Learn more about treatments for cancer of the ampulla of Vater, including the Whipple procedure and minimally invasive surgery.
Ampullary (AM-poo-la-ree) cancer is a rare cancer that forms in an area of your digestive system called the ampulla of Vater. The ampulla of Vater is located where your bile duct and pancreatic duct join and empty into your small intestine.
Ampullary cancer forms near many other parts of the digestive system, such as the liver, pancreas and small intestine. When ampullary cancer grows, it may affect these other organs.
Ampullary cancer treatment often involves extensive surgery to remove the cancer and a large margin of healthy tissue.
Signs and symptoms of ampullary cancer may include:
Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.
It's not clear what causes ampullary cancer.
In general, cancer starts when cells develop changes (mutations) in their DNA. A cell's DNA contains the instructions that tell the cell what to do. The changes tell the cell to begin multiplying uncontrollably and to continue living when normal cells would die. The accumulating cells form a tumor that can invade and destroy normal body tissue.
Factors that can increase the risk of ampullary cancer include:
Tests and procedures used to diagnose ampullary cancer include:
Passing a thin, flexible scope down your throat (endoscopy). Endoscopy is a procedure to examine your digestive system with a long, thin tube (endoscope) equipped with a tiny camera. The endoscope is passed down your throat, through your stomach and into your small intestine to view the ampulla of Vater.
Special surgical tools can be passed through the endoscope to collect a sample of suspicious tissue.
Endoscopy can also be used to create images. For instance, endoscopic ultrasound may help capture images of ampullary cancer.
Doctors may also inject a dye into your bile duct using endoscopy in a procedure called endoscopic retrograde cholangiopancreatography. The dye shows up on X-rays and can show blockages in your bile duct or pancreatic duct.
Ampullary cancer treatment options may include:
Surgery to remove the pancreas and small intestine. The Whipple procedure (pancreaticoduodenectomy) involves removing the head of your pancreas as well as a portion of your small intestine (duodenum), your gallbladder and part of your bile duct.
The Whipple procedure can be done using a large incision in your abdomen, or as a minimally invasive surgery, which uses several small incisions.
Combined chemotherapy and radiation. Chemotherapy uses drugs to kill cancer cells. Radiation therapy uses beams of energy, such as X-rays and protons, to kill cancer cells. Used together, these treatments may be more effective for ampullary cancers.
Combined chemotherapy and radiation may be used before surgery, to make it more likely that a cancer can be removed completely during an operation. The combined treatment can also be used after surgery to kill any cancer cells that might remain.
A cancer diagnosis can permanently change your life. Each person finds his or her own way of coping with the emotional and physical changes cancer brings. But when you're first diagnosed with cancer, sometimes it's difficult to know what to do next.
Here are some ideas to help you cope:
Find someone to talk with. Find a good listener who is willing to hear you talk about your hopes and fears. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your doctor about support groups in your area. Other sources of information include the National Cancer Institute and the American Cancer Society.
Start by making an appointment with your family doctor if you have any signs or symptoms that worry you. If your doctor suspects you might have ampullary cancer, you might be referred to a doctor who specializes in treating diseases and conditions of the digestive system (gastroenterologist) or a doctor who specializes in treating cancer (oncologist).
Because appointments can be brief, and because there's often a lot of information to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions will help make the most of your time together. List questions from most important to least important in case time runs out. For ampullary cancer, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover other points you want to address. Your doctor may ask:
October 30th, 2021