Women who don't have BRCA mutations could have other high-risk genes that affect treatment choices
by hanginginthere on Sat Mar 13, 2010 11:21 PM
I've been recently diagnosed with ampullary cancer. I would like to avoid a Whipple surgery if possible. I've read some papers from PubMed on ampullectomies to remove the ampulla of Vater to treat very small cancers of the ampulla of Vater. The five year survival rates are comparable to Whipple surgery to treat pancreatic cancer but not as high as Whipples to treat ampulary cancer. I fear becoming a digestive invalid and the pain and digestion problems I would most likely have to endure. I don't think I could handle the change in the quality of my life that would most likely occur. I'm an athlete who runs and lifts weights for the past twenty five years and my life is very busy and active with nobody to take over for me while I would be recovering from a Whipple. An ampullectomy sounds so much better and perhaps they could remove my gall bladder while in there. I am also seaking a doctor to do any surgery by laparoscope. Thank you for any input or information you might have.
by mhagg on Tue Mar 16, 2010 01:55 AM
I was going to get an ampullectomy but my surgeon did not like the way my tumor looked. We decided the whipple was the best bet. As it turned out my tumor was cancerous even though all tests said that it was not. The only difference that I have now than before the whipple is this rather large scar. I eat what I want,I take no medications , I have no pain,there is no discomfort or difference from before the whipple. My quality of life I think has actually improved because my digestive system can only digest so much fat most of it just passes thru. Which translates to me not gaining any weight good luck
by hanginginthere on Wed Mar 17, 2010 05:19 PM
Can you eat as much as you want without problems? Did you have a time after your surgery when there were eating issues. If so, how long after your surgery were you able to eat anything you wanted? Did they do a full whipple on you including removing the duodenum and part of the stomach? Could you gain weight if you wanted to? Thank you so much for answering these questions.
by mhagg on Thu Mar 18, 2010 12:53 PM
I had the head of my pancreas, bile duct, gall bladder, and all the duodenum with the exception of the pylorus,( which is the valve at the end of the stomach)removed along with 27 lymph nodes. By saving the pylorus alot of problems like early dumping syndrome are eliminated.I had a month and a half to prepare for the surgery. During this time I did cardio and stomach excerises plus I packed on as much extra pounds as I could. After the surgery you are up and walking the next day. I was fed thru a feeding tube until all the other tubes were removed and had a bowel movement. Around the sixth day I was on a liquid diet. More solid food was introduced and after eight days I was home. At home I required no assistance with the exception of lifting . I was told do not lift anything heavier then a small bag of groceries, because you do not want to herniate your incision.I took a purple pill(can't recall the name)once a day and a creon(digestive enzyme pill )before each meal and I had to stay away from hard to digest foods like nuts.I was at work after six weeks. I am a mailman with plenty of walking and medium lifting,and after 90 days the two pill types were eliminated one at a time and deemed not necessary and I was without dietary restrictions.I was 52 at the time of the surgery with a height of 5'11" and weighed 211lbs. After surgery I weighed 188lbs.I now weigh between 181 to 190 lbs My cholesterol numbers are excellent and I probably could easily drop a few more pounds if I wanted to. As far as gaining weight, that would be a little more difficult, maybe if I became more of a couch potato or I ate a lot more food. The one problem I have is fat malabsorption
Fat malabsorption. Malabsorption of fat is the inability to digest or absorb fat. Fat malabsorption may occur because of reduced pancreatic secretions that are necessary for normal digestion of fat (for example, due to pancreatitis or pancreatic cancer) or by diseases of the lining of the small intestine that prevent the absorption of digested fat (for example, celiac disease). Undigested fat enters the last part of the small intestine and colon where bacteria turn it into substances (chemicals) that cause water to be secreted by the small intestine and colon. Passage through the small intestine and colon also may be more rapid when there is malabsorption of fat.
THe ampulla regulates the out flow of bile and pancreatic enzymes. Without it the flow can be erractic sometimes resulting in the following
Gray stools, pale stools, putty or clay colored stools may be seen in hepatitis, gallbladder disorders, or malabsorption conditions. Bile salts in the stool excreted by the liver give it a normal brown color. Obstruction to bile flow out of the liver (you may see the word "cholestasis"), or liver infections like viral hepatitis (A, B, C, etc.), may produce clay colored stools. Possible causes for clay colored stool result from problems in the biliary system (the drainage system of the gallbladder, liver, and pancreas): Malabsorption problems can cause undigested fat in the stool (steatorrhea) which is characterized by foul smelling, light yellow to gray, greasy or frothy stools. This may also be caused by low bile output.
Your gas output can be substantial. I eat alot of fat ,but you sound like that is something that you watch so this may not be much of a problem for you.
The most important decision on getting the whipple done is picking the surgeon. Find the most experienced one you can. Complications from the surgery are the biggest problems and determine your length of recovery. And don't rush and herniate that incision.
by shertzer on Fri Mar 19, 2010 06:03 PM
Go for the whipple. This is not a cancer to mess around with. The Whipple is a complicated surgery, but it has much better outcomes than local resection. A longer recovery or even unwelcome side effects are better than an early death. The critical success factor for whipple is the skill and experience of of the surgeon. My wife was blessed to have the most experienced whipple surgeon in the world (Dr. Cameron, Johns Hopkins) perform her whipple 7 weeks ago. It was highly successful with hardly any complications. She is still staying away from highly spicy foods, but other than that is already eating normally.
by joytothe_world on Sat Apr 03, 2010 10:31 AM
I am female, was diagnosed of peri-ampullary cancer and had whipple surgery in May 1991. AT the same time, my gall bladder was also removed. This coming May will be my 19th anniversary. I don't know if I am the longest survivor of this kind of cancer. I had no chemo after the surgery. There was no metastasis involved. I had digestive problems for a few weeks but it's nothing to worry about, I was able to recover completely after a year.
Good luck to you.
by hanginginthere on Sat Apr 03, 2010 04:02 PM
Thank you for that great message of hope and to all who responded and gave me their success stories.
by joy12345 on Thu Mar 03, 2011 05:33 AM
How have you been doing lately? dis you ever opt for the surgery? My husband had the whipple for cancer of the ampulla of vater and just finished 6 months of chemo. He has a scan soon.
by joy12345 on Thu Mar 03, 2011 05:35 AM
Did she have chemo or lymph node involvement?
by gastro1 on Tue Apr 05, 2011 03:40 PM
Hi, I've been following this thread with interest. In 2008 I had a small bowel resection to remove a precancerous tumor on my Ampulla of Vater. They took just the tumor and rerouted the bile and pancreatic ducts. Before the surgery, the surgeon wasn't sure whether he would have to do a Whipple or not, but there were clear margins, so he just took the tumor. Just last month, I had a followup biopsy and my cells are changing again. After checking and rechecking the slides, the pathologist, who originally said precancer, said that the cells are changing, but they feel they are benign. I go for another biopsy early next year. If it is precancerous then, I'm afraid a Whipple will be pretty certain.
The original surgery was tough for a couple of months afterwards (lost 17 pounds in 3 weeks), but overall I recovered well and quickly. I have gastroparesis, but not entirely sure it was a result of that surgery. I'm a little afraid of what the Whipple will do, lol.
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