Diagnosis
If you have any symptoms of fallopian tube cancer, your doctor will conduct a physical exam and review your personal and family medical history. During the physical exam, your doctor may feel your abdomen for any tumors or fluid buildup. If your doctor is suspicious that fallopian cancer might be present, he or she will likely perform or order one or more of the following tests to diagnose the disease and evaluate its spread. These could include:
Pelvic Examination
Your doctor will feel inside your vagina and rectum with gloved, lubricated fingers to check for any growths or abnormalities on your fallopian tubes or nearby organs. A rectal exam is important since it allows the doctor to feel deep in the pelvis for any growths which might not be felt on the vaginal exam.
CA-125 Blood Test
CA-125 is a protein that may be made by fallopian tube cancer cells in some (but not all) patients and is used as a tumor marker for gynecologic cancers. Its levels may be elevated in women with fallopian cancer. This test alone can't find fallopian tube cancer. High levels of CA-125 do not necessarily mean you have cancer of the fallopian tubes and low levels of CA-125 do not necessarily mean you do not. This test is most useful for detecting recurrent cancer and monitoring treatment progress.
- Please see Understanding Tumor Markers: CA-125 for more information
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Transvaginal Ultrasound
Ultrasounds bounce sound waves off of your internal organs in order to create echoes that form a picture. For this test, a wand-shaped scanner with an ultrasound device covered by a condom is inserted into your vagina. An ultrasound can help spot a tumor in the fallopian tubes and tell if it is solid or filled with fluid.
Chest X-Ray
X-rays use electromagnetic radiation to produce images of the inside of your body. Your doctor may order a chest X-ray to see if the cancer has reached your lungs.
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Computed Tomography (CT) Scan
A computed tomography (CT) scan uses narrow beams X-rays to produce an image of your body. A special dye may be injected into your veins and you may be asked to drink a special fluid in order to make the internal organs stand out. A CT scan reveals the presence of tumors and whether or not the cancer has spread to other parts of the body.
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Magnetic Resonance Imaging (MRI) Scan
Magnetic resonance imaging (MRI) uses radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show "slices" of the body.
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Positron Emission Tomography (PET) Scan
For a PET scan, the doctor injects a small amount of radioactive glucose (a sugar) into your bloodstream. This substance collects in areas where sugar is getting used up the most. Malignant (cancerous) cells in your body usually show up brighter in this type of study because they are dividing more quickly and using more glucose than normal cells do. This technique helps the doctor find the exact location of cancer in the body. This study may be paired with a CT scan to better localize disease.
Biopsy
Biopsy: A biopsy is the only way to tell for sure if cancer is present. Your doctor will remove a sample of abnormal tissue and send it to a lab to be analyzed under a microscope. An interventional radiologist (a doctor who is a specialist in performing procedures under X-ray guidance) may perform a fine needle aspiration (FNA) biopsy and place a needle directly into the tumor through the abdomen. In other cases, your doctor might remove a sample of fluid from your abdomen to diagnose fallopian tube cancer. Your doctor may also perform the biopsy laparoscopically and remove the specimen through a small incision in the abdomen. Finally, the biopsy may be performed at the time of definitive surgery described later. >
Genetic Testing
Genetic Testing – The Society of Gynecologic Oncology recommends genetic testing of all women who have been diagnosed with high grade fallopian tube cancer. Twenty percent of fallopian tube, ovarian, and primary peritoneal cancers are thought to be due to inherited genetic mutations. While BRCA1 and 2 comprise most of these mutations, there are others as well. It is important to learn whether you have a genetic mutation because these mutations can impact your risk of developing other cancer types and the type of treatment you receive in the future. It is also important to let your family members know if you have a genetic mutation so that they can get tested as well.
