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HomeHealthAmpullary Cancer: Risk Factors, Treatments, and Prognosis - Healthline

Ampullary Cancer: Risk Factors, Treatments, and Prognosis – Healthline

Ampullary cancer is a rare type of cancer that affects the ampulla of Vater in the gastrointestinal system. According to 2014 research, this gastrointestinal cancer accounts for 0.2 percent of all gastrointestinal cancers. It can have a good outlook compared with other similar cancers, such as pancreatic cancer.
Keep reading for more information about ampullary cancer, including how to find support.
Doctors believe most ampullary cancers arise spontaneously — they aren’t usually due to lifestyle factors, family history, or other possible risks. Doctors most commonly diagnose ampullary cancer in people who are in their 70s.
However, doctors have found some connections with certain medical conditions. These conditions are inherited and may increase your risk of ampullary cancer. They include hereditary polyposis syndrome and hereditary nonpolyposis colorectal cancer.
Hereditary polyposis syndrome increases the likelihood a person will develop polyps in their digestive tract. The presence of polyps can increase a person’s risk of colorectal cancer.
Hereditary nonpolyposis colorectal cancer increases a person’s risk of developing colorectal cancer where polyps are either very small or not present at all.
Having either of these conditions can increase your risk of ampullary cancer 200 percent.
Cancer survivors and their supporters will often wear a colored ribbon to show support for a cause. While there isn’t a specific ribbon for ampullary cancer, you could wear several ribbon types to show your support:
To understand ampullary cancer’s symptoms, it’s important to know more about its location in the body.
Ampullary cancer can affect the functions of the organs around the ampulla of Vater. This includes the liver, pancreas, and small intestine. Examples of symptoms include:
The most common symptom in those with ampullary cancer is obstructive jaundice. This occurs when bile can’t pass to the small intestine. Symptoms associated with obstructive jaundice include:
If you experience these symptoms, your doctor will typically begin testing for underlying causes, which could include ampullary cancer.
Recurrence is when a cancer comes back after treatment. When ampullary cancer recurs, the cancer doesn’t always occur in the ampulla of Vater. Instead, 2022 research shows that cancerous cells may grow in areas such as the liver, lining of the abdominal cavity, lungs, or in multiple locations. The most common recurrence area is the liver.
As a result, recurrence symptoms can be different. Liver cancer symptoms may include unexplained weight loss, appetite loss, and feeling very full, even after just eating a small amount. If you have symptoms and are uncertain if they could be related to a history of ampullary cancer, talk with your doctor.
A doctor will use imaging studies, and possibly biopsies of the tumor, to determine what stage your ampullary cancer is. The most common staging system is the TNM system. This stands for tumor, nodes, and metastases.
The tumor (T) staging describes where the initial tumor has spread in the body. The categories include:
Nodes (N) refers to if the cancer has spread to nearby lymph nodes. This includes:
Metastases (M) refers to metastasis, or if the cancer has spread to nearby organs. The more a cancer has spread, the more difficult the cancer usually is to treat.
Ampullary cancer treatment options depend on what stage the cancer is in. Because this cancer type is so rare, a 2020 review found that not much information is available to doctors about the effectiveness of different treatments.
Most treatments involve a combination of surgery and chemotherapy. Doctors may also recommend radiation to shrink or destroy a tumor, but this treatment is less common.
In early stage disease where the cancer hasn’t spread, a doctor will usually recommend surgery known as a pancreaticoduodenectomy. Another name for this procedure is a Whipple. In this procedure, a surgeon removes the:
Following the surgery, a doctor will usually recommend taking a medication to kill any remaining cancer cells. This is known as chemotherapy. The medication for ampullary cancer after a Whipple procedure is usually gemcitabine (Gemza), a medication that keeps cancer cells from rapidly dividing.
Sometimes, ampullary cancer has spread to other organs or its location is unresectable, meaning a surgeon can’t remove it. When this happens, a doctor may prescribe chemotherapy medications to keep the cancer from spreading further. Ideally, this will also reduce symptoms.
A doctor may prescribe a combination of chemotherapy medications, such as an antimetabolite, like fluoropyrimidine or gemcitabine, with a platinum compound, like cisplatin or oxaliplatin. These medications attack cancer cells in different ways to keep the cancer from spreading.
Ampullary cancer tends to cause symptoms at earlier stages than other cancer types, such as pancreatic cancer. This helps to improve outcomes because the cancer is diagnosed at earlier, more treatable stages.
The 5-year survival rate for those with ampullary cancer whose cancer has not spread to nearby lymph nodes is 70 to 80 percent. The 5-year survival rate for cancer that has spread is 20 to 50 percent.
An estimated 45 percent of people treated with surgery for ampullary cancer experience a recurrence of their cancer. If a person has a tumor at stage T2 or higher, a doctor will usually recommend chemotherapy to prevent cancer recurrence.
As a note, these numbers are based on studies that (while still recent) are a couple of years old. Cancer research is constantly improving and the exact statistics of your prognosis are likely to be more positive.
Because ampullary cancer is so rare and often involves similar treatments, many ampullary cancer survivors will join pancreatic cancer support groups. Examples of these and other cancer support groups include:
You can also visit ClinicalTrials.gov to find out about clinical studies being conducted around the world. Be sure to discuss these trials with your doctor before pursuing any change or addition to your treatment plan.
Ampullary cancer is a rare gastrointestinal cancer that has a good outlook with early treatment but is known to recur.
Although the condition most commonly occurs with no family history, those with certain hereditary conditions should talk with their doctor about their need for additional screening.
Last medically reviewed on May 27, 2022





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