Treating Fallopian Tube Cancer
Up for Discussion
The optimal treatment for an individual with cancer of the fallopian tubes is based on many factors, including medical history, stage of the disease, and personal preference. There may be other factors involved in the decision of how to treat such cancers. This is something for the patient and the physician to discuss at length.
Fallopian tube cancers are most often diagnosed through surgery. The protocol is similar to that used in diagnosing ovarian cancer and includes a sampling of pelvic fluid, pelvic and abdominal washings, hysterectomy, removal of the ovaries and fallopian tubes, removal of connective tissue folds, selective removal of pelvic lymph nodes and biopsies of the lining of the abdominal walls and peritoneum.
In the case of very advanced disease, the goal of surgery will be to remove as much of the tumor as possible. Some surgeons advocate performing second-look surgery, in which a repeat abdominal surgery is performed to look for remaining or recurrent disease at a later time.
Chemo or Radiotherapy?
According to national studies comparing postoperative chemotherapy to postoperative radiation therapy, there was no significant difference in survival between the two treatment groups. Because cancer of the fallopian tube is so rare, it is difficult to know if such findings are reliable and we may never know which treatment is the more effective of the two. The patient and physician need to determine which course of treatment is more suitable based on the location of any remnants of the disease, as well as taking into account the patient's lifestyle and overall health.
Fallopian tube cancer seems to respond better to chemotherapy that employs cisplatin as opposed to other agents or multi-drug regimens. However, any individual chemotherapeutic regimen must be developed by the oncologist with the patient's individual needs in mind.
Varying degrees of success have been seen with hormonal therapy for fallopian tube cancer, though the role of such treatment remains unclear. Medroxyprogesterone acetate and megestrol acetate have been used in combination with chemotherapy and are sometimes more and sometimes less successful.
The latest treatment approach is called combined modality in which a variety of treatments are used in combination for treating advanced disease. This would include removing as much of the tumor as is possible, post-surgical chemotherapy to reduce the remaining tumor, and possible radiation of the abdomen and pelvis.
Because of the rarity of cancer of the fallopian tube, it is difficult to cite figures relating to prognosis, though one recent population-based study found that the five year survival rate for Stage I disease is 95%, 75% for Stage II, 69% for Stage III, and 45% for stage IV. In general, the prognosis for patients with cancer of the fallopian tubes is a bit better than for those with ovarian cancer.