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Pancreatic Cancer Surveillance Program Saves Lives

In the last few years, the number of people in the U.S. with pancreatic cysts has been increasing at a surprising rate.

“Twenty years ago, I hardly ever saw a case of it. Today, I see them all the time,” said Robert R. Selby, M.D., program director of the Hoag Pancreas and Hepatobiliary Cancer Program.

As scientists study the cause of this increase, physicians at Hoag are equally working on addressing cysts through a unique program to prevent pancreatic cysts from becoming pancreatic cancer.

With the help of donor support, Hoag’s Pancreas and Hepatobiliary Cancer Program has developed a specialized pancreatic cyst active surveillance program to assess a patient’s cancer risk, biomedically and genetically analyze the fluid inside a cyst, monitor cyst growth and surgically remove cysts before they become cancer.

Most pancreatic cancers don’t originate from a cyst, meaning there is no forewarning that a deadly cancer is developing. The one-year survival rate for pancreatic cancer patients is 20% and the five-year survival rate is 7%. But for the small percentage of people who do develop cysts before developing cancer, detecting and monitoring these cysts at an early stage could lead to a complete cure.

“The capabilities and set of skills that you find here around pancreatic cancer is unique,” Dr. Selby said. “By assessing people’s genetic history, using our advanced imaging techniques and conducting molecular genetic analysis of cyst fluid, we are able to take care of people before it is too late.”

Hoag is currently following 1,000 patients, with new patients arriving every week who have one of several types of pancreatic cysts. These cysts includeIntraductal Papillary Mucinous Neoplasm (IPMN), which grows within the ducts of the pancreas; serous cystadenoma, mucinous cystadenoma, papillary cystic tumor and cystic islet cell tumors of the pancreas.

Because many pancreatic cysts can be precancerous or cancerous, it’s important to be evaluated by a center that provides a multidisciplinary, specialized team of hepatobiliary and pancreatic experts, Dr. Selby said.

“The evolution of a cysts is not a certainty, and most people will not require an operation,” Dr. Selby said. “We don’t want patients to undergo unnecessary operations. Because of the volume of our program, we are able to profile who we think requires surgery and who needs to be watched.”

It is a program that is only possible at a center that has the expertise in identifying and treating the complexities of this particularly deadly cancer.

“What is interesting about what we are doing with pancreatic cysts is we’re identifying cancers that are no thicker than a one-cell layer. Because we have the capability and expertise to identify cancer at a micromolecular level, we are able to offer a cure,” Dr. Selby said. “That’s unique in terms of cancer screening in general, and pancreatic cancer in particular.”

Symptoms of Pancreatic Cysts (IPMN)

Most pancreatic cysts are asymptomatic and discovered only when people undergo imaging studies for other reasons. If signs or symptoms of pancreatic cysts do occur, they typically include:

  • Abdominal pain in the upper abdomen
  • Nausea or vomiting
  • History of pancreatitis
  • Yellowing of the skin or jaundice
  • Loss of appetite and/or weight loss
  • Fever and/or night sweats
  • Loss of color in the stools

For more information, call 888-805-3837.