Fallopian Tube Cancer Diagnosis
Diagnostic Tests And Surgery

Diagnosis of Fallopian Tube Cancers

Transvaginal Ultrasound

Transvaginal (TVS) Ultrasonography

Fallopian Tube Cancer Diagnosis

Contents

How Is Fallopian Tube Cancer Diagnosed?
Doctor Examination
Blood Tests
Ultrasound Scans
Surgery


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Fallopian Tube Cancer

How Is Fallopian Tube Cancer Diagnosed?

As the symptoms of fallopian tube cancer can be vague it can be mistaken for a host of other conditions. Those conditions range from PMS, to uterine fibroids, ovary cysts, uterine polyps, endometriosis and cervical cancer, to name just a few. While symptoms (in particular pain in the abdominal region) may cause women to seek medical advice earlier than those with ovarian cancer (which is often asymptomatic and more commonly discovered in later stages); women with fallopian tube cancer are frequently misdiagnosed. This may partly be explained by the rarity of the disease; even a busy clinical practice may only see one instance every decade. In one study 38 percent of women with the disease displayed symptoms for more than 6 months and 13 percent for over a year before being correctly diagnosed. The same study showed that 14 percent of women were asymptomatic (no signs of disease) at time of diagnosis. In fact many patients are only diagnosed by accident while undergoing surgery for some other reason. However, if a doctor does suspect cancer there are several tests which can be performed.

Doctor Examination

The doctor will start by taking a medical history, and will pay particular attention to any instances of gynecologic cancers in the family. Recent indications show that women with BRCA genetic mutations may not only be vulnerable to cervical cancer and breast cancer, but also to fallopian tube cancer (see genetic testing for breast cancer). Next the doctor will perform a pelvic examination to feel for the shape, position and size of the pelvic organs. He will use a speculum, an instrument made of plastic or metal to keep the vaginal walls open, while he inspects the vagina and cervix. He will look for any swellings, lesions, discoloration or abnormal discharges. Using a cotton swab he will take a sample of cells from the vagina, and may also perform a Pap test, depending on when the patient had their last one. This will help rule out cancer of the vagina and cancer of the vulva and cervix. If the woman has an IUD device (intrauterine device), its position will also be checked. A pregnancy test may also be done to rule out ectopic pregnancy (if the woman is of childbearing age). Up to 75 percent of women with fallopian tube cancer will present with a pelvic mass at time of diagnosis. If the doctor does discover a pelvic mass it is likely to be fluid filled. If it ruptures, it will cause a vaginal discharge. Although rupturing may reduce pain in the pelvic area, cancer will still continue growing. Discovery of a pelvic mass however is still not enough to make a clinical diagnosis.

Blood Tests

A blood test checking for the tumor marker CA 125 may be carried out. Rising levels of the marker are associated with advancing stages of the disease and it is nearly always positive at the most advanced stage. One study by the Department of Gynecology, Cancer Institute Hospital, Tokyo (1997) concluded that CA 125 tests used in combination with endometrial aspiration cytology is highly effective in detection and diagnosis of this rare disease. Endometrial aspiration cytology involves inserting a cannula (tube) into the uterine cavity and aspirating a sample of tissue with a syringe for examination in a lab for signs of cancer.

Ultrasound Scans

Transvaginal (TVS) ultrasonography is playing a larger role in the diagnostic process of fallopian tube cancer, particularly where a pelvis mass has been detected and CA 125 levels are raised. The woman lies on a table with her knees bent and feet held in stirrups. A probe called a transducer is inserted into the vagina. The probe will be covered with a condom and gel for ease of passage. It sends out sound waves which a computer picks up and converts into images of the internal pelvic structures. It can be useful for determining the presence of lumps and for differentiating between solid masses and fluid filled cysts such as ovarian cysts. If a solid mass is discovered this still does mean a clinical diagnosis is possible. A biopsy is still necessary but the results of the TVS will help guide a surgeon to the correct area to biopsy.

Other Scans

X-rays, CT scan and MRI scan may be used to help confirm the presence of a tumor after TVS. If the results show any abnormalities the doctor may recommend exploratory surgery to allow surgeons to physically see inside the pelvis area. This type of surgery is called laparoscopy.

Surgery

A laparotomy is usually carried out under general anesthesia. The surgeon makes a small incision just below the bellybutton and inserts a thin lighted tube called a laparoscope through the incision. He directs it towards the ovaries and fallopian tubes. Small cutting tools can be attached to the laparoscope to allow the surgeon to take a biopsy of any suspicious looking tissue. This will be sent to a lab for testing by a pathologist. A sample (washing) of abdominal fluid may also be extracted for investigating.

The pathologist will be able to conclusively diagnose cancer once he has examined the biopsied samples. Once cancer has been confirmed, he will need to carry out fallopian tube cancer staging. This process will determine the extent and stage of cancer which is essential for both designing the optimal treatment plan and estimating the patient's prognosis (that is their fallopian tube cancer survival rate). If cancer is found near or on the ovaries it may be difficult to determine where it started - whether it is in fact ovarian cancer, or fallopian tube cancer. This is an important call the pathologist has to make because it can affect prognosis. For primary fallopian tube cancer to exist, the ovaries should be either unaffected or have a tumor smaller than those found in the fallopian tubes. As the disease is so rare case studies are limited - but those studies do indicate that most women with this cancer are diagnosed in the early stages.

Next see: Fallopian tube cancer treatment and also, read about fallopian tube cancer recurrence.

Did You Know?

You may have heard of the Greek Cancer Cure which consists of a blood test which can reportedly diagnose cancer and can be used as an intravenous therapy to cure the disease. The injections are believed to contain a serum with extracts of organic substances such as amino acids, sugars and vitamins. Practitioners of the Greek Cancer Cure claim that regular injections boost the patient's immune system so that it can attack tumors more effectively. There is currently no scientific evidence to support this theory - that it can be used either for detection, cure or cancer prevention. The first stage of treatment involves a blood test which is supposed to pinpoint the location and size of the tumor. The next stage involves daily injections with the special serum for between 6 and 30 days. Patients are advised to stop chemotherapy and radiation treatment for the duration of treatment as well as halt taking certain medications including aspirin therapy and laxative pills. The 'cure' was developed by Dr Alivizatos in Greece in the 1970s. The doctor lost his license several times for refusing to provide details of the serum to medical bodies for testing. It was subsequently tested by the University of Washington and revealed to only contain vitamin B3 (niacin) and water. Dr Alivizatos died in 1991 but his treatment is still marketed in certain parts of Europe as Cellbal or METBAL.

  Related Articles on Fallopian Tube Cancer

For more information, see the following:

Causes of fallopian tube cancer: STDs, endometriosis and more.
Thermography screening
Fallopian tube cancer prevention: reduce your risks.

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