Fallopian tube cancer typically forms in the cells that line the inside of the fallopian tubes, the two tiny ducts that connect the ovaries to the uterus. It is one of the rarest gynecological cancers.
More common are cancers that start in other parts of the body and spread to the fallopian tubes including ovarian, endometrial, gastrointestinal and breast cancer. These are called secondary fallopian tube cancers.
If a woman has not gone through menopause, her ovaries produce eggs (ova) that travel through the fallopian tubes to the uterus. In the uterus, they are fertilized or expelled as part of menstruation (also called the menstrual cycle or periods).
Usually, an egg is released from the ovaries into the fallopian tubes each month. The tubes are lined with small hair-like projections called cilia. These help move the eggs to the uterus.
Fallopian Tube Cancer Types
The two main types of fallopian tube cancer are serous adenocarcinomas and endometrioid adenocarcinomas. These are the cancers that start in the lining of the fallopian tubes.
More rare types of Fallopian tube cancer include leiomyosarcomas, which form in the smooth muscle of the tube, and transitional cell, which form in other cells inside the tube.
Fallopian Tube Cancer Risk Factors
Because Fallopian tube cancer is so rare, we do not know the exact causes and risk factors. Risk factors may include:
- Age: Fallopian tube cancer can occur in women of any age. But it most often is found in white women between 50 and 60 years old who have had few or no children. The usual age is 60 to 66 years.
- Family history of Fallopian tube cancer
- Gene mutations: Women who have certain gene mutations may have a higher risk of Fallopian tube cancer. These include:
- BRCA gene mutations, particularly BRCA1, which cause high risk of breast and ovarian cancer
- One of the genes that cause HNPCC (hereditary nonpolyposis colorectal cancer), also called Lynch syndrome
Some women have a lower risk of getting Fallopian tube cancer. These include women who have:
- Used birth control pills
- Delivered and breast-fed children. The more children you have had, the lower your risk of Fallopian cancer.
Not everyone with risk factors gets Fallopian tube cancer. However, if you have risk factors, it’s a good idea to discuss them with your health care provider.
If you are concerned about inherited family syndromes that may cause Fallopian tube cancer, learn more about the risk to you and your family on our genetic testing page.
Learn more about fallopian tube cancer:
A woman could have her fallopian tubes removed for any number of reasons. Sometimes, it’s necessary to treat an ectopic pregnancy or to resolve an infection caused by pelvic inflammatory disease. In other cases, it’s done as a form of permanent birth control.
But a growing body of evidence suggests that the distal fallopian tube — or flower-shaped section located nearest the ovary — is the site of many cases of high-grade serous ovarian cancer, the most common type of ovarian cancer and one of the most aggressive.
Research also suggests that an opportunistic salpingectomy — the complete removal of the fallopian tubes during an unrelated pelvic surgery — could help reduce the chances of one day developing ovarian cancer.
So, who should consider having their fallopian tubes removed, and when? And, should anyone who’s finished childbearing seek out the procedure, even if they’re only at average risk of ovarian cancer? We asked Michaela Onstad-Grinsfelder, M.D., a surgeon specializing in gynecologic cancers.
Why do women typically have their fallopian tubes removed?
Women don’t usually go in just to have their fallopian tubes removed unless it’s for permanent birth control or to treat an ectopic pregnancy.
Having the fallopian tubes removed is one form of surgical sterilization, or “having your tubes tied.” Until fairly recently, it was more common for surgeons to use a metal clip or a ring to constrict and physically block the tubes, rather than removing the structures themselves.
Why has that changed?
A growing body of data suggests that the fallopian tubes may be the origin of many ovarian cancers. So, a lot of surgeons have changed their practice to remove the fallopian tubes entirely to give patients additional protection against ovarian cancer.
In the United States, the Society for Gynecologic Oncology and the American College of Obstetricians and Gynecologists both support the removal of fallopian tubes as permanent sterilization for women at average risk for ovarian cancer, but it’s also recommended by professional organizations in Australia, Canada, Germany and New Zealand.
How was this information discovered?
After the BRCA gene was linked to an increased risk for breast and ovarian cancers, doctors started removing the ovaries and fallopian tubes as a type of risk-reduction surgery, once BRCA-positive women were finished with childbearing.
Most ovarian cancers are diagnosed at stage III or IV, so we don’t usually see the disease in its earliest stages. But what we noticed when we started performing these surgeries is that there were often pre-cancerous lesions present in the fallopian tubes.
This was a really exciting discovery because, before that, we hadn’t known there was a lesion that could one day become ovarian cancer. So, we were able to start finding ovarian cancers really early that we hadn’t been able to catch before.
How did that discovery lead to the recommendation of opportunistic salpingectomies?
There was a lot of excitement in the medical community at that point about the possibility of reducing the risk of ovarian cancer by removing the fallopian tubes during hysterectomies or when patients were having their “tubes tied.” Before that, whenever someone had a hysterectomy, we would normally only take out their fallopian tubes if we were also taking out their ovaries.
But as the new data emerged, there was an increased interest in removing the fallopian tubes along with the uterus when performing hysterectomies. Because if a woman is pre-menopausal, her ovaries might still be benefitting her. But once she’s finished childbearing, the fallopian tubes serve no real purpose.
So, who should consider having their fallopian tubes removed?
People who are at increased risk of developing ovarian cancer, such as those who carry the BRCA genetic mutation, are recommended to have a stand-alone surgery to remove fallopian tubes with both ovaries (called a risk-reducing salpingo-oophorectomy).
Otherwise, it’s only recommended as an opportunistic salpingectomy: something to be done when you’re already having another type of gynecologic procedure, such as a hysterectomy.
Are any related clinical trials available?
We have a clinical trial going on right now for BRCA-positive women who are done with childbearing but are not quite ready to have their ovaries removed.
In this clinical trial, participants will have their fallopian tubes removed now, but delay the removal of their ovaries until later (between the ages of 35 and 45 for patients with BRCA1 and between the ages of 40 and 50 for those with BRCA2). The goal is to determine if it may be safe to delay the removal of both ovaries for women at high risk of developing ovarian cancer.
Do you ever foresee a time in which an opportunistic salpingectomy could be combined with another procedure, such as an appendectomy or a hernia repair?
Right now, we don’t typically bundle other types of surgeries with the removal of fallopian tubes. That’s partially because only OB-GYNs are specifically trained in that procedure.
But we’re actively looking for ways to team up with other surgeons to offer this service together. It could be an exciting strategy in the future to further reduce patients’ risk of ovarian cancer.
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Why come to MD Anderson for your fallopian tube cancer care?
Fallopian tube cancer treatment at MD Anderson's Gynecologic Oncology Center includes comprehensive, exemplary care that is planned by some of the nation's top experts. Your care team may include medical, surgical and radiation oncologists; pathologists; and diagnostic radiologists, all working toward the best possible treatment outcome. MD Anderson diagnoses and treats more patients with Fallopian tube cancer than most oncologists in the United States.
MD Anderson uses the latest, most-advanced technology and techniques to treat Fallopian tube cancer. Among these are innovative surgical techniques, including minimally invasive options for some patients.
Studies have shown that the success of any surgery depends a great deal on the skill of the surgeon. MD Anderson's renowned surgeons have some of the highest levels of experience and expertise in Fallopian tube cancer procedures.
Pioneering Fallopian Tube Cancer Research
If you are at high risk for Fallopian tube cancer because of inherited genetic conditions, such as BRCA or HNPCC (hereditary nonpolyposis colorectal cancer), MD Anderson offers complete genetic testing. Results can help you find if you or your family members are at risk of certain types of cancer, including Fallopian tube cancer.
Fallopian tube cancer is like ovarian cancer in some ways. Many studies in our renowned ovarian cancer research program are open to women with fallopian tube cancer. This enables us to offer a wider range of clinical trials than many other cancer centers.
MD Anderson fallopian tube cancer patients can get treatment at the following locations.