Ampullary Cancer

Ampullary cancer begins in the ampulla of Vater. This is where fluids from your pancreas and bile ducts empty into your small intestine. Its symptoms can be like those of bile duct or pancreatic cancer and other gastrointestinal (GI) conditions. These symptoms include abdominal (belly) pain, other gut problems, unexplained weight loss and jaundice — yellowing of your skin and the whites of your eyes.

The sooner we diagnose ampullary cancer, the more effective treatment can be. Particularly if you catch it in its early stages before it spreads to other parts of your body (metastasizes). Because ampullary cancer can be easily confused with other GI conditions, it’s important to have healthcare providers who recognize the subtle signs of this rare digestive cancer.

What to expect at your first visit

Our caring providers understand that you might be feeling a lot of emotions right now. That’s why we start your visit by getting to know each other. In fact, one of the most important things you can do when you meet your provider is to share your story. It helps them confirm a diagnosis and build a treatment plan. They’ll ask questions and answer your questions, too. They might want to know:

• What are your symptoms?
• How did they start?
• How long have you had them?
• Are they getting worse?
• Do you have any other health conditions?
• Have any of your family members had cancer?

During your appointment, you’ll also have a physical exam so your provider can look for signs of ampullary cancer or other health conditions with similar symptoms. Your provider may also order tests to get a better idea of what’s happening in your digestive system. These tests might include:

• Blood tests for cancer.
• Pancreas tests.
• MRI.
• CT scan.
• PET scan.
• Upper endoscopy.
• Endoscopic ultrasound.
• Endoscopic retrograde cholangiopancreatography (ERCP).
• Biopsy.

Second opinions for ampullary cancer at Cleveland Clinic

Learning you may have a rare digestive cancer can be a shock — and leave you wondering about your future. That’s why it’s important to work with caring healthcare providers you trust. You want ones who’ll listen to you, answer your questions and make sure to always keep you at the center of your care.

At Cleveland Clinic, we encourage second opinions. Our highly skilled ampullary cancer team takes the time to help you understand what’s happening, explain treatment options and offer their expertise, every step of the way.

And because we know that cancer doesn’t wait, we always try to schedule your appointment with us as soon as possible. When you get a second opinion, you can have peace of mind knowing you’ll get the best possible treatment from the most capable and compassionate healthcare providers.

Meet our ampullary cancer team

Cleveland Clinic’s team-based approach to care puts all of the expert providers you need on a highly personalized care team. They work together to confirm a diagnosis and build a treatment plan that focuses completely on you and your unique needs. And they continue to partner with you through treatment, recovery and follow-up, keeping you at the center of your care. Your team may include:

• Medical and surgical oncologists.
• Gastroenterologists.
• Radiologists.
• Pathologists.
• Anesthesiologists.
• Psychologists.
• Social workers.

Digestive cancers can be complex. And no two diagnoses are the same. A lot of different things — like your test results, age and overall health — help us decide which treatments are right for you. Depending on your needs, you may have a combination of treatments.

Surgery for ampullary cancer

The Whipple procedure (also called a pancreaticoduodenectomy) is the most common treatment for ampullary cancer. Your surgeon removes the tumor from the ampulla of Vater, your gallbladder, portions of your bile ducts and small intestine and the head of your pancreas.

Other treatments

We may recommend chemotherapy or radiation therapy after surgery. These therapies reduce the risk of cancer returning. Or you may receive chemotherapy if cancer has spread widely or you’re not healthy enough for surgery. Your care team may suggest both treatments as part of your plan.

Sometimes we place a stent (small mesh tube) to drain a blocked bile duct. Biliary drainage as a palliative therapy can reduce jaundice and relieve other symptoms.

Taking the Next Step

While you didn’t choose to have ampullary cancer, you do have a choice when it comes to finding the best healthcare providers and treatments. You’ll want providers who look beyond test results and treatment options to see the whole you and base your care on just that — you and your needs. At Cleveland Clinic, we’ll help you make informed, confident decisions about your treatment plan and offer guidance and support every step along the way.