Ampullary cancer, or ampullary carcinoma, is a life-threatening cancer that forms in a body part called the ampulla of Vater. The ampulla of Vater is a small opening that enters into the first portion of the small intestine, known as the duodenum. The ampulla of Vater is the spot where the pancreatic and bile ducts release their secretions into the intestines.
Facts about ampullary cancer
Ampullary cancer is a fairly rare form of cancer. In fact, only about 0.2 percent of cancers related to the gastrointestinal tract are ampullary cancer.
Types of ampullary cancer
True ampullary cancers originate in the ampulla of Vater. They are often confused with periampullary cancers, which originate in the pancreas, bile duct, or intestines close to the ampulla of Vater. In general, cancers that are ampullary have a better survival rate than periampullary cancers.
Jaundice is the most common symptom of ampullary cancer. This is because the tumor in the ampulla of Vater blocks the bile duct. Instead of flowing into the intestines, the bile enters the bloodstream and causes yellowing of the skin. Other symptoms of ampullary cancer include:
Progressive weight loss
Pruritus, or skin itchiness, associated with the jaundice
Stomach upset and vomiting
Loss of appetite
Because jaundice is the most common symptom of ampullary cancer, this is the physical symptom that will lead doctors to look for ampullary cancer as a possibility. Tests that doctors will do to determine if ampullary cancer is the cause include blood tests and urine tests to look for markers of the cancer.
Doctors may use specific scans to look for the presence of a tumor inside the ampulla of Vater. These may be ultrasounds, or CT or MRI scans.
If your doctors determine that you have ampullary cancer, the standard approach is to remove the tumor from the ampulla of Vater with a procedure called pancreaticoduodenal resection, or Whipple procedure. This procedure involves the resection, or removal, of the tumor in the affected portion of the ampulla of Vater and the surrounding areas.
The procedure is performed using endoscopic instruments. That means that the cameras and tools used to perform the procedure are inserted through small incisions in the abdomen. This makes the procedure minimally invasive and improves the chances of recovering from the surgery.
Ampullary cancer is a life-threatening diagnosis, but thanks to the use of the Whipple procedure, the survival rates from the cancer are improving. In the last decade, people treated using the Whipple procedure have shown a five-year survival rate ranging from 25 to 55 percent, based on how far the tumor has progressed.
Ampullary cancer is such a rare condition that experts aren’t sure what steps, if any, can be taken to prevent it. It does appear to be more common among men than women.
Managing ampullary cancer
Unfortunately, the vast majority of people with ampullary cancer die from complications within five years. The best thing you can do is have a positive outlook, and trust in your doctor that the procedures will be successful in helping to cure your ampullary cancer.
If a loved one has this type of cancer, these are some of the things that you can do for that person:
Spend time with the person, allowing him to express his wishes, fears, and feelings.
Let him reminisce about the past.
Be honest and forthcoming about his medical condition and outlook.
Reassure him that you will honor his wishes after their death.
Be willing to help him in any way that you can.
Respect the person’s privacy when he needs it.
For many, relying on their religion or faith is critically important in this trying time. Don’t be afraid to rely on the support of family, friends, or people from your faith community to help you either cope with the treatment of ampullary cancer or deal with the end-of-life issues if the cancer has become terminal.