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Fallopian Tube Cancer

by Pedro T. Ramirez, MD, David M. Gershenson, MD

Fallopian tube cancer develops in the tubes that lead from the ovaries to the uterus.

  • Most cancers that affect the fallopian tubes have spread from other parts of the body.

  • At first, women may have vague symptoms, such as abdominal discomfort or bloating, or no symptoms.

  • Computed tomography is done to check for abnormalities.

  • Usually, the uterus, ovaries, and fallopian tubes are removed, followed by chemotherapy.

In the United States, fewer than 1% of gynecologic cancers are fallopian tube cancers. Cancer that starts in the fallopian tubes is rare. Most cancers that affect the fallopian tubes originate elsewhere in the body. It is usually diagnosed in women aged 50 to 60. It is more likely to develop in women who have had the following:

  • Long-term inflammation of the fallopian tubes (chronic salpingitis)

  • Disorders that cause inflammation in other parts of the body, such as tuberculosis

  • Infertility

More than 95% of fallopian tube cancers are adenocarcinomas, which develop from gland cells. A few are sarcomas, which develop from connective tissue. Fallopian tube cancer spreads in much the same way as ovarian cancer—usually directly to the surrounding area or through the lymphatic system, eventually appearing in distant parts of the body.

Symptoms

Symptoms include vague abdominal discomfort, bloating, and pain in the pelvic area or abdomen. Some women have a watery discharge from the vagina. When cancer is advanced, the abdominal cavity may fill with fluid (a condition called ascites), and women may feel a large mass in the pelvis.

Diagnosis

Fallopian tube cancer is seldom diagnosed early. Occasionally, it is diagnosed early when a mass or other abnormality is detected during a routine pelvic examination or an imaging test done for another reason. Usually, the cancer is not diagnosed until it is advanced, when it is obvious because a large mass or severe ascites is present.

If cancer is suspected, computed tomography (CT) is usually done. If the results suggest cancer, surgery is done to confirm the diagnosis, determine the extent of spread, and remove as much of the cancer as possible.

Doctors stage the cancer based on how far it has spread:

  • Stage I: The cancer occurs only in one or both fallopian tubes.

  • Stage II: The cancer has spread to nearby tissues but is still within the pelvis (which contains the internal reproductive organs, bladder, and rectum).

  • Stage III: The cancer has spread to abdominal organs (such as the intestine and liver) or nearby lymph nodes.

  • Stage IV: The cancer has spread to distant organs.

Prognosis

The prognosis is similar to that for women who have ovarian cancer.

Treatment

Treatment almost always consists of removal of the uterus (hysterectomy) and removal of the ovaries and fallopian tubes (salpingo-oophorectomy), adjacent lymph nodes, and surrounding tissues. Chemotherapy (as for ovarian cancer) is usually necessary after surgery. The most commonly used chemotherapy drugs are carboplatin and paclitaxel.

Radiation therapy is rarely useful. For cancer that has spread to other parts of the body, removing as much of the cancer as possible improves the prognosis.

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