What you need to know about Ampullary Cancer

Have you recently noticed that your eyes and skin are turning a little yellow? Or, have you suddenly lost weight for no apparent reason? Although these are common things that we sometimes think of as not paying much attention to, these could be the first signs of a rare but serious disease called Ampullary Cancer. Don't be scared when you hear this name. The most important thing is to be fully informed about any disease. So, today we will talk about what Ampullary Cancer is, how it develops, what are the symptoms, and the treatment methods in a simple way that you can understand.

What is Ampullary Cancer?

To understand this, we first need to know about a small part of our body. We have two organs in our body called the pancreas and the liver. Both of these secrete special juices that help us digest our food. Imagine that these two juices come together and come to one place, like an intersection where two roads meet. Then from there, all these juices come together and go into our small intestine (duodenum).

In medicine, we call the tiny opening where that juice collects the ampulla of Vater .

So, when cancer cells start to grow in this very area called the ampulla of Vater , we call it ampullary carcinoma . This is a very aggressive type of cancer. Also, because the area where it develops is very close to very important organs like the liver and pancreas, the cancer has a high chance of spreading to those organs as well. Therefore, the best way to get the best results is to remove this cancer through surgery before it spreads.

How common is this disease?

This is actually a very rare cancer . Less than 1% of all cancers in our digestive system (gastrointestinal tract) are reported as ampullary cancer. Therefore, this is not a disease that affects everyone.

What are the symptoms? How do we recognize this?

The most unique thing about this cancer is that it shows symptoms in the early stages. Among them, the main and most common symptom is jaundice . This means that the whites of the eyes and the skin turn yellow.

In addition to this main symptom, there are several other symptoms that can be seen. Let's look at them in an easy-to-understand way.

Why does this kind of cancer develop?

In fact, experts still can't say exactly why this ampullary cancer develops. But we do know that all cancers develop when there is a change (mutation) in the DNA that controls the genetic information in the cells of our body. In this way, abnormal cells with DNA changes begin to divide rapidly and uncontrollably. A cancerous tumor is formed when many cells grow together without control.

Experts are still researching the DNA changes associated with this cancer. Based on that information, more effective treatments may be found in the future.

Risk Factors

There are several factors that increase the risk of developing this cancer:

• Over 70 years of age: The risk increases with age.
• Being male: This cancer is more common in men than women.
• Some genetic conditions: Some genetic conditions can increase the risk of cancer. For example, conditions like Familial Adenomatous Polyposis (FAP) and Lynch syndrome.

How does a doctor accurately diagnose this disease? (Diagnosis)

Usually, when a person goes to a doctor with yellow eyes and skin (jaundice), suspicions arise and tests begin. Several tests are performed to confirm the disease.

• Blood and urine tests: These check the levels of chemicals in the body that are associated with cancer cells, called tumor markers.
• Imaging Tests: These are used to take pictures of the organs inside the body to check for cancer. Tests such as `CT scan`, `Ultrasound scan` and `MRCP` are used for this.
• Endoscopic Tests: This involves inserting a long, thin tube (endoscope) with a camera attached through your mouth to look at the cancer. Upper endoscopy and ERCP (Endoscopic Retrograde Cholangiopancreatography) are two such tests. You will be given anesthesia during these tests, so you will not feel any pain.
• Biopsy: This is the only test that can confirm 100% whether it is cancer. During the endoscopy, a very small piece of tissue is taken from the suspicious area and tested in the laboratory to confirm whether there are cancer cells.

What is the staging of cancer?

Once the disease is diagnosed, the doctor will determine how far the cancer has spread. This is called staging. Treatment is determined based on this stage. Cancer that is caught in the early stages is more likely to be cured.

It is very important to clearly understand the stage of your cancer and how it will affect your treatment by asking your doctor.

What are the treatments?

There are several treatment options for ampullary cancer.

• Whipple Procedure: This is the most common and most common surgery for this type of cancer. It is a fairly complex, major surgery. In this procedure, not only the tumor itself is removed, but also the surrounding area (gallbladder, part of the bile duct, part of the small intestine, and the head of the pancreas) where cancer cells may have spread.
• Endoscopic Surgery: If the cancer is in a very early stage, it is sometimes possible to remove the cancer using an endoscope.
• Chemotherapy: This involves giving the body powerful drugs that kill cancer cells. This treatment is given to kill any remaining cancer cells after surgery or to control the growth of the cancer when surgery is not possible.
• Radiation Therapy: This is where powerful beams of energy are used to destroy cancer cells. Sometimes this treatment is given along with chemotherapy to shrink the tumor before surgery or to destroy any remaining cells after surgery.
• Palliative Care: This is a treatment that focuses on relieving symptoms rather than curing the disease. For example, a stent may be placed in a blocked bile duct to open it. This can help reduce symptoms such as jaundice and itching, which can provide significant relief.

Can this cancer be completely cured?

The only way to completely cure this cancer is to completely remove the cancer through surgery. This is most likely to be successful when the cancer is found in its early stages.

Sometimes the cancer disappears completely after surgery. However, it can recur after a while (recurrent cancer). Therefore, even after surgery, it is very important to continue to go to the doctor for tests and clinics as recommended. The risk of cancer reoccurring is especially high within the first five years.

Is there a way to prevent this?

Unfortunately, the risk factors (age, genetics) that cause this cancer are not something we can control. Therefore, there is no specific way to prevent it. However, if you have a genetic condition like FAP or Lynch syndrome, your doctor may recommend that you undergo regular screenings. This can help detect cancer at an early stage.

It's normal to feel overwhelmed and shocked when you learn about cancer. Talk openly with your doctor and family about your questions, fears, and doubts. Getting the right information, the right treatment, and emotional support will be a great strength on this journey.