Ampullary cancer is a rare type that develops in the ampulla, a small sac-like structure where the bile duct and pancreatic duct enter the duodenum (the first part of the small intestine). Ampullary cancer often has symptoms similar to pancreatic cancer that are sometimes mistaken for the disease. The ampulla of Vater secretes digestive enzymes into the duodenum and regulates bile flow from the liver and gallbladder. This cancer is sometimes referred to as periampullary cancer because it can also develop in nearby tissues, such as the pancreas or bile duct.
Most ampullary cancers are adenocarcinomas, which begin in cells lining the inside of the ampulla and producing mucus. These cancers are usually slow-growing and do not spread (metastasize) to other body parts. However, ampullary cancer can be challenging to treat because it is often not caught in its early stages. By the time it is diagnosed, cancer may have spread beyond the ampulla and into nearby tissues.
What causes Ampullary Cancer
The cause of ampullary cancer is unknown but speculated to occur when normal cells in the ampulla start to grow out of control. Symptoms of ampullary cancer include pain in the abdomen, weight loss, jaundice (yellowing of the skin and eyes), and diarrhea or constipation.
Several risk factors for developing ampullary cancer include chronic pancreatitis, familial adenomatous polyposis (FAP), and specific inherited genetic syndromes such as Lynch syndrome. Smoking is also a risk factor. People with these conditions should discuss ways to reduce risk with their doctor.
How is Ampullary Cancer Diagnosed?
Ampullary cancer is diagnosed through a combination of medical imaging tests, such as CT, MRI, and endoscopic procedures, such as upper endoscopy. A biopsy, where a small tissue sample is used for examination under a microscope, is often needed to confirm the diagnosis.
What are the available treatments?
Treatment for ampullary cancer may include surgery, radiation therapy, or chemotherapy. The treatment type depends on the cancer stage (how far it has spread) and the person’s overall health. Surgery is the most common treatment for ampullary cancer. In some cases, only part of the ampulla needs to be removed. However, a more extensive operation, such as pancreaticoduodenectomy (also called a Whipple procedure), may be necessary if cancer has spread beyond the ampulla.
Radiation therapy and chemotherapy are used to treat ampullary cancer. These treatments are given before or after surgery, depending on the cancer stage. Clinical trials testing new therapies for ampullary cancer are always ongoing. People with this condition should speak with their doctor about all treatment options, including clinical trials.
Ampullary cancer is a rare but serious condition. However, treatment has improved recently, and with early diagnosis and proper treatment, patients with ampullary cancer can often lead long and healthy lives.