Ampullary (AM-poo-la-ree) cancer is rare and similar to pancreatic and bile duct cancers. The name comes from the ampulla of Vater, where the bile duct and pancreatic duct meet. Ampullary cancer can block bile from flowing through the bile ducts and into the small intestine, causing the skin and eyes to turn yellow (jaundice) and other symptoms. These symptoms can cause people to seek treatment earlier than they would for most pancreatic cancers, leading to better outcomes.
- Expertise and experience. Mayo Clinic surgeons are nationally known for their skill and experience in treating rare cancers as well as for their multidisciplinary approach to treatment. Special treatments include minimally invasive (laparoscopic) surgery. Certain early ampullary cancers can be surgically removed during endoscopy — a procedure used to visually examine your upper digestive system with a tiny camera on the end of a long, flexible tube (endoscope).
- Mayo Clinic Cancer Center Gastrointestinal Program (GI Program). Mayo's GI Program includes clinical research activities in eight different disease sites. Each area is organized into scientific programs that work with clinical areas to conduct research to help patients with gastrointestinal cancers, including ampullary cancer, and those at risk.
- Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach focused on cancer prevention, diagnosis and treatment.
Mayo Clinic in Rochester, Minn., is ranked among the Best Hospitals for cancer by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked high performing for cancer by U.S. News & World Report.
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Mayo Clinic doctors use the latest diagnostic tests to help determine the best treatment plan for you. In tests that involve radiation, specialists carefully monitor doses to avoid the risk of radiation overexposure. Your doctor will determine which of the tests below may benefit you.
- X-rays. These generate a 2-D view of the chest and abdomen.
- Barium X-rays. For this test, you drink a liquid containing barium. The barium solution coats your intestines, allowing suspicious areas to show up better on X-rays.
- Ultrasound. Ultrasound uses high-frequency sound waves to form images on a screen to identify tumors.
- Endoscopic ultrasound (EUS). For more detailed images, an ultrasound probe is passed through a thin, lighted, flexible tube (endoscope) into your gastrointestinal tract. Doctors may use endoscopic ultrasound before surgery to determine the depth of the tumor and whether it has spread to the liver.
- Computed tomography (CT) scans. CT scans generate 2- or 3-D images that may reveal whether cancer has invaded other tissues or organs.
- Magnetic resonance imaging (MRI). An MRI uses magnetic fields and radio waves to create detailed images of the abdomen and identify small abnormalities seen in 2- and 3-D views.
- Positron emission tomography (PET). To perform a PET scan, a radioactive type of sugar (glucose) is injected into your bloodstream. The scan helps show if a tumor has spread, because tumors typically pick up the sugar and appear on the image as "hot spots."
- Endoscopy. During endoscopy, doctors use an endoscope to see the inside of the first part of the small intestine (duodenum).
- Endoscopic retrograde cholangiopancreatography (ERCP). This test uses an endoscope through which dye is injected into the pancreas and X-rays of the ducts are taken. Samples of cells from the ducts can be obtained and studied under the microscope.
- Percutaneous transhepatic cholangiography (PTC). This test can identify obstructions that may be tumors. A specialist inserts dye into the bile ducts with a thin needle and then views its movement using a specialized X-ray machine.
- Biopsy. In a biopsy, a pathologist removes a small tissue sample and looks under a microscope for cancer cells.
- Cytology. Cells can be obtained from the bile ducts from a brushing through ERCP and examined under the microscope. Specialized testing called fluorescence in situ hybridization (FISH) can be done on these cells to determine if they are cancerous (malignant).
Read more about ultrasound, CT scan, MRI, PET scan, endoscopy and biopsy.
Your treatment team will diagnose the type of ampullary cancer and collaborate to plan the most effective treatment for you. Treatment options depend on many factors, including the tumor's type, size and stage.
Surgery is the most common treatment for ampullary cancer. During surgery, doctors may also remove nearby lymph nodes to determine if the disease has spread. Sometimes doctors can perform minimally invasive (laparoscopic) surgery, using a camera and miniature instruments inserted through tiny incisions in the abdomen. If the ampullary tumor is large or has spread, surgeons will usually recommend a Whipple procedure (pancreatoduodenectomy), which involves removing the cancer and part of your pancreas. Local removal only for cancer has a limited effectiveness.
Your doctors may recommend radiation therapy and chemotherapy if surgery is not an option or along with surgery to improve chances of cancer control. Radiation and chemotherapy may also be used for people whose cancer has spread to other parts of the body.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
A collaborative team of experienced specialists at Mayo Clinic in Arizona determines the best treatment approach for you. The treatment team for ampullary cancer includes doctors from gastroenterology and hepatology, general surgery, oncology, radiation oncology and other specialties, as needed.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
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A collaborative team of experienced specialists at Mayo Clinic in Florida determines the best treatment approach for you. The treatment team for ampullary cancer includes doctors from gastroenterology and hepatology, general surgery, oncology, radiation oncology and other specialties, as needed.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
A collaborative team of experienced specialists at Mayo Clinic in Minnesota determines the best treatment approach for you. The treatment team for ampullary cancer includes doctors from gastroenterologic and general surgery, oncology, radiation oncology and other specialties, as needed.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach focused on cancer prevention, diagnosis and treatment. Mayo also participates in the American College of Surgeons Oncology Group (ACOSOG), funded by the National Cancer Institute, which evaluates the surgical management of patients with malignant solid tumors.
See a list of publications by Mayo doctors on ampullary cancer on PubMed, a service of the National Library of Medicine.
May 09, 2011