Materiały źródłowe

• #1 Ampullary Cancer: An Overview

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4966534/

  Ampullary cancers are rare, accounting for only 0.2% of gastrointestinal cancers and approximately 7% of all periampullary cancers. […] The management of locoregional disease is primarily a surgical intervention by a pancreaticoduodenectomy (or Whipples procedure) followed by the administration of adjuvant chemotherapy (preferably gemcitabine). […] The management of unresectable and metastatic disease is primarily through the administration of systemic therapy with an anti-metabolite (fluoropyrimidine and/or gemcitabine) combined with a platinum compound, (usually cisplatin or oxaliplatin). […] Given the rarity of this disease, there is absence of randomized clinical trials focused on ampullary carcinomas and treatment recommendations are mainly derived from results of adjuvant clinical trials conducted in pancreaticobiliary cancers where ampullary cancers may represent a sub-group of patients.

• #2 Ampullary Cancer: Symptoms, Staging and Survival Rate

  https://www.cancercenter.com/cancer-types/ampullary-cancer

  Ampullary cancer is a type of cancer that develops in a small opening called the ampulla of Vater, where the pancreatic and bile ducts meet and then empty into the small intestine. […] Generally, ampullary cancer is diagnosed in patients 70 and older, but it may also occur earlier in patients with pre-existing health conditions. […] Its important to note that the presence of one or more of these symptoms doesnt necessarily mean theyre being caused by ampullary cancer. Patients should seek advice and speak to a doctor about any concerns involving changes to their body. […] The care team will recommend a treatment plan based on the type of cancer, personal preferences and any pre-existing health conditions. The most commonly used treatments include: […] Surgery is the only treatment option, used to remove the cancer. A surgical resection with pancreaticoduodenectomy, also known as a Whipple procedure, is a complex operation that removes part of the pancreas and small intestine.

• #3

  https://www.karmanos.org/karmanos/ampullary-cancer-treated-at-karmanos

  Ampullary cancer is when cancer (malignant) cells start to grow within the ampulla of Vater. The most common symptom of ampullary cancer is jaundice, which is the yellowing of the skin and eyes. […] There are different treatment types for patients with ampullary and periampullary cancers including endoscopic surgery, Whipples procedure, radiation therapy, chemotherapy, targeted therapy and/or immunotherapy if indicated.

• #4 Advice on Caring for Mother-n-law with Stage 4 Ampullary Cancer – General Nursing Support

  https://allnurses.com/advice-caring-mother-n-law-stage-ampullary-t395527/?do=findComment&comment=3956792

  My mother-n-law is now having difficulties where she lives and has asked to come live with us. […] What should I expect caring for someone in the 4th stage of cancer? Do they need someone to be looking after them all the time? […] She has already slowed down tremendously. She is always tired, has nausea and vomiting sometimes, fevers here and there, her appetite has decreased quite a bit, and she sleeps all day. […] What can I do at home to make her most comfortable? […] The chemo doesn’t seem to be working and we are already in the 8 month since she was diagnosed. […] Hospice should be able to show you everything you need to know to take care of her. […] The hospice team has a social worker; seek her/his advice. […] It is absolutely possible to help her accept this. Seek the professional advice of the team.

• #5 Ampullary cancer | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/ampullary-cancer?content_id=CON-20213615

  Ampullary cancer treatment often involves surgery to remove the cancer. Treatment also may include radiation therapy and chemotherapy to kill cancer cells. […] The Whipple procedure, also called pancreaticoduodenectomy, is an operation to remove the head of the pancreas. The operation also involves removing the first part of the small intestine, called the duodenum, the gallbladder and the bile duct. The remaining organs are rejoined to allow food to move through the digestive system after surgery. […] Surgery options may include: Surgery to remove the cancer and nearby structures. The Whipple procedure, also known as a pancreaticoduodenectomy, involves removing the cancer by removing the head of the pancreas. The surgeon also removes a portion of the small intestine, gallbladder and part of the bile duct. The Whipple procedure can be done using a large incision in the abdomen. It also can be done using several small incisions.

• #6 Ampullary cancer | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20213615/

  Ampullary cancer treatment often involves surgery to remove the cancer. Treatment also may include radiation therapy and chemotherapy to kill cancer cells. […] Ampullary cancer treatment often starts with surgery to remove the cancer. Other treatments may include chemotherapy and radiation. These other treatments can be done before or after surgery. The best treatment for your ampullary cancer depends on several factors. These include the size of the cancer, your overall health and your preferences. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A healthcare team that may include doctors, nurses and other specially trained health professionals provides palliative care. The care teams goal is to improve quality of life for you and your family. […] The use of palliative care with other treatments can help people with cancer feel better and live longer.

• #7 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  Ampullary cancer treatment options include: […] The only potential cure for ampullary cancer is surgery that removes it completely. […] Your healthcare provider is your best resource for explaining what to expect based on your situation. […] Cleveland Clinic offers personalized treatment, including the Whipple procedure, and caring support for rare gastrointestinal conditions like ampullary cancer.

• #8 NCCN Establishes Standards of Care in Ampullary Adenocarcinoma

  https://www.onclive.com/view/nccn-establishes-standards-of-care-in-ampullary-adenocarcinoma

  Physicians determine treatment for ampullary adenocarcinomas depending on whether the tumor histology is pancreatobiliary, intestinal, or mixed. […] The current standard of care for localized ampullary cancer is pancreaticoduodenectomy, also known as the Whipple procedure, in which a surgeon removes the head of the pancreas, part of the duodenum, the common bile duct, and the gallbladder. […] After surgical resection, we consider administering adjuvant therapy to reduce the odds of recurrence based, again, on the histology, Chiorean said. […] The guidelines suggest FOLFIRINOX or modified FOLFIRINOX with or without subsequent chemoradiation, or gemcitabine-based regimens with cisplatin, capecitabine, or nab-paclitaxel (Abraxane), all with or without subsequent chemoradiation for those with pancreatobiliary or mixed disease.

• #9 Mayo Clinic Health Library – Ampullary cancer | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20213615

  Ampullary cancer treatment often involves surgery to remove the cancer. Treatment also may include radiation therapy and chemotherapy to kill cancer cells. […] Ampullary cancer treatment often starts with surgery to remove the cancer. Other treatments may include chemotherapy and radiation. These other treatments can be done before or after surgery. The best treatment for your ampullary cancer depends on several factors. These include the size of the cancer, your overall health and your preferences. […] Surgery options may include: […] Surgery to remove the cancer and nearby structures. The Whipple procedure, also known as a pancreaticoduodenectomy, involves removing the cancer by removing the head of the pancreas. The surgeon also removes a portion of the small intestine, gallbladder and part of the bile duct. The Whipple procedure can be done using a large incision in the abdomen. It also can be done using several small incisions.

• #10 Periampullary cancer and cancer in head of pancreas: What is the difference?

  https://www.oatext.com/periampullary-cancer-and-cancer-in-head-of-pancreas-what-is-the-difference.php

  Surgical resection is the only chance for potential cure. […] The classical Whipple pancreaticoduodenectomy (PD) is the favoured surgical choice for resectable periampullary and cancer head of pancreas. […] A modification of PD surgery is the preservation of the pylorus which offers technical advantages (ease and speed) and may provide better quality of life and may prevent the occurrence of post-gastrectomy syndromes. […] The post-pancreaticoduodenectomy hospital mortality in high volume centers is in the single digit range but morbidity remains high. […] Palliative care includes surgical, endoscopic and other palliative techniques. […] Other palliative measures involve nutrition, pancreatic enzyme replacement and prophylaxis/treatment of venous thromboembolic (VTE) disease. […] An early detection and surgical resection are the only hope for cure for these cancer patients.

• #11 Ampullary Cancer: An Overview

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4966534/

  Overall, most studies did not suggest the presence of a survival benefit from adjuvant chemoradiation, except perhaps for a subset of patients with adverse risk factors (T stage, lymph node involvement, histologic grade) that may potentially benefit from chemoradiation. […] The role of radiation is less clear. For unresectable and metastatic disease, systemic therapy with an antimetabolite (fluoropyrimidine and/or gemcitabine) combined with a platinum compound, (usually cisplatin or oxaliplatin) should be considered.

• #12 Get Ampullary Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/ampullary-cancer-treatment

  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 youre not healthy enough for surgery. Your care team may suggest both treatments as part of your plan. […] While you didnt choose to have ampullary cancer, you do have a choice when it comes to finding the best healthcare providers and treatments. Youll 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, well help you make informed, confident decisions about your treatment plan and offer guidance and support every step along the way.

• #13 NCCN Establishes Standards of Care in Ampullary Adenocarcinoma

  https://www.onclive.com/view/nccn-establishes-standards-of-care-in-ampullary-adenocarcinoma

  In the adjuvant setting, the guidelines specifically cite the phase 3 ESPAC-3 trial (NCT00058201), which included patients with ampullary cancers, to support the use of postoperative gemcitabine or 5-fluorouracil (5-FU). […] Recurrence is common following surgery at 89.6% at 3 years in one study. […] The choice of second-line therapy depends on both disease subtype and the regimen used in up front. […] Similar to other solid tumor indications, the guidelines recommend genetic testing for hereditary cancer genes, as well as tumor genomic and molecular profiling, the latter for patients with advanced disease.

• #14 Ampullary Cancer: Symptoms, Staging and Survival Rate

  https://www.cancercenter.com/cancer-types/ampullary-cancer

  For patients with a high risk of cancer recurrence, doctors may recommend radiation therapy after surgery. This treatment uses high-energy X-rays to specifically target and kill cancer cells. […] For certain types of ampullary cancer, such as cases that have spread to the lymph nodes, chemotherapy may be used either after surgery or as a stand-alone treatment. Chemotherapy uses drugs, usually administered intravenously, to kill cancer cells.

• #15 9289 | Stanford Health Care

  https://stanfordhealthcare.org/publications/928/9289.html

  Adjuvant chemoradiotherapy decreases the risk of local recurrence in patients with adenocarcinoma of the ampulla of Vater and high-risk features. Adjuvant chemoradiotherapy for this population can be administered safely and without much morbidity. All patients completed the prescribed treatment course. Toxic effects were assessed twice a week during treatment and graded according to the National Cancer Institute Common Toxicity Criteria Scale. Adjuvant chemoradiotherapy for carcinoma of the ampulla of Vater is well tolerated and might improve control of this disease in patients with unfavorable features.

• #16 Mayo Clinic Health Library – Ampullary cancer | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20213615

  Other treatments may be used, including: […] Combined chemotherapy and radiation. Chemotherapy treats cancer with strong medicines. Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. Used together, these treatments may be more effective for ampullary cancers. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A healthcare team that may include doctors, nurses and other specially trained health professionals provides palliative care. The care team’s goal is to improve quality of life for you and your family. […] The use of palliative care with other treatments can help people with cancer feel better and live longer.

• #17

  https://journals.lww.com/ijcn/fulltext/2024/07000/perioperative_care_in_periampullary_tumours.6.aspx

  The incidence of periampullary tumours has been on the rise in India. […] Focussed perioperative care can have a significant effect in improving positive patient outcomes. This article outlines the disease, treatment options such as biliary drainage, surgery and clinical care guidelines in the perioperative period, which would enable nurses to provide competent and comprehensive care. […] Pre-operative biliary drainage (PBD) is found to be associated with improved liver function, coagulation, immune function and nutritional status. It also helps to avoid acute cholangitis as well as reduces the risk of operative and post-operative complications. […] Care of patients undergoing percutaneous transhepatic biliary drainage includes monitoring vital signs frequently for about 46 h after the procedure.

• #18

  https://journals.lww.com/ijcn/fulltext/2024/07000/perioperative_care_in_periampullary_tumours.6.aspx

  The patient is monitored for complications and discharged after 24 h. Follow-up evaluation of jaundice and fever and laboratory investigations such as serum bilirubin and alkaline phosphatase are done. […] The complexity and high morbidity associated with periampullary surgeries make it imperative to focus on surgical care to improve patient outcomes while reducing complications. […] Pre-operative counselling and patient education are essential to alleviate fear and anxiety along with promoting compliance with care. […] Early ambulation and mobilisation help reduce the risk of complications such as DVT, pneumonia and muscle weakness and play a significant role in improving outcomes. […] Adequate pain relief is vital to preventing pulmonary complications. […] The wound is dressed initially and may be left open unless indicated. The nurse monitors for excessive oozing or bleeding from the wound and signs and symptoms of wound infection. […] The patient and the family caregivers were instructed on the care of the surgical wound and dressing was demonstrated.

• #19 Ampullary cancer | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/ampullary-cancer?content_id=CON-20213615

  Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A healthcare team that may include doctors, nurses and other specially trained health professionals provides palliative care. The care team’s goal is to improve quality of life for you and your family. […] The use of palliative care with other treatments can help people with cancer feel better and live longer.

• #20 Ampullary Cancer: Causes, Symptoms, Risk Factors, Diagnosis and Treatment

  https://www.prepladder.com/neet-pg-study-material/surgery/ampullary-cancer-causes-symptoms-risk-factors-diagnosis-and-treatment

  Treatment for auxiliary malignancies frequently begins with surgery to remove the malignancy. Other treatments include chemotherapy and radiation. These additional treatments can be administered both before and after surgery. The best treatment plan for your ampullary carcinoma depends on several factors. These consist of the degree of the cancer, your preferences, and your overall health. […] Palliative care is a special sort of treatment that helps you feel better while you have a severe sickness. If you have cancer, palliative care can help with pain and other symptoms. A medical team that includes doctors, nurses, and other specially trained medical professionals provides palliative care. The primary goal of the care team is to improve your quality of life and that of your family. […] Palliative care experts work in tandem with you, your family, and your medical team. They provide an extra level of support while you receive cancer treatment. Intense cancer treatments like radiation, chemotherapy, or surgery can be given in addition to palliative care. […] When paired with other therapies, palliative care can enhance a cancer patient’s quality of life and increase their survival rate.

• #21 A tsunami of unmet needs: pancreatic and ampullary cancer patients’ supportive care needs and use of community and allied health services – PubMed

  https://pubmed.ncbi.nlm.nih.gov/26123474/

  Objective: People diagnosed with pancreatic cancer have the worst survival prognosis of any cancer. No previous research has documented the supportive care needs of this population. Our objective was to describe people’s needs and use of support services and to examine whether these differed according to whether or not patients had undergone surgical resection. […] Overall, 96% of participants reported having some needs. More than half reported moderate-to-high unmet physical (54%) or psychological (52%) needs, whereas health system/information (32%), patient care (21%) and sexuality needs (16%) were described less frequently. The three most frequently reported moderate-to-high needs included 'not being able to do things they used to do’ (41%), 'concerns about the worries of those close’ (37%) and 'uncertainty about the future’ (30%). […] Very high levels of needs were reported by people with pancreatic or ampullary cancer. Future work needs to elucidate why uptake of appropriate supportive care is low and which services are required.

• #22 Get Ampullary Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/ampullary-cancer-treatment

  Cleveland Clinic has the experts you need. Our providers combine advanced treatments with compassionate support for even the rarest cancers. […] Cancer care is more than medical treatment. From support groups and counseling to complementary therapies and help with appointments, billing and insurance, we connect you to everything you need for your physical, mental and emotional health. […] Personalized care relies on the power of teamwork. Thats why youll have providers from different specialties on your side. These expert providers work together to build a treatment plan that considers your unique diagnosis and needs. […] During your appointment, youll 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 whats happening in your digestive system.

• #23 Advice on Caring for Mother-n-law with Stage 4 Ampullary Cancer – General Nursing Support

  https://allnurses.com/advice-caring-mother-n-law-stage-ampullary-t395527/?do=findComment&comment=3956792

  I’d say anger is common. Don’t let her abuse you or anything but expect it. […] The reality is that there will most likely come a time when she may become heavily if not completely dependent on you/others for ADLs and may be mostly bed confined and/or require help with transfers. […] A hospital bed is excellent for pt’s comfort, positioning and bed mobility. […] If she chooses to eat, soft, creamy foods are almost always palatable…yogurt, pudding, ice cream, or even popsicles broken up into bite-size pieces. […] At this point, it really is about her being surrounded with love and support.

• #24 Ampullary Cancer – Caring for someone with cancer – Cancer Chat | Cancer Research UK

  https://cancerchat.cancerresearchuk.org/f/caring-for-someone-with-cancer/73050/ampullary-cancer

  My Husband was diagnosed with Ampullary cancer last August. […] We have just had a visit from our cancer nurse specialist, Hubbys cancer is quite rare, but i believe now likened to Pancreatic now that is has spread. […] I have support from Marie Curie nurses who sit in overnight so i can rest, and the cancer nurse specialist. […] Ampullary Cancer is very difficult to treat. […] I had a temporary stent to relieve the bile buildup. […] I had the Whipple procedure a couple of months later. […] I think my good outcome was probably due to my age and general health, including the factor of doctors taking my symptoms more seriously, so early diagnosis.

• #25 Get Ampullary Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/ampullary-cancer-treatment

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

• #26 Challenges and Advancements in Palliative Chemotherapy for Ampullary Adenocarcinoma

  https://www.gutnliver.org/journal/view.html?pn=myread&uid=2208&vmd=Full

  Future therapeutic strategies for AA require a personalized approach that incorporates histological features and genetic and molecular heterogeneity. […] The discovery of novel therapeutic targets necessitates next-generation sequencing and germline genomic testing in AA patients. In addition, eligible patients should be encouraged to participate in clinical trials. Consequently, further studies are needed to establish more effective and personalized treatment strategies for AA.

• #27 Diagnosed with Ampullary Cancer | Cancer Stories | CancerCare

  https://www.cancercare.org/stories/124-michelle_k

  Michelle is a young adult who was diagnosed with ampullary cancer three weeks after having her first child. […] Her treatment plan involved surgery that removed her gallbladder as well as part of her pancreas and small intestine, which successfully removed the tumor. […] While surgery was an effective treatment, Michelles recovery period was physically difficult. […] Michelle also received chemotherapy administered by her health care team as an insurance plan to determine that no more cancerous cells could be detected, which resulted in side effects and fatigue. […] One of the most helpful forms of support Michelle received from her community was helping with her baby, especially when she was undergoing chemotherapy. […] CancerCare support groups also played an important role in her experience. Joining a CancerCare young adult survivorship support group has been pivotal in my healing.

• #28 Ampullary cancer survivors? — Cancer Survivors Network

  https://csn.cancer.org/discussion/147263/ampullary-cancer-survivors

  I had stage 2a ampullary cancer. Had a whipple, radiation and chemo. It has been two and a half years since surgery. […] My brother had a Whipple’s procedure for ampullary cancer on 03/12/10 at Johns Hopkins. There was one lymph node that was cancerous and he will be starting chemo and radiation in about 5 weeks. […] I had one positive node (regional) and negative margins of tumor and node. Whipple on 5/25/10 and finished chemo and radiation 9/3/10. Feeling much better now that I through with treatments. […] I had whipple surgery 9/10, I had 1 positive lymph node site. I’m completing my 6th month of gemcitabine chemotherapy and will start combo chemo-radiation in the end of May. […] I am now a four year survivor of ampullary cancer. […] There is a new Facebook page called „Ampullary Cancer Survivors.”

• #29 Ampullary carcinoma: retiree beats lethal stomach cancer | University of Iowa Health Care

  https://uihc.org/patient-story/ampullary-carcinoma-retiree-beats-lethal-stomach-cancer

  Jims condition was a potentially fatal ampullary carcinoma. This type of cancer affects an area of the digestive system where the bile duct and pancreatic duct join and empty into the small intestine. Treatment typically involves extensive surgery (Whipple procedure) to remove the cancer and a large margin of healthy tissue. […] Once he was strong enough to return home, Jim received daily care from a home health nurse for three months. His recovery was remarkable. The cancer was gone. Quarterly doctor visits became semi-annual. Life, more precious than ever, returned to normal. […] We feel very fortunate to be here, with high-quality health care nearby at UI Hospitals Clinics. I cant imagine getting better care anywhere.

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