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Fallopian tube cancer

Fallopian tube cancer
Sometimes cells forming the fallopian tube change and start to behave abnormally. Those changes may sometimes lead to uncontrolled division and growth of those cells which will result to development of cancer. Compared to other cancers of female reproductive system, fallopian tube cancer is very rare type of cancer. Depending on the cells involved, fallopian tube cancer is divided into several types. These types include the following,

• Adenocarcinoma: these originate from glandular cells found on the lining of the tubes, these cells are responsible for production of mucus. This is the most common type of fallopian.
• Transitional cell carcinoma: This start from transitional cell epithelium in the lining of the tube.
• Sarcomas: These start from connective tissues and in our case it start from muscles located on the walls of the tube.


Others include malignant teratoma, endometroid and squamous cell carcinoma.

Risk factors of fallopian tube cancer
When it comes to cancer, anything that increases your probability of developing cancer is called a risk factor. Risk factors only influence development of cancer but it does not directly cause cancer. Sometimes people with risk factors do not develop the disease while those with no risk factors do develop

the disease. Knowing risk factors will help you live your life making some better healthy choices to reduce the risk. Those risk factors include the following,

• Family history. If several of your close relatives have ever suffered from breast, ovarian or fallopian tube cancer, you may have a slightly increased risk of developing fallopian tube cancer. It is not clear whether the family`s pattern of cancer is by chance or shared lifestyle or even genetic factors passed from parents to children or combination of all. Close relatives include mother, sister or daughter.

• Gene mutations. Researches indicate that changes in BRCA genes may increase the risk of developing breast cancer, ovarian cancer as well as fallopian tube cancer. Change in BRCA (BRCA1 or BRCA2) genes is normally inherited (passed from parents to children). It is common to the families that one or several family members suffered from breast , ovarian or fallopian tube cancer.
Other possible risk factors/h5> These are the risk factors with no enough evidence to support them but are also linked with this type of cancer. These include the following,

• Chronic infection. Chronic infection of the reproductive system is linked with development of fallopian tube cancer.
• Never bearing a child. The risk of this cancer is said to be slightly higher to women who have never given birth (never been pregnant) in their child bearing age.
• Hormone replacement therapy. These are treatment that involve giving a woman certain drugs as a replacement of female hormones when are no longer produced (at menopause age) so as to relieve some symptoms of menopause. Some of the drugs are said to put people at risk of this cancer although there are no enough researches to support that.

Prevention of fallopian tube cancer
Since there are no known specific cause of these cancers, it is not possible to prevent this cancer. Although there are some of the advices that may help reduce the risk of developing fallopian tube cancer.

• Pregnancy. Since never giving birth until your old increases your chance of developing fallopian tube cancer, then giving birth at the right age is the best choice.
• Discuss with your doctor about hormone replacement therapy. Knowing the benefits and risks of your hormone replacement therapy before undergoing it, is very important.
• Opting to have gynecological surgeries. Some choose to cut or block the fallopian tube. This is called tubal ligation and it reduces the risk of developing this type of cancer. Having your uterus removed also reduce the risk of this type of cancer too.

Early detection and screening
Screening is the process of running some tests to those with no symptoms with the purpose of testing for any signs of a disease like cancer and others. This process provide platform of early detection of diseases because if a person is found with any sign of disease, she will be advised to go for more diagnostic tests.

Early detection of cancer increases the chance for better prognosis. However, for fallopian tube cancer there is no widely recommended screening tests for people at average risk of developing it.

Those at high risk of developing the disease including those with family history of breast and ovarian cancer and those with BRCA1 or BRCA2 gene mutation are advised to go for checkup more often than others. Among the tests that are mostly done to this group of women include the following,
• Pelvic examination
• Antigen test (level of CA 125)
• Transvaginal ultrasound

Signs and symptoms of fallopian cancer

• Watery discharge from vagina
• Vaginal bleeding between normal periods or after menopause
• Filling abdominal or pelvic pain
• Swollen abdomen (filling a lump inside pelvis)


Those are the main common signs and symptoms shown by women with fallopian tube cancer. But that doesn`t mean that, every women experiencing those symptoms has cancer. So it is strongly advised to go for medical checkup when you fill that something is not normal in your body.

Diagnosis

Laboratory tests. Laboratory tests are important in ruling out other conditions and confirming diagnosis. For cancer diagnosis laboratory tests normally include blood tests, urine tests, tumor markers and other body fluids tests.

• Blood tests. Blood tests help to reveal level of different substances in the blood which will help doctors to know if there is anything wrong in the body. From blood tests doctors can see complete blood count which indicates number, size and maturity of blood cells. Also from the blood tests doctors can analyze if kidney and liver are working properly.
• Urine tests. Urine tests (urinalysis) involve laboratory examination of urine to check presence of blood, proteins, and other substances such as drugs. For instance blood in the urine may be an indication of benign condition, infection or other health problem.
• Tumor markers. These are biomarkers (proteins) that can be produced by both cancer cells and normal body cells in response to cancer. Tumor markers are released into the blood or urine. Although studies are still conducted to determine role of these markers in diagnosing cancer because sometimes people with benign condition will have elevated level of these proteins. Also not all tumors have their markers and some markers are not specific to one type of tumor.


Diagnostic imaging. Diagnostic imagings involve tests that create pictures of inside the body that help the doctor to see if there is tumor or not. There are several imaging tests used in cancer diagnosis depending on the type and location of cancer suspected. These imaging tests include;

• Computed tomography (CT) scan. CT scan machine is a donut-shaped scanner that uses x-rays to create series of pictures of body organs from different angles. This machine is linked to a computer where those series of pictures taken will be combined to create a 3D- image of inside the body. During the scanning process patient will lie still on the table which will slide into the scanner. In order to get a clear image, sometimes the doctor will inject the patient with a contrast material before scanning. From the images the doctor will be able to differentiate between healthy and unhealthy tissues.
• Magnetic resonance imaging (MRI). MRI is an imaging technique that uses powerful magnet and radio waves to take series of pictures of body organs and create a 3D image in a computer linked to a machine. Just like in CT, during MRI procedure the patient will lie on a table that will slide into a long round chamber. Also during this procedure the doctor may inject the patient with a contrast material for clear image view.
• X-ray. This is an imaging technique that is uses low dose of radiation to create pictures of inside your body. Technician will position the patient and direct the x-ray beam to the intended part of the body.
• Ultrasound. Ultrasound is a diagnostic imaging procedure that uses high energy sound waves to produce images of organs inside the body. During the examination, a patient will lie on the table while the technician will slowly move a device called transducer on the skin over the part of the body that is being examined.
• PET scan. Positron emission tomography (PET) scan is an imaging test that uses radioactive glucose to create 3-D images of areas inside the body. Radioactive glucose is used for this test because cancer cells tend to absorb more glucose than normal body cells, so the scan will show which areas of the body has more glucose than others. Before the scan, doctor will inject the patient with tracer called radioactive glucose then during imaging the patient will be asked to lie on the table that will be moving back and forth through the scanner.
• Bone scan. Bone scan is used to examine bones. When it comes to cancer, bone scan is used for diagnosis of bone cancer or cancer that has metastasized into the bones. Before the test, patient will be injected with small amount of radioactive material that tends to collect more on abnormal parts of the bones. Then pictures that will be taken by a scan will indicate the distribution of those radioactive materials in the bones throughout the body.


Biopsy. Biopsy is a diagnostic procedure that involves removing a tissue sample from the body and examines it under microscope in the laboratory. Examination in the laboratory is normally done by a pathologist who will check if the cells in the tissue are cancerous or not. In most cancer cases, biopsy is considered to be the confirmatory test. Depending on the location and type of cancer, biopsy can be obtained in different ways. Some of them include;

• Using needle. By using a thin needle, doctors can draw same tissue or fluid for examination under microscope. This method can be used to draw some fluid (spinal tap), bone marrow (bone marrow aspiration), blood or small amount of tumor from the suspected organ such as liver and breast (fine needle aspiration).
• Surgery. Abnormal tissue samples are obtained while the doctor is performing the surgery. Tissues are then sent to the lab for examination during the surgery. If the surgeon removes just a portion of abnormal area it is called incisional biopsy while when the entire tumor (abnormal site) is removed it is called excisional biopsy.
• Using endoscope. Endoscope is a thin, lighted tube with a camera (focusing telescope) at the end. It is used for viewing inside the body through natural openings like mouth and anus. During an examination if the doctor sees any abnormal tissue, then endoscope can also be used to take sample for that tissue. There are different kinds of endoscopy exams depending on the site of the body being examined. Some of the exams include colonoscopy (for rectum and colon), bronchoscopy (for trachea, bronchi and lungs) and esophagogastroduodenoscopy EGD (for esophagus, stomach and duodenum)

Treatment options Treatment of fallopian tube cancer requires a team of doctors and other health care professionals. This team work together and it is called multidisciplinary team. Team may vary depending on the treatment option for a particular case. But normally multidisciplinary team for treatment of fallopian tube cancer includes surgical oncologist, medical oncologist, radiation oncologist, radiation therapist, pathologist and other health care professionals like oncology nurses and palliative care team. Treatment options include the following

Surgery For fallopian tube cancers, surgery is the primary treatment option. A total hysterectomy and bilateral salpingo-oophorectomy is the most common surgery. A total hysterectomy removes the uterus, cervix, nearby lymph nodes and the omentum while salpingo-oophorectomy removes the ovary and fallopian tube. Salpingo-oophorectomy may be involving one side (unilateral) or both sides (bilateral).

Cases that are still at an early stage may require only salpingo-oophorectomy and when disease has spread to other structures of abdomen and pelvis, then surgery is done to reduce the size of tumor as much as possible.

Side effects of surgery will depend on the type of procedure and woman`s general health. But some of the common side effects include the following.

• Fertility problems. Since surgery involves the removal of ovaries, that means you will not be able to produce female eggs. And if your surgery involved removal of only one ovary you will need to talk with your doctor about your chance of having kids again.
• Pain. Sometimes surgery may cause some pains, but these are normally relieved by medications.
• Loss of blood. Sometimes surgery may cause loss of a lot of blood, this can be solved through blood transfusion.

Chemotherapy

Chemotherapy is a treatment option that use drugs to destroy cancer cells or stop its growth. It is given by a doctor known as medical oncologist. For fallopian tube cancers, chemotherapy are usually is given following surgery. Generally chemotherapy is can be given through injection into vein (intravenously) by using a needle or given as a pill or capsule that is swallowed (orally). But for advanced and recurrent fallopian tube cancers chemotherapy can be given intraperitoneally (delivered directly into the peritoneal cavity by using catheter).

Side effects of Chemotherapy
The side effects of radiotherapy of may vary depending on whether a person had radiotherapy of brain or spinal cord but some of the effects are similar. The side effects normally occur during the course of treatment and fed away soon after completion of treatment or may last for few months or in some cases may last for years. These effects include the following;

• Loss of hairs
• Nausea and vomiting, if it becomes severe it can be relieved by medications.
• Loss of appetite, this can also be relieved by medication.

Radiotherapy Radiotherapy is the treatment of cancer by using high energy x-rays and other radiation particles to destroy cancer cells. For fallopian tube cancers, radiotherapy is normally used after surgery and chemotherapy for recurrent cancers or relieving symptoms for advanced cases. This type of treatment is given by doctor known as radiation oncologist.

Side effects of Radiotherapy
• Fatigue. This normally disappears soon after completion of treatment
• Mild skin reactions. Sometimes this treatment option may bring mild skin reactions. These can be relieved by using special cream.
• Loose bowel movement

Targeted therapy
Targeted therapy is an option that involve targeting specific molecules in the cancer cells using drugs. The drug will stop the growth and spread of cancer cells and at the same time limit harm to normal cells. Drugs for this kind of treatment work differently to that of normal chemotherapy drugs. Drugs for this treatment option can sometimes help even when chemo isn’t, but they can also be used along with normal chemotherapy to help it work better. Some of the common used drugs for targeted therapy of fallopian tube cancer include Olaparib (Lynparza) and Bevacizumab (Avastin)

Side effects
Side effects of chemotherapy depend on the dose given, type of drug used and periodic time by which it has been used. Most of those side effects will stop after completion of treatment while some of them can be relieved by medication if they become serious during and after treatment course. Some of the possible side effects include the following;

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Nausea and/or vomiting

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