Memorial Sloan Kettering (MSK) has a special program for people who have benign (not cancer) pancreatic cysts or precancerous lesions. Our Pancreatic Cyst Surveillance Program is among the largest of its kind in the United States.

For almost 30 years, our experts have safely monitored more than 5,000 people with pancreatic cysts. They will know when the time has come for you to need treatment.  Our team of pancreatic experts will then make a treatment plan that’s right for you.

Most people do not need surgery if the pancreatic cysts are mostly small and do not cause symptoms. There are risks to having surgery.

In general, surveillance (monitoring) is the best option when surgery is riskier than the chance a cyst can harm you. Surgery may be best if the cysts are cancer or will become cancer.

Some cysts, such as an intraductal papillary mucinous neoplasm, can come back. We may recommend ongoing surveillance if you had surgery to remove a cyst that can come back.

We also recommend monitoring if you had surgery where not all of the pancreas was removed.

What is pancreatic cyst surveillance?

When you join MSK’s Pancreatic Cyst Surveillance Program, you will have routine diagnostic tests that screen for problems. Most people in the program visit MSK every 6 months to 1 year for screening.

You will have regular CT scans and MRI imaging tests. These tests look for changes that could be a sign of cancer. The goal is to find cysts that can become cancer early, when they’re easier to remove. Your care team will talk with you about the test results and next steps.

During your first or second visit you will meet with a pancreatic surgeon or a gastroenterologist. A gastroenterologist (GAS-troh-EN-teh-RAH-loh-jist) is a doctor with special training in the gastrointestinal (GI) system.

After that, you will meet regularly with a nurse practitioner (NP) who has special training in pancreatic care. Your NP is part of your pancreatic care team.

Your advanced practice providers

Nurse practitioners work with surgeons and gastroenterologists to care for people with diseases of the pancreas.

MSK is a MAGNET hospital. It’s recognized by the American Nurses Credentialing Center’s Magnet Recognition Program® for meeting very high standards for nursing excellence. MAGNET is the highest national honor for nursing. Only about 8 out of every 100 hospitals in the nation reach are MAGNET hospitals like MSK.

Frequently asked questions (FAQs) about pancreas cysts

Can I just remove the pancreatic cysts instead of monitoring them?

Many people wonder if it’s better to just remove pancreatic cysts instead of watching them. The answer is pancreatic surgery is complex. For most people, the risk of surgery is higher than the risk a pancreatic cyst can harm you.

Surveillance (monitoring) is safe and works well. We recommend surgery to remove pancreatic cysts only when there’s a high risk it’s cancer, or will become cancer soon. We use the latest imaging methods to monitor the cysts for any signs of change.

What’s does pre-cancerous pancreatic cyst mean?

Pre-cancerous means something that can become cancer. Not all pancreatic cancer starts as a cyst. Most cysts will never turn into pancreatic cancer.

There are pre-cancerous cysts called IPMNs, or intraductal papillary mucinous neoplasms. IPMNs have a very low risk of becoming pancreatic cancer.

Still, they’re the most common type of cyst that can turn into cancer. People with IPMNs have a little higher chance of getting pancreatic cancer than someone who does not have IPMNs. We closely monitor IPMNs for any signs of cancer.

Do I need to have a biopsy of pancreatic cysts?

Not always. If you have very small cysts or cysts that show no problems, you do not need to a biopsy. Talk with your healthcare provider about whether you need a biopsy, a procedure to get samples of cells or tissue. Most biopsies are done during an  endoscopic ultrasound  (EUS).

What are signs of problems in a pancreatic cyst?

We look for any changes in the pancreatic cysts. These signs could mean you need imaging scans more often, a biopsy, or surgery. We monitor whether the cyst is:

• Larger than 3 centimeters.
• Partly solid.
• Growing and causing pain or pressure on other areas, such as the bile duct.

I’m worried about seeing a nurse practitioner (NP) instead of a surgeon. Why am I seeing an NP?

This is a common question. Our NPs have special education and training in best practices for managing pancreatic cysts. They’re highly skilled in caring for people with pancreatic cysts.

They work closely with MSK pancreatic surgeons and are part of our larger team of surgeons, gastroenterologists, radiologists, and nurses. This team meets regularly to talk about the care of each patient.

During your clinic visits, our NPs will give you the best care possible for a pancreatic cyst. If you have a visit that’s related to surgery, that’s when you can talk with your surgeon.