Pancreatic Cysts: Diagnosis and Treatment

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2013- Focus on Pancreatic Cancer Conference. In this blog, she discusses pancreatic cysts.

In recent years, the number of pancreatic cysts detected has increased significantly. Most of these are found “incidentally,” meaning that they show up on imaging studies done for other reasons, not because they are causing any symptoms.

The question, according to Vinay Chandrasekhara, MD, Penn gastroenterologist, is “what to do about them?” The key to answering that question lies in determining the type of cyst, and what its potential is for becoming cancerous. Based on that, about half of all pancreatic cysts will require close monitoring or treatment.

The primary difference is between neoplastic cysts—which have the potential to be or become cancerous and non-neoplastic cysts which are largely the result of inflammation and rarely, if ever, become malignant. Dr. Chandrasekhara recently spoke a the 2nd Focus on Pancreatic Cancer Conference and noted there are very specific features that doctors look for when they make this determination. He also noted that, in most cases, this requires a procedure known as a guided aspiration, in which the doctor is able both to visualize the cyst and try to withdraw fluid from it for examination under the microscope.

“What to do about them” depends on the type of cyst, its size and stability. Many patients with worrisome cysts undergo surgery, while others have follow up surveillance to determine if the cyst is growing or changing.

For patients, a pancreatic cyst can be a source of concern or uncertainty. The best approach is to have pancreatic cysts diagnosed, evaluated, followed and if necessary, treated in a center that has experience in this area.