Fallopian tube cancer is a disease that affects the ducts that connect the ovaries to the uterus, which allow the transport of eggs from the ovary to the uterus. Fallopian tube cancer is relatively rare, accounting for between 0.1% and 1.8% of all female genital tract cancers. Because of its rarity and the non-specificity of many of its symptoms, it is frequently missed until the malignancy is advanced.
The symptoms of fallopian tube cancer are very vague and are typical of many other gynecologic conditions. It is an extremely uncommon cancer, so, in most cases, the symptoms will be related to other less serious conditions. The most common symptoms of fallopian tube cancer include vaginal discharge, pelvic pain, abnormal bleeding, and a pelvic mass.
Vaginal discharge that is white, clear, or tinged with pink (blood) can be a symptom of fallopian tube cancer. However, it is much more likely to be caused by something far less severe.
If you are experiencing this type of vaginal discharge, you can expect your healthcare provider to swab your vagina and perform a microscopic examination of the sample. Depending on when your last Pap smear was done, your practitioner may want you to have one as well.
Abdominal or Pelvic Pain
A growing tumor in the fallopian tube can push against the walls of the tube and cause abdominal pain. Cancer can spread through the walls of the fallopian tubes and eventually into the pelvis (lower abdomen) and stomach areas if left untreated.
Because fallopian tube cancer is rare and pelvic pain is common with many other conditions, this symptom does not raise immediate flags for the disease. Pelvic pain that is persistent and lasts for two weeks definitely needs to be evaluated by your healthcare provider. If you are experiencing pelvic pain, your practitioner will want to know:
- When the pain occurs
- What triggers the pain for you
- What you are taking to relieve the pain
Abnormal Vaginal Bleeding
Abnormal vaginal bleeding can occur with fallopian tube cancer. Vaginal bleeding is considered abnormal when it occurs between periods, after sex or douching, or if you have very heavy periods. Any type of vaginal bleeding in postmenopausal women is abnormal.
Pelvic pain, discharge, and a pelvic mass are the most common symptoms present when women are diagnosed with fallopian tube cancer. However, these symptoms rarely present themselves altogether.
A pelvic mass that can be felt during a pelvic exam is an important symptom, but may often be related to benign conditions, like ovarian cysts. If a pelvic mass is discovered during an exam, your healthcare provider will want to follow up with other tests, such as an ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) to gather more information about the mass.
Characteristic signs of fallopian tube cancer on imaging studies include a distinctive sausage-shaped mass with evidence of water accumulation in the fallopian tubes (hydrosalpinx) or uterus (hydrometra).
It is this accumulation of water that ultimately creates the pelvis mass that many women feel and sometimes see beneath the skin.
The disease is rare, and there is not a lot of definitive information about its causes and risk factors. Women who have inherited a mutated BRCA gene are at an elevated risk of developing fallopian tube cancer.
Menopausal status can play a role in how symptoms are managed and in the diagnostic process of fallopian tube cancer. We do know that fallopian tube cancer is most commonly seen in postmenopausal Caucasian women between 50 to 60 years of age. Less commonly, the disease can affect minority women as well as those younger and older than the 50-to-60-year age bracket.
Post-menopausal women who are experiencing abnormal vaginal bleeding warrant a thorough and timely evaluation. While vaginal bleeding in a postmenopausal woman does not immediately indicate fallopian tube cancer, it does signal that something is wrong and needs to be evaluated. It could be a simple side effect of hormone replacement therapy, or it could be something more serious, like cancer.
If you are post-menopausal and are experiencing vaginal bleeding, it is important to report it to your healthcare provider.
Reducing the Risk
Early fallopian tube cancers are sometimes found when the fallopian tubes are removed as part of a pre-emptive surgery to reduce the risks of cancer for women with BRCA gene mutations.
For women at high risk for the disease, experts recommend removing both ovaries and fallopian tubes (salpingo-oophorectomy) once they have finished having children to help protect against ovarian and fallopian tube cancers.
The recommendation to remove the fallopian tubes is made because some surgeries have actually revealed fallopian tube cancer when originally the cancers were thought to be ovarian or primary peritoneal cancers (which develops in a thin layer of tissue that lines the abdomen).
Though this operation lowers the risk, it doesn’t fully eliminate it as some women with a high risk of developing ovarian cancer already have microscopic developments of cancer in their ovaries and fallopian tubes at the time of their operation.