Keeping A Close Eye On Pancreatic Cysts

An innovative program identifies cysts on the pancreas before they can develop into cancer.

Approximately 15 percent of people in the U.S. are believed to have a cyst—a small, fluid- filled pocket—within their pancreas. While most pancreatic cysts are benign, some have the potential to progress to pancreatic cancer over time—and pancreatic cysts are the most identifiable precursor to pancreas cancer.

Although there’s no sure way to prevent pancreatic cancer, identifying and monitoring pancreatic cysts can help physicians detect precancerous changes or pancreatic cancer at an earlier stage, when it is operable.

Russell C. Langan, MD
Russell C. Langan, MD
To do this, Cooperman Barnabas Medical Center (CBMC) has pioneered a Pancreatic Cyst Surveillance Program, one of the first cloud-based data management platforms in the nation to identify, track and monitor patients with pancreatic cysts.

Russell C. Langan, MD, a Director of Surgical Oncology for RWJBarnabas Health/Rutgers Cancer Institute of New Jersey and the Chief of Surgical Oncology and Hepatopancreatobiliary Surgery at CBMC, explains.

Why is pancreatic cancer awareness important?

Unfortunately, many pancreas cancers are diagnosed late and have either already spread or are not technically able to be removed. We believe it is exceedingly important to have heightened awareness of pancreas cancer and its precursors to attempt to identify cancers at earlier stages or even in the precancerous stage.

The practice of preventive medicine in the setting of pancreas cancer can greatly impact the development of the cancer and potentially even prevent its development. I have no doubt that our surveillance program will change the landscape for patients with pancreatic cysts and tumors and have a true impact on survival from pancreatic-related diseases.

How are pancreatic cysts found?

Pancreatic cysts typically have no symptoms. The great majority of them are found incidentally on imaging studies that have been ordered for other reasons. In fact, it’s been reported that up to 19 percent of MRIs will incidentally identify a pancreatic cyst.

In coordination with the Rutgers Cancer Institute of New Jersey, the Pancreatic Cyst Surveillance Program at CBMC is a new, novel program helping people who are at risk. We have partnered with Eon, a healthcare technology company, to build and roll out the country’s first pancreatic cyst surveillance artificial intelligence platform. Our new cloud-based system uses computational linguistics models to automatically flag patients when scans discover pancreatic cysts so at-risk people can be contacted for potential follow-up.

It’s widely believed that in patients with certain pancreatic cysts, such as intraductal papillary mucinous neoplasms (IPMN), the risk of developing a pancreas cancer is not only within the cyst but within the entire gland. In fact, mucinous pancreas cysts are the most common identifiable precursor of a pancreas cancer. That’s why surveillance is so essential.

What should patients look for when seeking care for pancreatic cancer?

Once pancreatic cancer is identified, it is of utmost importance that the patient be seen by a pancreatic expert and evaluated at a high-volume pancreatic center. CBMC, RWJBarnabas Health and Rutgers Cancer Institute of New Jersey—the state’s only National Cancer Institute-Designated Comprehensive Cancer Center, with which we have a partnership—meet those criteria.

We have dedicated pancreas care teams set up for pancreatic cyst patients. Our pancreas surgeons treat the highest volume of cases in the state of New Jersey, and we hold a weekly pancreas multidisciplinary team conference. Pancreas cysts can be nuanced and should only be cared for by individuals focused within this field.

Once a cyst is identified, we encourage patients and doctors to refer to multidisciplinary pancreatic care teams. They can assess the characteristics of the cyst, the pancreas, the patient’s family history and other possible risk factors.

What is the Pancreas?

  • A gland located deep in the abdomen, between the stomach and the spine.
  • In adults, it’s about six inches long and under two inches wide.
  • This important organ produces enzymes that help digest food and secretes hormones—such as insulin—that help regulate metabolism.

Risk Factors For Pancreatic Cancer

Risk factors that can be changed:

  • Smoking.
  • Being very overweight.
  • Type 2 diabetes.
  • Heavy alcohol use, which is often linked to chronic pancreatitis, a long-term inflammation.
  • Heavy workplace exposure to chemicals used in dry cleaning and metalworking.

Risk factors that can’t be changed:

  • Age: almost all patients are older than 45.
  • Gender and race: men and Black Americans are slightly more likely to develop pancreatic cancer.
  • Family history: Although 90 percent of pancreatic cancers are sporadic, 10 percent do have a genetic component. Patients who have a BRCA mutation, for instance, are at higher risk of developing pancreatic cancer and require surveillance. Additionally, if a patient has two first-degree family members with pancreatic cancer, there is a 10 percent lifetime risk they will develop pancreatic cancer, and they are encouraged to seek surveillance as well.

Learn more about the Pancreatic Cyst Surveillance Program at Cooperman Barnabas Medical Center.