What is ampullary cancer?
Ampullary cancer is a rare cancer that forms in the ampulla of Vater, a small area where the bile duct and pancreatic duct empty into the small intestine. This part of the digestive system helps move bile and digestive enzymes into the intestine to support digestion.
Because the tumor can block the flow of bile, many people first notice yellowing of the skin or eyes. Early evaluation is important so treatment can begin as soon as possible.
The exact cause of ampullary cancer is not fully understood. It develops when abnormal cells grow uncontrollably in the ampulla of Vater.
Factors that may increase risk include:
- Certain inherited conditions that cause polyps in the digestive tract
- Inflammatory bowel disease
- Older age
Symptoms
Ampullary cancer can cause symptoms related to blocked bile flow and digestive changes. Symptoms may develop slowly or appear suddenly.
Common symptoms include:
- Yellowing of the skin and eyes (jaundice)
- Dark urine
- Pale or greasy stools
- Belly pain or back pain
- Nausea or vomiting
- Loss of appetite
- Unexplained weight loss
- Itchy skin
- Fever
- Fatigue or weakness
How is it diagnosed?
Providers use several tests to diagnose ampullary cancer and determine whether it has spread. Your care team will review your symptoms, medical history, and perform a physical exam.
Testing may include:
- Blood tests to check liver function and bilirubin levels
- CT scans, MRI scans, or ultrasound imaging
- Endoscopy to closely examine the digestive tract
- ERCP to look at the bile and pancreatic ducts
- Biopsy to confirm cancer cells are present
A biopsy is the only way to confirm the diagnosis. Additional imaging and testing may also be used to determine the stage of the cancer and help guide treatment decisions.
How is it treated?
Treatment depends on the size of the tumor, whether the cancer has spread, and your overall health. Surgery is often the main treatment when the cancer is found early.
The most common surgery is called the Whipple procedure. During this operation, surgeons remove the tumor along with nearby structures that may contain cancer cells.
Other treatments may include:
- Chemotherapy
- Radiation therapy
- Procedures to relieve blocked bile ducts
- Supportive care to manage symptoms and nutrition
Many patients receive a combination of treatments. Recovery can take time, especially after major surgery, and ongoing follow-up care is important.
