Diagnosis of fallopian tube cancer

Diagnosis is the process of finding out the cause of a health problem. Diagnosing fallopian tube cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for fallopian tube cancer or other health problems.

The process of diagnosis may seem long and frustrating. It’s normal to worry, but try to remember that other health conditions can cause similar symptoms as fallopian tube cancer. It’s important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of fallopian tube cancer.

The following tests are usually used to rule out or diagnose fallopian tube cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment.

Your health history is a record of your symptoms, risk factors and all the medical events and problems you have had in the past. Your doctor will ask questions about your history of:

• symptoms that suggest fallopian tube cancer
• hormone replacement therapy
• pregnancies

Your doctor may also ask about a family history of:

• fallopian tube cancer
• risk factors for fallopian tube cancer
• other cancers, such as breast or ovarian

A physical exam allows your doctor to look for any signs of fallopian tube cancer. During a physical exam, your doctor may:

• do a pelvic and rectal exam to check the uterus, vagina, ovaries, fallopian tubes, bladder and rectum for any unusual changes
• feel the abdomen for lumps, bloating or organs that are larger than normal such as the liver

Find out more about physical exams and pelvic exams.

An ultrasound uses high-frequency sound waves to make images of parts of the body. A pelvic or transvaginal ultrasound may be done to look for fallopian tube cancer. With the transvaginal ultrasound, the wand or probe is placed a short distance into the vagina and aimed at the fallopian tubes instead of on the surface of the skin. Ultrasounds are used to:

• find a fallopian tumour and see if it is a solid tumour or a fluid-filled cyst
• see the shape and size of the fallopian tube and how it looks inside
• check for a buildup of fluid in the abdomen

Find out more about ultrasounds.

Tumour markers are substances found in the blood, tissues or fluids removed from the body. Tumour marker tests are generally used to check your response to cancer treatment. They can also be used to diagnose fallopian tube cancer. The tumour marker that may be measured is cancer antigen 125 (CA125). The level may be abnormal in women with fallopian tube cancer.

Find out more about tumour marker tests.

A CBC measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to provide information about your general health, to check for anemia from long-term vaginal bleeding and to provide a baseline to compare with future CBCs during and after treatment.

Find out more about a complete blood count (CBC)..

Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are functioning and can help find abnormalities. Blood chemistry tests used to diagnose and stage fallopian tube cancer include the following.

Blood urea nitrogen (BUN) and creatinine may be measured to check kidney function. Increased levels may indicate that cancer has spread to the kidneys.

Find out more about blood chemistry tests.

During a laparoscopy, the doctor makes a small cut (incision) in the abdomen and places a thin tube with a light on the end (called a laparoscope) into the abdominal cavity. Surgical instruments can be passed through the laparoscope to remove small pieces of tissue. Laparoscopy is done to:

• check for abnormal growths and remove samples of tissue from the fallopian tubes and other organs in the abdomen for biopsy
• remove tumours or cysts that appear to be quite small on imaging tests
• help confirm the stage of a cancer
• plan surgery or other treatments

Find out more about laparoscopies.

During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. A report from the pathologist will show whether or not cancer cells are found in the sample. Biopsies can be obtained by needle (fine needle aspiration or core biopsy) or can be done during surgery.

Biopsies for fallopian tube cancer are commonly done during surgery that is called a laparotomy. This surgery is used to diagnose, stage and treat fallopian tube cancer, often all at the same time. During a laparotomy, the surgeon makes a large cut (incision) in the abdomen to examine all organs in the abdominal cavity. During this surgery, the surgeon usually removes the entire tumour and also removes additional tissue samples from different parts of the pelvis and abdomen to see if cancer has spread to those areas. The samples are sent to the lab to help stage the cancer. This is called surgical staging.

Find out more about biopsies.

An x-ray uses small doses of radiation to make an image of parts of the body on film. It is used to look for signs of fluid around the lungs (pleural effusion), which could be caused by fallopian tube cancer that has spread to the lungs.

Find out more about x-rays.

A paracentesis is a procedure in which a hollow needle or tube is inserted through the skin and into the abdominal cavity. This procedure is done to remove a buildup of fluid in the abdomen (ascites). The fluid is examined for cancer cells.

A computed tomography (CT) scan uses special x-ray equipment to make 3D and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer turns the images into detailed pictures.

A CT scan is used to:

• assess the chest, pelvis and abdominal organs and lymph nodes
• see if cancer has spread to other organs or tissues
• guide the needle when doing a biopsy of an area of suspected metastasis

Find out more about CT scans.

Magnetic resonance imaging (MRI) uses powerful magnetic forces and radiofrequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer turns the images into 3D pictures. An MRI is used to assess the pelvis, abdomen and lymph nodes to see if cancer has spread to other organs or tissues.

Find out more about MRIs.

A positron emission tomography (PET) scan uses a small amount of radioactive materials called radiopharmaceuticals to look for changes in the metabolic activity of body tissues. A computer analyzes the radioactive patterns and makes 3D colour images of the area being scanned.

A PET scan may be used to find fallopian tube cancer that has come back or has spread to other organs or tissues.

Find out more about PET scans.

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