What is ampullary cancer?
Ampullary cancer is a rare type of cancer. It’s when cancer starts in the part of
the body called the ampulla of Vater. The ampulla of Vater is a small opening where
the pancreatic and bile ducts (from the liver) connect to the first part of the small
intestine (the duodenum). There they ducts release their secretions into the intestines.
Ampullary cancer may also be called ampulla of Vater cancer.
What causes ampullary cancer?
Experts aren’t sure what causes ampullary cancer. But it occurs when cells in the
body change and grow out of control. These abnormal cells may grow to form a lump
or mass called a tumor. If they are in the body long enough, they can grow into (invade)
nearby areas. They can even spread to other parts of the body (metastasis).
Who is at risk for ampullary cancer?
A risk factor is anything that may increase your chance of having a disease. The exact
cause of someone’s cancer may not be known. But risk factors can make it more likely
for a person to have cancer. Some risk factors may not be in your control. But others
may be things you can change. There are no clear risk factors for ampullary cancer.
You might be at increased risk for this cancer if you:
Talk with your healthcare provider about your risk factors for ampullary cancer and
what you can do about them.
What are the symptoms of ampullary cancer?
The most common symptom of this cancer is jaundice. This is yellowing of the skin
and eyes. It happens because the tumor in the ampulla of Vater blocks the bile duct.
Instead of flowing into the intestines, the bile goes into the blood and causes yellowing
of the skin.
Other symptoms of the cancer are:
Loss of appetite
Stomach upset and vomiting
Digestive tract bleeding
Low red blood cell counts (anemia)
Inflammation of the pancreas (pancreatitis)
Pale, greasy stools
Many of these may be caused by other health problems. But it’s important to see your
healthcare provider if you have these symptoms. Only a healthcare provider can tell
if you have cancer.
How is ampullary cancer diagnosed?
Jaundice is the most common symptom of this cancer, and it’s often what leads people
to see a healthcare provider. Your provider will ask you about your health history,
symptoms, risk factors, and family history of disease. He or she will do a physical
You may also have one or more of these tests:
Blood and urine tests. These are used to look for anemia, bilirubin levels, and other changes that may be
signs of this cancer.
Imaging tests. These can be used to look for a tumor inside the ampulla of Vater. They may be ultrasounds
or CT or MRI scans.
Endoscopy. Healthcare providers may use an endoscope to look at the ampulla. An endoscope is
a long, thin tube. It has a tiny video camera on the end. It’s threaded down the mouth,
through the esophagus and stomach, and into the duodenum to the ampulla. It can also
be used to take out small pieces of tissue (samples) to look for cancer cells.
Endoscopic retrograde cholangiopancreatography (ERCP). This test might be used to look at the pancreatic and bile ducts to see if they are
It can be hard to tell the difference between pancreatic cancer and ampullary cancer.
A biopsy is the only way to confirm this cancer. Small pieces of tissue are taken
out and checked for cancer cells.
After a diagnosis of ampullary cancer, you’ll likely need more tests. These help your
healthcare providers learn more about the cancer. They can help determine the stage
of cancer. The stage is how much and how far the cancer has spread (metastasized)
in your body. It’s one of the most important things to know when deciding how to treat
Once your cancer is staged, your healthcare provider will talk with you about what
the stage means for your treatment. Ask your healthcare provider to explain the stage
of your cancer to you in a way you can understand.
How is ampullary cancer treated?
Your treatment choices depend on the type of ampullary cancer you have, test results,
whether the cancer can be removed with surgery, and the size and stage of the cancer.
The goal of treatment may be to cure you, control the cancer, or to help ease problems
caused by the cancer. Talk with your healthcare team about your treatment choices,
the goals of treatment, and what the risks and side effects may be.
Types of treatment for cancer are either local or systemic. Local treatments remove,
destroy, or control cancer cells in one area. Surgery and radiation are local treatments.
Systemic treatment is used to destroy or control cancer cells that may have traveled
around your body. When taken by pill or injection, chemotherapy is a systemic treatment.
You may have just one treatment or a combination of treatments.
The main treatment for ampullary cancer is surgery to remove the tumor. The Whipple
procedure (also called a pancreaticoduodenectomy) is used. This is a major surgery.
During it, a surgeon removes the tumor in the affected part of the ampulla of Vater.
Other nearby tissues are often removed too. These include the head of the pancreas,
the lower half of the stomach, duodenum, gallbladder, and lymph nodes.
Some people can’t have a Whipple procedure. In these cases, a less complex surgery
or another procedure (such as using a laser to kill the tumor) may be done. It’s not
clear if these methods can cure ampullary cancer. Some healthcare providers may also
suggest other treatments after surgery, such as chemotherapy or radiation therapy.
Talk with your healthcare providers about your treatment options. Make a list of questions.
Think about the benefits and possible side effects of each option. Talk about your
concerns with your healthcare provider before making a decision.
When should I call my healthcare provider?
Call your healthcare provider if you have:
Key points about ampullary cancer
Ampullary cancer forms in a body part called the ampulla of Vater. This is a small
opening that connects the bile and pancreatic ducts to the duodenum.
It’s a rare form of cancer.
People with certain inherited conditions that cause growths (polyps) in the digestive
system are more at risk for this type of cancer.
The most common symptom is jaundice, or yellowing of the skin and eyes. It’s caused
by bile going into the blood instead of into the duodenum.
The main treatment is a type of surgery called the Whipple procedure. It removes the
tumor and nearby tissues.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that
Know how you can contact your provider if you have questions.