Tubal cancer is a rare disease. Its prevalence is up to 2% among all malignant neoplasms of the reproductive system. Sometimes young girls and pregnant women hear a similar diagnosis, but most often women aged 50 to 62 have to deal with it. The prognosis for recovery largely depends on timely diagnosis and well-chosen therapy.
Medical certificate
Cancer of the fallopian tubes according to ICD-10 has the code C57. This is a pathology, which is characterized by the development of a malignant neoplasm. Most often it is unilateral. Bilateral process is observed only in 30% of cases.
Determining the type of cancer helps to choose the most appropriate treatment tactics. To describe the staging of the oncological process, the TNM classification of fallopian tube cancer is used. It will be discussed in more detail below.
There are also primary and secondary forms of the tumor. In the latter case, speechis a hematogenous or lymphogenous metastasis from the main focus, for example, from the ovaries, uterus or stomach. The primary form always develops on its own.
Histological examination of the tumor allows us to distinguish the following varieties:
- serous;
- endometrioid;
- mucinous;
- clear cell;
- transitional cell;
- undifferentiated.
Main reasons
The main cause of any oncological process is the mutation of cellular elements with a high rate of division. It can lead to a decrease in immunity, damage to cells or genes. The likelihood of a mutation occurring increases with age. Therefore, older women are always at risk.
Regeneration of mucous membranes is also possible under the influence of the following factors:
- inflammatory processes in the pelvic organs;
- viral/bacterial infection;
- mechanical or chemical damage (abortion, curettage);
- irradiation;
- bad habits;
- prolonged exposure to carcinogens.
Scientists managed to prove the direct role in the occurrence of this oncological process of the human papillomavirus. It provokes cancer of the ovaries, fallopian tubes, cervix and body of the uterus. More than 80% of the population are carriers of this virus. Infection occurs mainly through sexual contact, much less often through airborne droplets.
Another oncogenic pathogen is the herpes virus. It may not appear for a long time. However, with a decreaseimmunological status becomes very aggressive, causing cancer of the reproductive system.
Clinical picture
Symptoms of fallopian tube cancer appear only as the disease progresses. In the initial stages, a woman may complain of the following he alth problems:
- serous or purulent discharge from the vagina, accompanied by a burning sensation;
- appearance of brown discharge outside the period of menstruation;
- paroxysmal pain in the lower abdomen.
In 70% of cases, the characteristic symptoms of cancer are absent. The pathology itself is usually detected by chance during a gynecological examination or ultrasound for another reason. On palpation in the area of the fallopian tubes, a volumetric formation is well palpable. Such a lump is an accumulation of exudate.
Possible and non-specific symptoms of fallopian tube cancer. They manifest themselves in the form of fatigue, general malaise, deterioration of well-being. At later stages, an increase in temperature joins them. In this case, the pain in the affected area becomes more intense, the abdomen increases in size. There is also a disorder of urination, problems with intestinal patency.
Steps in the process flow
According to the International Classification of Diseases (ICD), fallopian tube cancer is divided into 4 stages:
- I stage. Cancer is confined to the space of the fallopian tube.
- II stage. The neoplasm is located in one orboth fallopian tubes, but already extending to the ovaries or pelvic tissue.
- III stage. There is a lesion of only one or two fallopian tubes, abdominal organs. Possible metastasis to the inguinal or iliac lymph nodes.
- IV stage. During the examination, metastases are found in distant lymph nodes.
Determination of the stage of pathology allows you to choose the most effective treatment option.
Diagnostic Methods
Since there are no obvious signs of fallopian tube cancer in the initial stages, patients seek medical help late. Diagnosis of the pathological process is complex. It includes the study of the clinical picture, laboratory and instrumental methods.
After examination on a gynecological chair, a woman is assigned a cytological examination of smears from the vagina and cervical canal. However, using this method, pathological cells can be detected only in 23% of cases. The accuracy of cytological examination increases the sampling of biological material using a special swab. It is inserted into the vagina for several hours.
The most informative diagnostic method is the analysis of the oncomarker CA-125. It is a natural protein that is released into the bloodstream by tumor elements. An increase in the content of CA-125 in the blood at stages I and II of cancer is observed in 68% of patients. In the case of stage III or IV, this figure is 95%. A slight increase in this parameterpossible with endometriosis and during menstruation.
Ultrasound examination in the case of cancer of the fallopian tubes is considered relatively informative. It allows you to identify a neoplasm, evaluate some of its features. Ultrasound with Doppler mapping is recognized as more informative. With its help, it is always possible to detect pathological blood flow, signaling a malignant neoplasm. This diagnostic method is used even in overweight women.
Computed tomography is also considered informative if oncology is suspected. It is a detailed diagnosis of the abdominal organs. However, high cost and high radiation exposure make CT a limited method of examination. His help is resorted to in exceptional cases, for example, with questionable results.
Features of therapy
This pathology is extremely rare. Therefore, a single therapeutic tactic has not been developed. All treatment is reduced to the elimination of the neoplasm, the prevention of recurrence and metastasis. For this purpose, surgery and chemotherapy are used today. Each method is described in detail below.
Surgery
Radical treatment of fallopian tube cancer involves the removal of not only the affected organs, but extirpation. In the latter case, under general anesthesia, the uterus with appendages and the affected lymph nodes are excised. If it was not possible to confirm the malignancy of the neoplasm, an organ-preserving intervention is performed. Also for his helpresorted to treating young patients who want to take on the role of a mother in the future.
During the operation, an audit of the abdominal cavity, washings from the peritoneum, a biopsy of distant lymph nodes are carried out. After a histological examination, the doctor determines further tactics: reoperation or radiation therapy.
If there are contraindications to surgery or late seeking medical help, symptomatic therapy is recommended. The patient is prescribed painkillers that help to alleviate the general condition. The lethal outcome in the last stages occurs within a few months and does not depend on the growth rate of the neoplasm.
Administration of chemotherapy
Tubal cancer is difficult to diagnose in the early stages. Surgical treatment is often ineffective. Therefore, all patients are prescribed combined chemotherapy, regardless of the stage of the pathology.
The standard treatment regimen involves a combination of "Cyclophosphamide" with drugs containing platinum ("Cisplastin", "Carbolplastin"). Partial or even complete regression of the tumor with such therapy is observed in 53-92% of cases, and the five-year survival rate is 51%. If the neoplasm does not show a positive reaction to drugs with platinum, they are replaced with drugs from the taxane group. However, in this case, the five-year survival rate is about 30%.
Chemotherapy is almost always accompanied by side effects. For example, patients haveweight loss, skin rash, gastrointestinal disorders, fatigue. In addition, there is a suppression of the bone marrow. These phenomena disappear on their own after stopping the course of treatment.
Prognosis for recovery
Prognosis for fallopian tube cancer is determined by the percentage of survival after treatment for 5 years. In the absence of combination therapy, this figure is 35%, and in the case of the initial stage of the disease - 70%. After the operation and taking chemotherapy drugs, the five-year survival rate for stages I-II is 100%, for stage III - no more than 28%.
Prognosis is largely determined by the general he alth of the patient, the individual characteristics of her body and the type of tumor itself. With this pathology, cases of relapse are not excluded. Thanks to the development of medicine, at almost any stage, it is possible to extend a person's life. However, this does not apply to the last stage, because in this case the patient is already doomed to death.
Is pregnancy possible?
In the case of unilateral damage to the fallopian tube, the probability of becoming pregnant is extremely small. The thing is that the pathological process violates the tubal patency due to the filling of its lumen with a neoplasm and a developing adhesive process. With a bilateral lesion, it is not possible to conceive a child on your own.
Prevention Methods
Specific ways to prevent uterine cancerpipe does not exist. Prevention of the disease comes down to the standard rules recommended for any oncological disease. Among them are the following:
- compliance with the regime of work and rest;
- proper nutrition;
- exclusion of stressful situations;
- giving up bad habits;
- active lifestyle.
According to some doctors, the absence of predisposing factors protects against cancer of the fallopian tubes. Therefore, experts advise timely treatment of inflammatory diseases affecting the organs of the reproductive system. In addition, it is important to use barrier contraceptives during intimate intercourse to eliminate the risk of contracting an STI. An essential measure of prevention are periodic examinations by a gynecologist. It is necessary to plan in advance the conception of a child in order to eliminate the risk of unwanted termination of pregnancy.
Compliance with the above recommendations and precautions can minimize the risk of developing oncopathology.
