatic structures and the affected omentum are additionally removed.
All these treatment options are available in more than 900 hospitals worldwide (https://doctor.global/results/diseases/fallopian-tube-cancer). For example, bilateral adnexectomy is performed in 25 clinics across Turkey for an approximate price of $3.7 K (https://doctor.global/results/asia/turkey/all-cities/all-specializations/procedures/bilateral-adnexectomy).
Prevention
To reduce the risk of developing tubal cancer, it is recommended to follow simple rules:
- be selective about sexual partners, use barrier contraception;
- timely and thoroughly treat gynecological diseases;
- give up bad habits;
- an active lifestyle;
- avoid stressful situations as much as possible.
Rehabilitation after surgical treatment
The peculiarities of the rehabilitation period depend on the type of the intervention. Usually, patients are prescribed medication to control the existing symptoms and prevent the development of complications. During the recovery period after surgery, it is necessary to refuse bathing in the bathtub, taking heat procedures, sexual contacts and physical exercises. After the treatment of tubal cancer, a woman needs regular follow-up with an oncologist.
