Treatments for fallopian tube cancer

If you have fallopian tube cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for fallopian tube cancer, your healthcare team will consider the stage and grade of your cancer.

Surgery is often the first treatment for fallopian tube cancer.

During surgery, the surgeon will remove abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes as well as the fallopian tubes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.

A total hysterectomy and bilateral salpingo-oophorectomy is the most common surgery. This operation usually removes the uterus, ovaries and fallopian tubes. You may also have nearby lymph nodes, omentum and any other tissues that look abnormal at the time of surgery removed.

A salpingo-oophorectomy removes the ovary and fallopian tube. It may be unilateral (on one side) or bilateral (on both sides). A salpingo-oophorectomy may be done for early stage fallopian tube cancer.

Surgical debulking removes as much of the cancer as possible from the abdomen and pelvis.

Some surgical procedures may be done to relieve symptoms of late-stage fallopian tube cancer (called palliative surgery).

Side effects of surgery will depend mainly on the type of surgical procedure and your overall health. Find out more about side effects of surgery.

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is usually given following surgery for fallopian tube cancer.

Chemotherapy for fallopian tube cancer may be given intravenously (into a vein) or by intraperitoneal (IP) chemotherapy. When drugs are given during IP chemotherapy, they circulate and treat tumours throughout the abdomen. They are also absorbed into the bloodstream.

IP chemotherapy is only considered if the cancer has spread inside the abdomen and there is minimal cancer left after surgery. During IP chemotherapy, drugs are injected directly into the abdomen through a port. The port allows the drugs to be safely delivered with minimal spillage into the surrounding tissue. The surgeon may place the port during surgery for fallopian tube cancer or during a separate surgery.

Chemotherapy can also be given to relieve pain or to control the symptoms of advanced fallopian tube cancer (called palliative chemotherapy).

The most common chemotherapy drug combination used to treat fallopian tube cancer is paclitaxel (Taxol) and carboplatin (Paraplatin, Paraplatin AQ).

Other chemotherapy drugs that may be used are:

• cisplatin
• pegylated liposomal doxorubicin (Caelyx)
• topotecan (Hycamtin)

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health. Find out more about the side effects of chemotherapy.

Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells. Targeted therapy may also be called molecular targeted therapy.

You may have targeted therapy to control the growth of advanced fallopian tube cancer.

Olaparib (Lynparza) may be given to women with a BRCA1 or BRCA2 gene mutation. It is usually taken by mouth twice a day. Olaparib may also be given as maintenance therapy for women (with or without a BRCA mutation) with advanced recurrent ovarian cancer that has responded to chemotherapy with a platinum drug such as carboplatin or cisplatin.

Bevacizumab (Avastin) may be given in combination with platinum drugs such as carboplatin, with taxane drugs such as paclitaxel or with other chemotherapy drugs at the time of diagnosis or recurrence. It is given by IV every 2 to 3 weeks. For recurrent cancer, bevacizumab is usually combined with the chemotherapy drugs paclitaxel and pegylated liposomal doxorubicin or topotecan to help the chemotherapy drugs work better.

Niraparib (Zejula) may be used as a maintenance therapy for women with recurrent fallopian tube cancer that has responded to chemotherapy with a platinum drug such as carboplatin or cisplatin.

Side effects of targeted therapy will depend mainly on the type of drug or combination of drugs, the dose, how it’s given and your overall health. Find out more about the side effects of targeted therapy.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is rarely used to treat fallopian tube cancer. You may have radiation therapy:

• if you cannot have chemotherapy because of your older age and health problems
• to treat small areas of recurrent or metastatic cancer that are causing symptoms
• to relieve pain or control the symptoms of advanced fallopian tube cancer (called palliative radiotherapy)

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Find out more about the side effects of radiation therapy.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first 5 years after treatment has finished. These visits allow your healthcare team to monitor your progress and recovery from treatment.

Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away.

Follow-up visits for fallopian tube cancer are usually scheduled:

• every 3 to 4 months for the first 2 to 3 years after finishing initial treatment
• every 4 to 6 months for the next 3 years
• then once a year

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping. Your doctor may do a physical exam, including:

• a pelvic and rectal exam
• feeling the neck, abdomen and legs for swelling
• feeling the lymph nodes in the groin

Tests are often part of follow-up care. You may have any of the following tests:

• Tumour marker tests may be done to monitor how the treatment is working. Rising levels of a tumour marker may mean that the cancer has recurred.
• Blood chemistry tests may be done to show how well certain organs are working. They can also be used to find abnormalities, which may mean that cancer has spread to certain organs.
• Imaging tests such as a chest x-ray, a CT scan, an MRI or a PET scan may be ordered to check how the treatment is working or to investigate new symptoms.
• If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.

Talk to your doctor about clinical trials open to women with fallopian tube cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

To make the decisions that are right for you, ask your healthcare team questions about treatment.