| Weekly Q&A - Fallopian Tube Cancer | |
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Dianne writes: I have carcinosarcoma of the fallopian tube with metastatic adenocarcinoma in the ovary. Right now I am having chemo Taxol and carboplain every three weeks. My question is I can't seem to find out a lot about my cancer. Right now some doctors feel like I should have radiation after and some do not. I have been given reasons why I should but no reason why I should not. Also, I am concerned of what follow up test I should have after my treatments are over.
Hi, Dianne - I'm so sorry you're going through this. Cancer is bad enough without having doctors disagree over your treatment. :-(
Fallopian tube cancer (tubal cancer, FTC) is rare, which is probably why there is disagreement over how to proceed, and also why it's difficult to find information.
Possibly one reason for disagreement between physicians is this: Since tubal cancer is rare, it is common to fall back on accepted practice for ovarian cancer, and for good reasons. Ovarian cancer and fallopian tube cancer have a lot of similarities microscopically, in how they spread, and in how they respond to treatment. Ovarian cancer is not usually treated with radiation therapy, because it has not been found to be all that effective in most cases.
However, in the meager literature on fallopian tube cancer, there are at least two studies that do show positive effects for whole abdomen radiation as treatment. The most-often cited one is:
Schray MF, Podratz KC, Malkasian GD.. Fallopian tube cancer: the role of radiation therapy. Radiother Oncol 1987 Dec;10(4):267-75
This study showed a clear advantage for radiation therapy. However, you will notice that this is rather old (1987). This is because there are so few cases of fallopian tube cancer that it is difficult to do studies. Since chemotherapy for ovarian cancer has improved in the last 15 years, it may be that some physicians feel that this study is outdated. Happily, these days with improved communication, there are efforts to do a better job of at least registering patients and tracking their progress, so hopefully women and their doctors will have more to go on in the future.
Why NOT radiation? Always with any treatment, the possible positives must be weighed with the negatives. If there is a slim chance of getting help from a therapy, but a large chance of debilitating side effects, most will shy away from the therapy. For a discussion of the side effects of radiation therapy, see the link below.
I think a good step would be to get your doctors to talk to each other about this. You shouldn't have to make this decision on your own. Also, as a point of reference, a gynecologic oncologist would generally be more aware of current treatments than other physicians.
As far as follow-up goes, the protocol, as far as I know, is pretty much the same as that for ovarian cancer. It varies a bit from physician to physician, but basically, a physical examination is done every 2-4 months at first. If CA 125 seems to be a good indicator for your cancer, that will be included. CT scans are usually done less often, but at least twice a year for the first year or two.
More Information about Fallopian Tube Cancer
Side Effects of Radiation Therapy
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