Ampullary cancer (carcinoma of the ampulla of vater) is a type of cancer that occurs in the ampulla of vater, a small tube-like structure that connects the common bile duct and pancreatic duct to the small intestine. The ampulla is located in the upper part of the small intestine, near the stomach.
Ampullary cancers are relatively rare, and are treated like pancreas cancers as they lead to development of similar symptoms. Ampullary cancers often block the bile duct while they’re still small and have not spread far. This blockage causes bile to build up in the body, which leads to yellowing of the skin and eyes (jaundice). Because of this, these cancers are usually found earlier than most pancreatic cancers, and they usually have a better prognosis (outlook).
- Abdominal pain.
- Jaundice (yellowing of the skin and whites of the eyes).
- Nausea and vomiting.
- Loss of appetite.
- Weight loss.
- Changes in bowel habits.
- Dark urine.
- Pale stools.
These symptoms may be caused by a blockage of the bile or pancreatic ducts, which can occur if the cancer grows large enough to obstruct the flow of fluids.
Diagnosis of ampullary cancer usually involves a combination of tests, such as:
- Imaging studies (such as CT or MRI).
- Endoscopy, and biopsy.
- Endoscopic ultrasound (EUS).
- Endoscopic retrograde cholangiopancreatography (ERCP).
Treatment may include:
- Surgery to remove the cancer.
- Chemotherapy and/or radiation therapy.
The prognosis for ampullary cancer depends on the stage of the cancer at diagnosis, as well as other factors such as the patient’s age and overall health.
The exact cause of ampullary cancer is not known, but there are several risk factors that may increase the likelihood of developing the disease, such as smoking, excessive alcohol consumption, chronic pancreatitis, and a family history of ampullary cancer.
Symptoms of ampullary cancer can include abdominal pain, jaundice, weight loss, nausea, vomiting, diarrhea, and yellowing of the skin and whites of the eyes.
Ampullary cancer is typically diagnosed using a combination of imaging tests, such as CT scan, MRI, and ERCP, as well as blood tests to check for elevated levels of bilirubin, a marker of jaundice, and a biopsy.
Treatment options for ampullary cancer include surgery, radiation therapy, and chemotherapy. The type of treatment recommended will depend on the stage of the cancer and the patient’s overall health.
The prognosis for ampullary cancer depends on the stage of the cancer at the time of diagnosis. If the cancer is caught in the early stages, the prognosis is generally better. In general, the 5-year survival rate for ampullary cancer is around 60%.
Currently, there are no routine screening tests for ampullary cancer. However, people with a family history of the disease or known risk factors may be advised to undergo regular imaging tests, such as ERCP or endoscopic ultrasound, to check for signs of the cancer.
There is no sure way to prevent ampullary cancer, but making certain lifestyle changes can help to reduce the risk of developing the disease. These include quitting smoking, limiting alcohol consumption, maintaining a healthy diet, and avoiding exposure to environmental toxins.
Ampullary cancer can spread to other parts of the body, such as the lymph nodes, liver, and lungs. This is known as metastasis. If the cancer has spread, it can make treatment more difficult and may affect the prognosis.
Ampullary cancer can recur after treatment. The risk of recurrence is higher for people who have a higher stage of cancer at diagnosis, and for those who have not undergone complete surgical resection.
After treatment for ampullary cancer, it is important to follow a healthy diet that is low in fat and high in fiber. Your healthcare provider may also recommend a special diet, such as a low-salt or low-sugar diet, depending on your individual needs.