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Pancreatic Cysts: Do They Raise Your Risk of Cancer?

The pancreas is a vital organ with two key functions: It produces enzymes that help digest food, and it secretes hormones—such as insulin—that help regulate metabolism.

It’s not unusual for cysts—balloon-like packets filled with fluid—to form in the pancreas. Most pancreatic cysts are benign, meaning they’re not cancerous, and they arise from conditions other than cancer, like inflammation associated with pancreatitis. However, some cysts are considered “precancerous,” and a small percentage of pancreatic cysts are malignant or can become cancerous over time.

How a cyst looks, what’s inside of it, and where in the pancreas it forms, can all provide clues about whether it is cancerous or at high risk of turning into cancer.  

“Not every cyst is treated the same way or should be viewed as the same,” said Sanjay S. Reddy, MD, FACS, a surgical oncologist at Fox Chase Cancer Center.

That’s why if you are diagnosed with a pancreatic cyst, it’s important to see a specialist who can suggest the appropriate treatment plan—which could consist of a biopsy of the cyst, following it with serial scans, or even removing it. At Fox Chase, we follow many patients with pancreatic cysts, and specialize in diagnosing and treating them.

Finding pancreatic cysts

Pancreatic cysts often don’t cause symptoms, so they’re frequently found during an imaging scan for something else.

“Often, they’re an incidental finding,” Reddy said. For instance, a pancreatic cyst might be discovered if someone has an imaging study after sustaining an abdominal injury in a car accident.

Sometimes pancreatic cysts that are inflamed might cause abdominal pain and, depending on their location and size, some people develop jaundice (yellowing of the skin).

Whether a cyst is discovered incidentally, or if there are symptoms that lead to its discovery, you should take the growth seriously.

What is the link with pancreatic cancer?

Some pancreatic cysts are filled with a mucus-like substance called mucin, which can cause the pancreatic duct to be blocked. Mucin-containing cysts have the potential to become malignant, especially if they have other worrisome features, such as a larger size or have a thick wall that lights up with contrast on imaging. The most common type of these cysts is the intraductal papillary mucinous neoplasm (IPMN). Proper management should be overseen by specialists.

Some pancreatic cysts are made up of both solid and liquid components, and determining this is vital, so that proper follow-up and care can be established

A scan alone can’t reveal whether a cyst is cancerous, and for a more definitive answer, the cyst needs to be biopsied.

“The biopsy will tell us whether there are malignant cells within a cyst,” Reddy said. 

Treating pancreatic cysts

Pancreatic cysts don’t always have to be removed. “Some cysts may have benign cells in them, and have no high-risk features on imaging. For these, simple follow-up is enough,” Reddy said.

If you have a low-risk cyst, your doctor will likely recommend imaging tests every six months or yearly to see if the cyst is changing. “The majority of patients that I see for pancreatic cysts, we monitor closely,” Reddy said.

Cysts deemed high-risk are often removed, but pursuing surgery shouldn’t be an automatic decision. Instead, it’s worth weighing your individual risks and benefits—including your age, overall health, and the type of cells found in the cyst during the biopsy.

Consulting with a team of specialists is key for making that decision. “The operation itself depends on the location, and the use of minimally invasive surgical techniques, including robotics, has changed the landscape of treating this disease. However, these operations are serious,” Reddy said. "That's why coming to a center like Fox Chase with a lot of pancreatic cyst and surgery expertise is really important."

Learn more about pancreatic diagnoses at Fox Chase.