Fallopian Tube Cancer Treatment: More Options, Better Outcomes

  • Shashikant Lele, MD, FACOG, Clinical Chief of Gynecologic Oncology, discusses treatment options with a patient.

Your physician will determine the best treatment option for you based on the stage of the disease and the tumor grade. The doctor also considers other factors, including your age and general health. Some of the most widely recommended treatment options for fallopian cancer are listed below.

Surgery

Traditional open surgery for the treatment of fallopian tube cancer involves the removal of the uterus (hysterectomy) through an incision in the abdomen. The doctor also removes both fallopian tubes and both ovaries in a procedure called a bilateral salpingo-oophorectomy. To determine if cancer has spread, the lymph nodes near the tumor may be removed and areas surrounding the fallopian tubes may be sampled.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may have chemotherapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

Chemotherapy

The second line of defense against fallopian tube cancer is typically chemotherapy treatment, using drugs to kill cancer cells. This may be prescribed before or after surgery and may be administered in different ways:

Investigational Approaches

Roswell Park researchers are investigating alternative treatment methods for fallopian tube cancer, specifically whether treatments used for ovarian cancer might also be used to treat cancer in the fallopian tubes. One of these options is IP chemotherapy, a treatment developed by Roswell Park oncologists now recommended for advanced ovarian cancer.

IP chemotherapy uses the same drugs as IV chemotherapy, but they are delivered at 10 to 100 times the concentration directly to the abdomen, bathing the peritoneal cavity in anticancer agents. Research found that adding IP chemotherapy improved progression-free survival and overall survival significantly enough that the National Cancer Institute issued a clinical announcement recommending that women with Stage III ovarian cancer be considered for IP chemotherapy after the surgical removal of tumors.

Treatment begins a couple of weeks post surgery and continues once a month for six months. Because the toxicity of the drugs is higher, side effects may be more pronounced. Patients with early-stage ovarian cancer or those with certain risk factors may not be candidates for IP chemotherapy, so discuss this option, along with the risks and benefits, with your care team.

Making an Informed Decision

You may find that your options for treatment here are greater than anywhere else, which can be reassuring but also overwhelming. We are committed to providing you with the information you need to make an informed decision about your treatment. Here are some points to consider as you evaluate your options:

  • Fertility and sexuality:┬áBecause treatment for fallopian tube cancer often involves the removal of reproductive organs, it is important to understand how this will impact your ability to have children as well as your sexual function. If you are concerned about these issues, talk to your care team about what to expect after treatment and steps you might take prior to treatment that may preserve your ability to conceive.
  • Side effects:┬áCancer treatments often damage healthy cells and tissues along with the cancer cells, so side effects are common. These side effects vary depending on the type and extent of treatment, and from one patient to the next. Knowing what to expect prior to treatment will allow you to be proactive in managing side effects or, taking quality of life into consideration, may also help you rule out particular treatment options.
  • Second opinion:┬áBefore starting treatment, you might want a second opinion about the diagnosis, the stage of cancer, and the treatment plan. Some insurance companies require a second opinion; others may cover a second opinion if you request it. Gathering medical records and arranging to see another doctor may take a little time. In most cases, a brief delay does not make treatment less effective.