Health, Cancer

Ampullary Cancer: Causes, Symptoms, and Treatment

Ampullary Cancer

What is Ampullary Cancer?

Ampullary cancer is a rare type of cancer that affects the ampulla of Vater in the gastrointestinal system. According to research, about 0.2 percent of gastrointestinal tumors are malignant. The ampullary is a tiny opening that enters the first part of the small intestine, known as the duodenum. The ampulla of Vater is situated close to other organs in your digestive system. It includes the liver and pancreas.

This type of cancer accounts for less than 1% of all cancers. Over 70-year-olds are most likely to suffer from it. It is more common in men than in women. For every 100,000 males, 0.74 will develop while for every 100,000 females, 0.48 will develop.

What are the types of Ampullary Cancer?

Ampullary cancer begins in the ampulla of Vater. These originate in the pancreas, bile ducts, or intestines near the ampulla of Vater.

What are the causes of Ampullary Cancer?

Doctors believe that these types of cancer are inherited. But the main cause is not properly addressed.

Cancer begins when DNA changes in cells. DNA acts as an instructor for the cell. Cell changes start when they multiply uncontrollably and continue to grow and replace normal cells. The group of uncontrollable cells forms a tumor that captures and damages healthy tissue in the body. Later on, this tumor takes the form of cancer. These cancers can grow in the surrounding areas and spread to other parts of the body.

Spread of Ampullary Cancer

When ampullary cancer reaches an advanced stage, it is generally spread to the liver, lymph nodes, lungs, abdominal lining, and other organs. The stages of ampullary cancer are as follows:

Stage 1 – This cancer is found only on the inner surface of the small intestine and does not spread to other areas.

Stage 2 – This tumor has spread to the central surface of the small intestine. It spread to the Sphincter of Oddi – a muscular ring around the ampulla of Vater.

Stage 3 – This cancer spreads to the outside wall of the small intestine.

Stage 4 – Cancer spreads to areas of your body including lymph nodes or organs such as the liver or pancreas.

Symptoms of Ampullary Cancer

People with ampullary cancer generally develop symptoms like jaundice (it refers to the yellowing of the eyes and skin). It is one of the most common symptoms. This occurs when tumors in the ampulla of Vater obstruct the bile duct. This bile duct enters the bloodstream and may cause yellowing of the skin. Other symptoms of ampullary cancer include:

Loss of appetite

Abdominal pain

Back pain

Itching of the skin

Stomach pain

Weight loss

Vomiting

Diarrhea

Gastrointestinal bleeding

Pancreas inflammation

Pale, greasy stools

What are the risk factors for Ampullary Cancer?

Factors that increase the risk of ampullary cancer are:

Your age – Ampullary cancer is more common in adults and older people over 70 years of age.

Male – Males are more prone to developing ampullary cancer than females.

Hereditary Polyposis Syndrome – It increases the possibility of a person developing polyps in their digestive tract. The presence of polyps can raise the risk of colorectal cancer.

Hereditary non-polyposis colorectal cancer – It increases the person’s risk of developing colorectal cancer in which polyps are either very small or absent.

How is Ampullary Cancer diagnosed?

Your doctor has taken one or more tests to understand the problem.

Blood and Urine tests – These tests are mainly done to check anemia, bilirubin levels, and other changes that can be a sign of cancer.

Imaging test – This can be done to check the tumor inside the ampulla of Vater. This may be ultrasounds, CT Scans, or MRI Scans.

Endoscopy – It is done to examine the ampulla. An endoscopy is a long, thin tube. At the end, there is a small camera. It is put down through the mouth, esophagus, and stomach into the duodenum to the ampulla. It can be used to remove tiny tissue samples that will be examined to check the presence of cancer cells. 

Endoscopic retrograde cholangiopancreatography (ERCP) – You can use this test to check the pancreatic or bile ducts for blockages.

How is Ampullary Cancer treated?

Ampullary cancer is treated according to its type, size, stage, and testing results. This cancer can be eliminated through surgery. The objective of treatment is to cure, manage, or relieve problems caused by cancer. You can ask your healthcare team about treatment options, goals, risks, and benefits.

Types of treatment for cancer are:

Local treatment – This type of treatment destroys, damages, or manages cancer cells in a specific area. Doctors may use surgery and radiation for treatment.

Systemic treatment – This is used to damage or manage cancer cells that have spread all over your body. It is done by taking a pill or injection, chemotherapy, or systemic treatment.

Whipple procedure – It is also called a pancreaticoduodenectomy. This is a kind of surgery in which the surgeon eliminates the tumor in the affected area of the ampulla of Vater. Your surgeon can remove the surrounding tissues. These include the head of the pancreas, the lower halves of the stomach, the duodenum, the gallbladder, and lymph nodes.

Every surgery has some risks and benefits. Therefore it is better to discuss all the risks and benefits with your doctor before making a decision.

What are the complications of Ampullary Cancer treatment?

Every surgery has some complications. Ampullary cancer patients may experience the following symptoms:

Wound infection

Blood clots

Gastric problem

Pancreatic fluid leakage, due to disruption of the pancreatic ducts

Fatigue

Hair loss

Nausea

Diarrhea

Constipation

Infertility

Flu-like symptoms

Conclusion 

Ampullary cancer is a cancer of the part of the body called the ampulla of Vater. It originates in the pancreas and bile ducts. It is a very rare type of cancer. There is no proper cause for this cancer. But it affects your small intestine. It can damage the gastrointestinal system of the body. Your surgeon will monitor your condition before starting treatment. Treatment depends on your condition. It may be in the form of a pill, injection, or surgery. You should discuss all the risks and benefits of ampullary surgery with your doctor to prevent any kind of side effects from it. Follow your doctor’s advice.

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FAQ’S

Can Ampullary Cancer be curable?

Cancer can be cured if the tumor inside your body is removed completely. There is a chance of successful treatment at an early stage. If it is impossible to remove tumors completely at an early stage. Your healthcare team will help you to find other techniques to manage the condition.

What is the survival rate of Ampullary Cancer?

Ampullary cancer is known to be a life-limiting disease and its survival rate decreases as the stage of the disease increases. The survival rate for people who undergo the Whipple procedure is five years which ranges between 20% and 61%. In the Whipple procedure, some people live for more than five years. The time it takes to recover after treatment and the survival rate is not properly known. You should consult your doctor about this.

Can Ampullary Cancer come back?

Yes, it is possible to come back from this cancer. It is about 33% to 60% of recurrence.

When should I call my doctor?

You should call your doctor when you notice:

  • New symptoms or severe symptoms.
  • Signs of infection like fever.

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