Ampullary Cancer is a rare form of gastrointestinal cancer where the proliferation of cancer cells usually happens in the ampulla of Vater (i.e., a portion of the digestive system where the bile duct attaches to the pancreatic duct for emptying partially digested food contents into the small intestine for the process of assimilation).

Also Read: Gastric Cancer: Causes, Symptoms And Treatment
Ampullary Cancer

Although Ampullary cancer chiefly affects the ampulla of Vater, it can gradually spread and affect other parts of the digestive system, such as the liver, pancreas, and small intestine as well. Deemed a rare form of G.I cancer, Ampullary cancer accounts for approximately less than 1% of all cancers affecting the digestive tract. Ampullary cancer is a fast-growing cancerous condition and the treatment option mainly involves extensive surgery to remove cancer and a large portion of the surrounding healthy tissue.


Similar to any other form of a cancerous condition, the absolute cause of Ampullary sarcoma is yet undiscovered. But several pieces of research state that it usually stems from a change or mutation in the genetic material of the DNA strands of the cells of the ampulla of Vater. This causes the healthy cells to go rogue and divide and grow rapidly, without dying and eventually congregating to form malignant tumorous growths.

Also Read: Bile Duct Cancer: Causes, Symptoms And Treatment

Risk Factors

The various causative factors that aggravate the risk of Ampullary cancer include:

Age: It is commonly diagnosed in adults above the age of 70

Gender: Ampullary cancer is diagnosed more commonly in males than in females

Genetic Condition: Having been diagnosed with inherited syndromes like Lynch syndrome or familial adenomatous polyposis (FAP) increases the incidence of developing Ampullary cancer


The characteristic signs and symptoms usually depend on the size of the tumour and whether it has manifested in other parts of the body. These include:

  • Jaundice
  • Pancreatitis
  • Pain in the abdomen
  • Sudden weight loss
  • Loss of appetite
  • Nausea and vomiting
  • Fever
  • Diarrhoea
  • Anaemia
  • Clay-coloured stools (poop)
  • Rectal bleeding
  • Back pain
  • Itchy skin
Endoscopic ultrasound

Diagnosis And Treatment

On noticing any of the above-mentioned signs and symptoms, do consult a specialised doctor at the earliest to initiate the treatment right away. The doctor usually does a full physical checkup followed by acknowledging the patient’s past medical history and conducts a few of the diagnostics including:

Blood or urine tests: These are done to look for cancer markers

Imaging tests:  These include CT scans, ultrasounds and magnetic resonance imaging (MRI) to analyse the exact position of the tumours

Upper endoscopy: A procedure which involves the insertion of a tiny camera to check for cancer inside the digestive tract

ERCP (endoscopic retrograde cholangiopancreatography): An endoscopic procedure which checks if the bile duct is blocked

Biopsy: A small mass of tissue is scraped off from the site of the tumour and examined to look for cancer cells and the spread of the infection


To understand the extent of metastasis of the cancerous cells in the body, ampullary cancer is staged:

Stage 1: Cancer has only affected the inner layer of the small intestine, and has not spread to the surrounding areas yet

Stage 2: The tumorous growths have metastasized to the middle layer of the small intestine and even to the sphincter of Oddi (a muscular ring around the ampulla of Vater)

Stage 3: The malignant cells have spread to the outer wall of the small intestine

Stage 4: An advanced stage of the condition where cancer has spread to other areas of the body including the lymph nodes or organs such as the liver or pancreas


The available treatment options usually depend upon the age of the patient, the physical condition of the patient, the size and stage of the tumour,  and whether it has spread to other parts of the body. These include:

  • Endoscopic surgery: A surgery to remove small ampullary cancers with tools passed through an endoscope
  • Whipple procedure: Also known as pancreaticoduodenectomy, it involves the complete removal of the head of the pancreas as well as a portion of the small intestine (duodenum), the gallbladder and part of the bile duct
  • Chemotherapy alone
  • Combined chemotherapy and radiation therapy
  • Treatments targeted to reduce pain and discomfort