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.
However, doctors have found some connections with certain medical conditions. These conditions are inherited and may increase your risk of ampullary 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
What ribbon color shows support for people with ampullary cancer?
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:
- Purple. Purple is the ribbon color for pancreatic cancer. A small portion of ampullary tumors are of pancreatic cells.
- Blue. Blue is the ribbon color for colon cancer. Many ampullary tumors are made from intestinal tissue.
- Kelly green. Kelly green is the ribbon color for gallbladder cancer and bile duct cancer awareness.
- Light purple or lavender. A light purple or lavender ribbon is used to represent all cancer types.
To understand ampullary cancer’s symptoms, it’s important to know more about its location in the body.
- The gallbladder is an organ responsible for secreting bile, a substance that helps the body digest fats.
- The bile secreted by the gallbladder travels down the common bile duct, which is sort of like a pathway. From there, it empties into the small intestine.
- The pancreas is an organ that, among other tasks, releases a substance called pancreatic juice. Pancreatic juice helps to ensure digestion.
- Pancreatic juice travels down the pancreatic duct to empty into the small intestine.
- The area where the pancreatic duct and the bile duct meet is called the ampulla of Vater. This is where ampullary cancer occurs.
Ampullary cancer can affect the functions of the organs around the ampulla of Vater. This includes the liver, pancreas, and small intestine. Examples of
- gastrointestinal bleeding, which usually appears as dark, tarry, or bloody stools
- pain that radiates to the back
- weight loss
- abdominal pain
- dark urine
- itchy skin
- mental status changes, such as confusion
- pale-colored stool
- stools that are especially foul-smelling
- yellowing of the eyes or skin
If you experience these symptoms, your doctor will typically begin testing for underlying causes, which could include ampullary cancer.
Recurrence symptoms for 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
The tumor (T) staging describes where the initial tumor has spread in the body. The categories include:
- T1a. The tumor is limited to the sphincter of Oddi.
- T1b. The tumor has invaded the duodenal submucosa.
- T2. The tumor has invaded the duodenal proper muscle.
- T3a. The tumor has invaded the pancreas less than or equal to 0.5 centimeters.
- T3b. The tumor has invaded the pancreas greater than 0.5 centimeters.
- T4. The tumor involves the celiac axis or superior mesenteric artery.
Nodes (N) refers to if the cancer has spread to nearby lymph nodes. This includes:
- N0. No nodal metastasis has occurred.
- N1. Between 1 and 3 nodal metastases have occurred.
- N2. Greater than 4 nodal metastases have occurred.
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.
- M0. There is no distant metastasis.
- M1. Distant metastasis has occurred.
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.
Early stage disease treatments
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:
- head of the pancreas
- bile duct
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.
Treatments for late stage disease or unresectable tumor
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
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.
Living with ampullary cancer
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:
- Cancer Survivors Network
- Let’s Win! Pancreatic Cancer Support Group
- Pancreatic Cancer Action Network
- The National Pancreas Foundation
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.