Cancer of the fallopian tubes is a rare pathology. Its prevalence is up to 2% among all malignant neoplasms of the reproductive system. Sometimes a similar diagnosis is heard by young girls and pregnant ladies, but more often women from the age of 50 to 62 have to deal with it. The prognosis for recovery largely depends on timely diagnosis and well-chosen therapy.
Medical certificate
Cancer of the fallopian tubes according to ICD-10 has the code C57. This is a pathology characterized by the development of a malignant neoplasm. Most often, it is one-sided. Bilateral process is observed only in 30% of cases.
Identifying the type of cancer helps you choose the most appropriate treatment strategy. To describe the staging of the oncological process, the TNM classification of fallopian tube cancer is used. About it will be described in more detail below.
There are also primary and secondary forms of the tumor. In the latter case, we are talking about hematogenous or lymphogenous metastasis from the main focus, for example, from the ovaries, uterus or stomach. The primary form always develops independently.
Histological examination of the tumor allows us to distinguish the following varieties:
- serous;
- endometrioid;
- mucinous;
- clear cell;
- transitional cell;
- undifferentiated.
Main reasons
The main reason for any oncological process is the mutation of cellular elements with a high rate of division. It can lead to a decrease in immunity, damage to cells or genes. The likelihood of a mutation increases with age. Therefore, older women are always at risk.
Mucosal degeneration is also possible under the influence of the following factors:
- inflammatory processes in the pelvic organs;
- viral / bacterial infection;
- mechanical or chemical damage (abortion, curettage);
- irradiation;
- addictions;
- prolonged exposure to carcinogens.
Scientists were able to prove a direct role in the occurrence of this oncological process of the human papillomavirus. It provokes cancer of the ovaries, fallopian tubes, neck and body of the uterus. More than 80% of the population are carriers of this virus. Infection predominantly occurs through sexual contact, much less often through airborne droplets.
Another oncogenic pathogen is the herpes virus. It may not appear for a long time. However, with a decrease in immunological status, it becomes very aggressive, causing cancer of the organs of the reproductive system.
Clinical picture
Symptoms of cancer of the fallopian tube appear only as the disease progresses. In the initial stages, a woman may complain of the following health problems:
- serous or purulent discharge from the vagina, accompanied by a burning sensation;
- the appearance of a brown discharge outside the period of menstruation;
- paroxysmal pain in the lower abdomen.
In 70% of cases, characteristic symptoms of cancer are absent. The pathology itself is usually detected by chance during a gynecological examination or ultrasound for another reason. On palpation in the area of the fallopian tubes, a volumetric formation is well felt. Such a lump is a collection of exudate.
Possible and non-specific symptoms of cancer of the fallopian tube. They appear in the form of fatigue, general malaise, deterioration of well-being. At later stages, an increase in temperature joins them. In this case, the pain in the affected area becomes more intense, the stomach increases in size. There is also an urination disorder, problems with intestinal patency.
Stages of the process
According to the International Classification of Diseases (ICD), fallopian tube cancer is divided into 4 stages:
- I stage. Cancer is limited to the space of the fallopian tube.
- II stage. The neoplasm is located in one or both fallopian tubes, but already extends to the ovaries or pelvic fiber.
- III stage. Only one or two fallopian tubes, abdominal organs are affected. Perhaps metastasis to the inguinal or iliac lymph nodes.
- IV stage. During the examination, metastases are found in distant lymph nodes.
Determining the stage of pathology allows you to choose the most effective treatment option.
Diagnostic Methods
Since there are no obvious signs of tubal cancer in the initial stages, patients seek late medical attention. Diagnosis of the pathological process is complex. It includes the study of the clinical picture, laboratory and instrumental methods.
After examination on a gynecological chair, a woman is prescribed a cytological examination of smears from the vagina and cervical canal. However, using this method, pathological cells can be detected only in 23% of cases. The accuracy of the cytological examination increases the intake of biological material using a special swab. It is inserted into the vagina for several hours.
The most informative diagnostic method is the analysis of the tumor marker CA-125. It is a natural protein that is secreted into the bloodstream by tumor elements. An increase in the content of CA-125 in the blood at stages I and II of cancer is observed in 68% of patients. In the case of stage III or IV, this indicator is 95%. A slight increase in this parameter is possible with endometriosis and during menstruation.
Ultrasound examination for cancer of the fallopian tubes is considered relatively informative. It allows you to identify the neoplasm, evaluate some of its features. An ultrasound scan with Doppler mapping is recognized as more informative. With its help, it is always possible to detect pathological blood flow, signaling a malignant neoplasm. This diagnostic method is used even in overweight women.
Also informative with suspected oncology is considered computed tomography. It is a detailed diagnosis of the abdominal organs. However, the high cost and high radiation exposure make CT a limited examination method. They resort to his help in exceptional cases, for example, with dubious results.
Therapy Features
This pathology is extremely rare. Therefore, a single therapeutic tactic has not been developed. All treatment comes down to eliminating the neoplasm, preventing relapse and metastasis. To this end, surgery, chemotherapy is used today. Each of the methods is described in detail below.
Surgical intervention
Radical treatment of cancer of the fallopian tubes involves the removal of not only the affected organs, but extirpation. In the latter case, under general anesthesia, the uterus with appendages and the affected lymph nodes are excised. If the malignancy of the neoplasm could not be confirmed, an organ-preserving intervention is performed. They also resort to his help to treat young patients who in the future want to try on the role of the mother.
During the operation, an audit of the abdominal cavity, swabs from the peritoneum, and a biopsy of distant lymph nodes are performed. After a histological examination, the doctor determines the further tactics: repeated surgery or radiation therapy.
In case of contraindications for surgical intervention or late seeking medical help, symptomatic therapy is recommended. The patient is prescribed painkillers that help to alleviate the general condition. A fatal outcome in the last stages occurs within a few months and does not depend on the growth rate of the neoplasm.
Chemotherapy
Cancer of the fallopian tubes in the early stages is difficult to diagnose. Surgical treatment is often ineffective. Therefore, all patients are prescribed combination chemotherapy, regardless of the stage of the pathology.
The standard treatment regimen involves a combination of Cyclophosphamide with preparations containing platinum (Cisplastine, Karbolplastin). Partial or even complete tumor regression with such therapy is observed in 53-92% of cases, and five-year survival is 51%. If the neoplasm does not show a positive reaction to medicines with platinum, they are replaced with drugs from the group of taxanes. However, in this case, the five-year survival rate is about 30%.
Chemotherapy is almost always accompanied by side effects. For example, patients have a decrease in body weight, skin rash, gastrointestinal upset, and fatigue. In addition, bone marrow suppression occurs. These phenomena disappear on their own after the cessation of treatment.
Prognosis for recovery
The prognosis for cancer of the fallopian tube is determined by the percentage of survival after treatment for 5 years. In the absence of combination therapy, this indicator is 35%, and in the case of the initial stage of the disease - 70%. After surgery and chemotherapeutic drugs, the five-year survival rate in stages I-II is 100%, in stage III - no more than 28%.
The prognosis is largely determined by the general state of health of the patient, the individual characteristics of her body and the variety of the tumor itself. With this pathology, cases of relapse are not excluded. Thanks to the development of medicine at almost any stage, it is possible to extend the life of a person. However, this does not apply to the last stage, because in this case the patient is already doomed to death.
Is pregnancy possible?
In the case of a unilateral lesion of the fallopian tube, the likelihood of becoming pregnant is extremely small. The thing is that the pathological process violates the tube patency due to the filling of its lumen with a neoplasm and a developing adhesive process. With bilateral damage, it is not possible to conceive a child independently.
Prevention Methods
There are no specific ways to prevent uterine cancer. Prevention of the disease boils down to the standard rules recommended for any cancer. Among them, the following can be noted:
- compliance with the regime of work and rest;
- proper nutrition;
- elimination of stressful situations;
- refusal of addictions;
- active lifestyle.
According to some doctors, the absence of predisposing factors protects against fallopian tube cancer. Therefore, experts advise timely treatment of inflammatory diseases affecting the organs of the reproductive system. In addition, it is important to use barrier contraceptives for intimate contacts in order to eliminate the risk of infection with STIs. An essential preventive measure are periodic examinations by a gynecologist. It is necessary to plan the conception of the child in advance in order to eliminate the risk of unwanted termination of pregnancy.
Compliance with the listed recommendations and precautions allows you to minimize the risk of developing cancer.