Fallopian tube cancer is not easy to diagnose. This is because there are often no symptoms in the early stages. It is also difficult to see a tumour growing on the inside of a tube.
Many cases are diagnosed by accident when the patient is having surgery for some other reason. However, if your doctor suspects you have a tumour, they may do several tests.
Once cancer of the fallopian tubes is suspected, you should be referred to a gynaecologic oncologist. This is a doctor who has specialist training in cancer of the female reproductive system.
Physical examination and medical history
An internal (pelvic) examination is usually the first test your doctor will do. The doctor will feel for any lumps or strange feeling in the reproductive organs. They will also ask you about your medical history.
This test uses sound waves to create a picture of internal organs. A small device called a transducer is put into your vagina. It makes sound waves and receives echoes. A computer creates a picture based on the echoes produced when sound waves meet something dense, such as an organ or tumour.
Your doctor will order blood tests to check for tumour markers such as CA-125, and to do a completeblood count and measure levels of chemicals in the blood such as your kidney function and liver function.
Most people with suspected fallopian tube cancer will have an operation called a laparotomy. In this operation, a long cut is made in the abdomen (belly) to examine the internal organs. It is sometimes called an exploratory operation.
During this operation, the surgeon will assess the spread of the cancer and will try to remove all or most of the cancer. What is removed will be sent to a pathologist for testing.
The results will allow the doctor to stage the disease and plan any further treatment.
Staging and grading
The stage of a cancer is a term used to describe its size and whether it has spread beyond its original area of the body.
The grade of a cancer describes how quickly the tumour is likely to grow.
Knowing the grade and stage of the cancer helps doctors decide on the most appropriate treatment.
The following stages are used for cancer of the fallopian tube:
- Stage 1: Cancer is found inside one or both fallopian tubes.
- Stage 2: Cancer is found in one or both fallopian tubes and has spread to other organs in the pelvis such as the uterus, ovaries, bladder and bowel.
- Stage 3: Cancer is found in one or both fallopian tubes and has spread outside the pelvis to other organs in the abdomen (such as the liver or spleen) or to lymph nodes in the abdomen.
- Stage 4: Cancer is found in one or both fallopian tubes and has spread outside the abdomen to other parts of the body such as the lungs or lymph nodes in the groin.
Grading refers to the appearance of the cancer cells under the microscope and gives an idea of how quickly the cancer may develop.
Low grade means the cancer cells look like normal cells. They are usually slow growing and are less likely to spread.
High grade means the cells look very abnormal. They are likely to grow more quickly and to spread.