What are Pancreatic Cysts?

Pancreatic cysts are incredibly common but most people won’t realize they have cysts until they get a CT or MRI scan for an unrelated medical issue. If you discover pancreatic cysts, there is no reason to panic, said James Farrell, MD, pancreatic disease expert at Smilow Cancer Hospital and director of the Yale Center for Pancreatic Disease.

“For the majority of patients, they will not develop cancer. They will not require surgery,” said Dr. Farrell. “The majority of patients with pancreatic cysts will live with their cysts asymptomatically without any significant symptoms throughout their life.”

Types of pancreatic cysts

Pancreatic cysts are fluid-filled cavities in the pancreas that can range in size from several millimeters up to several centimeters. Some patients have just one cyst while other patients have multiple cysts.

Cysts also represent a wide range of possible pathologies, from benign to to precancerous, and sometimes cancerous. Benign cysts might not need any intervention. Dr. Farrell said those patients might only require follow up scans in the future. However, surgery may be required to remove premalignant and malignant cysts. 

What are the symptoms of pancreatic cysts?

The vast majority of cases are asymptomatic. That is why most patients do not know they have pancreatic cysts until they go in for a scan. Patients with large cysts of up to 5 or 6 centimeters may experience abdominal discomfort. Other signs can include weight loss, pain or an inflammation of the pancreas known as pancreatitis.

What should I do if I have cysts?

If you have a CT or MRI scan that shows pancreatic cysts, Dr. Farrell said the first step is to get a formal evaluation of the scan. There are certain features that can help experts distinguish between benign and premalignant or cancerous cysts. Some patients may require an endoscopic ultrasound, a minimally invasive procedure to analyze the cyst in detail and obtain a biopsy of the cyst.

Some cysts may require surgery but Dr. Farrell said one of the key advancements in treatment is improved patient selection. Experts at Yale New Haven Health are always getting better at identifying those patients who do, and as importantly, do not need surgery.

Lower risks for pancreatic cancer

Dr. Farrell said there are no known ways to lower risks for pancreatic cysts. It is unclear why some people develop them and others do not.

However, patients should be aware of their risks for pancreatic cancer. In addition to family history of pancreatic cancer, premalignant cysts and new onset diabetes are the two biggest risk factors, so it is important for people to manage those conditions properly. In addition, smoking, alcohol use and obesity are other risk factors. Anyone worried about his or her risk factors should ask for help.

“I think the best thing to do when someone is concerned about their risk factors, is to consult their family physician or an expert in the field,” Dr. Farrell said. “We certainly talk to many patients frequently in our Pancreas Cancer Early Detection Clinic to answer these types of questions.”