Are you aware of Fallopian Tube Cancer? Let's talk about it!

Do you sometimes feel like your stomach is full, or you often feel a little pain in your lower abdomen? You may think it's normal, or maybe it's a digestive problem. But these little symptoms, especially as women, should never be ignored. Today we're going to talk about a type of cancer that many people haven't heard of, but is very important for women's health. That is fallopian tube cancer.

Simply put, what is Fallopian Tube Cancer?

Okay, let's start at the beginning. The Fallopian Tubes are two very thin tubes that carry eggs from our ovaries to the uterus. Simply put, they are the most important part of the process where an egg meets a sperm to form a baby. So this cancer starts in the cells inside these fallopian tubes.

Most of the time, this cancer starts in the tissue that lines the fallopian tubes. In medical terms, we call this epithelial tissue. Surprisingly, the way this cancer behaves, the way it spreads, and the way we treat it are very similar to ovarian cancer. That's why doctors treat and manage both cancers in the same way.

The biggest challenge with this cancer is that it does not show symptoms in the early stages and spreads very quickly . But the good news is that if it is detected correctly in the early stages and the cancer cells can be completely removed through surgery, it is a completely curable disease . But by the time it is diagnosed, the cancer has already spread, making it a little more difficult to treat.

How common is this cancer?

For a long time, doctors thought that fallopian tube cancer was a rare type of gynecological cancer. Only about 1% of all female cancers start in the cells of the fallopian tubes.

But new research has found that the majority of the types of cancer we often call ovarian cancer, called epithelial ovarian cancer, actually start in the fallopian tubes. Specifically, it starts in the fimbriae, the ends where an egg enters the fallopian tube from the ovary. It then spreads to the surface of the ovary and to other parts of the pelvis and abdomen.

What symptoms should we look out for?

The biggest problem with this cancer is that the symptoms are difficult to recognize in the early stages and we tend to ignore them, thinking they are normal. You may not notice any major changes until the cancer has spread throughout the abdomen. But it is very important that we are aware of these symptoms.

Let's see what these symptoms are in the table below.

If someone in your family has a history of cancer, or if you have other risk factors, it's best to see a doctor even if you notice a small change like this.

What are the causes and risk factors for this cancer?

Researchers have not yet found the exact cause of this cancer. But we do know that about 90% of this cancer develops from the glandular cells that line the organ, the ``epithelial cells'' we talked about earlier. These are the same type of cells that form ovarian cancer. For this reason, fallopian tube and ovarian cancers are often called ``high-grade serous tumors.'' This means that these are very fast-growing cancers.

Factors that increase risk

There are several factors that increase your risk of developing this cancer. See if you have any of these.

• Age: More than half of people who develop fallopian tube or ovarian cancer are over the age of 63. This means that the risk increases with age.
• Family history: If one of your close blood relatives (mother, sister, daughter) has had breast cancer, ovarian cancer, or fallopian tube cancer, your risk is higher.
• Genetic mutations: Changes (mutations) in the breast cancer-related gene (BRCA) significantly increase the risk of this cancer.
• Other health conditions: Hereditary conditions such as Lynch syndrome and Peutz-Jeghers syndrome, and a condition called endometriosis, can also increase the risk.
• Pregnancy history: The risk is slightly higher for those who have never been pregnant and those who had their first child after age 35.
• Menstrual cycle history: Having your first period before the age of 12 and having menopause after the age of 51 are also risk factors.
• Obesity: A body mass index (BMI) of over 30, especially if you were obese at a young age, can increase your risk.

How do doctors diagnose this disease?

As we mentioned earlier, there are no symptoms in the early stages, so the disease is often diagnosed when it has spread a little. Perhaps you have a lump found during a pelvic exam when your doctor does a routine check-up.

After suspicion arises, the doctor will order several tests to further investigate the condition.

1. Blood tests: The CA-125 blood test measures the level of a protein called cancer antigen 125 in the blood. This level may be elevated in someone with fallopian tube cancer. However, it is important to remember that this level can also be elevated for reasons other than cancer.

2. Imaging tests: Scans such as `(Transvaginal ultrasound)`, `(CT scan)`, `(MRI)` or `(PET scan)` can produce clear images of the fallopian tubes and ovaries. This can help to see if there are any cysts or lumps.

However, these tests alone cannot confirm 100% that it is cancer. To diagnose the disease with certainty, a tissue sample must be taken and examined under a microscope. The methods used for this are:

• Exploratory surgery: A surgical procedure that looks directly at the organs to see if there is any suspicious tissue. This involves taking samples of the fallopian tubes, ovaries, and nearby lymph nodes and sending them to a lab for testing. This surgery can be done open (laparotomy) or through small incisions using a camera (laparoscopy).
• Biopsy: A small piece of tissue is removed from a suspicious tumor using a needle and examined.

How is the staging of cancer determined?

Once cancer is confirmed, the next most important thing is to determine its ``stage''. Simply put, it is finding out how far the cancer has spread (metastasized). This is essential for planning treatment and getting an idea of ​​the future course of the disease.

What are the treatments?

The treatment you receive will depend on many factors, including the stage of the cancer and your overall health. Your doctor will develop a treatment plan that is best for you.

• Surgery: Surgery is often the first treatment. This involves removing the uterus (hysterectomy), both fallopian tubes (salpingectomy), and both ovaries (oophorectomy). Depending on how far the cancer has spread, other nearby tissue may also need to be removed. In some young, childbearing women, if the cancer is detected early, only the cancerous tumor is removed, sparing the reproductive organs.
• Chemotherapy: These are powerful drugs that are given to kill cancer cells. This treatment is given to shrink the tumor before surgery, or to kill any cancer cells that may remain after surgery.
• Targeted therapy: This is a relatively new treatment method. It uses drugs that target specific molecules that are essential for the growth of cancer cells, without harming healthy cells like regular chemotherapy. This treatment method can be very successful, especially for people with a `(BRCA)` gene mutation.
• Immunotherapy: This involves stimulating our body's own immune system, giving it the strength to fight cancer cells.
• Palliative care: This is a common misconception. Palliative care is not just for those whose disease cannot be cured. It is about managing the side effects of cancer treatment, such as pain and nausea, and helping to maintain a good quality of life. This care can be provided at any stage of cancer.

What happens after treatment?

After treatment, about 80% of patients go into ``remission``, a state where there are no symptoms of cancer. However, there is a risk of the cancer ``recurring``.

• Cancers detected at an early stage have a recurrence rate of about 25%.
• Spreading, advanced stage cancers can recur in up to 80% of cases.

Therefore, even after treatment, it is essential to see a doctor at the scheduled time for checkups . This is especially important within the first five years.

Survival Rates

Don't be alarmed by these statistics. These are just averages based on data from thousands of patients. Your situation could be much different, much better. These are just to understand the severity of the disease.

• If the cancer is limited to the fallopian tubes (local): The 5-year survival rate is 94%.
• If it has spread to nearby organs (Regional): 5-year survival rate is 53%.
• If it has spread to distant organs (Distant): 5-year survival rate is 44%.

Are there ways to protect yourself from this cancer?

Although it cannot be completely prevented, there are several things we can do to reduce the risk.

If someone in your family has had breast, ovarian, or fallopian tube cancer, you may want to talk to your doctor about getting a genetic test for the BRCA gene. If you are diagnosed with the mutation, you may want to discuss with your doctor the possibility of having a prophylactic salpingo-oophorectomy (surgical removal of the ovaries and fallopian tubes) as a preventative measure after you have had children. This can reduce your risk of cancer by about 96%.

In addition, these things can help reduce the risk:

• Eating a good healthy diet and staying active.
• Maintaining a healthy weight that suits you.
• Stop or reduce smoking and alcohol use.
• If possible, breastfeed your children.
• Using hormonal birth control methods, such as birth control pills (but if you have a BRCA gene mutation, talk to your doctor about whether this is right for you).

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