Taking Charge of Pancreatic Cysts
The Medical Center’s new Pancreatic Cyst Surveillance Program uses top-notch technology—and a multidisciplinary team of doctors—to evaluate a pancreatic cyst before it becomes cancerous.
Approximately 15 percent of Americans are believed to have a pancreatic cyst, and unlike other cysts such as those on the ovaries, liver or kidneys, pancreatic cysts carry the potential to increase the patient’s risk for pancreatic cancer. So, these individuals need to be screened and surveyed appropriately by pancreas specialists who understand the nuisances of these growths. This is the reason for the brand-new Pancreatic Cyst Surveillance Program at Saint Barnabas Medical Center (SBMC), a high-volume pancreatic cancer center that works in tandem with Rutgers Cancer Institute of New Jersey, the state’s only National Cancer Institute-designated Comprehensive Cancer Center.
Over the last few years, Russell Langan, M.D., chief of surgical oncology and hepatopancreatobiliary surgery at SBMC, has been working with Denver-based medical tech company EON on “developing a modern electronic medical record platform to not only screen but monitor and follow patients with pancreatic cysts,” he says. Instead of recording the features of a patient’s cyst manually or via a spreadsheet, the platform inputs a cyst’s individual features—such as its size, pancreatic duct dilation or nodularity—into an algorithm, which tells doctors objectively if there is a risk of malignancy over time. The system flags patients with pancreatic cysts so they can be contacted for follow-up by a nurse navigator. The Pancreatic Cyst Surveillance Program is one of the first of its type in the United States.
“We are thrilled to have launched a modern, high-quality, patient-centered Pancreatic Cyst Surveillance Program due to the amazing work done by our pancreatic specialists in coordination with our partners at EON,” says Dr. Langan. “I have no doubt this will change the landscape for patients with pancreatic cysts and tumors and have true impact on survival for those with pancreatic-related diseases.”
Dr. Langan says that typically, patients who are referred to the program for consultation have cysts that are found incidentally via ultrasound, CAT scan or MRI throughout the Medical Center’s numerous imaging facilities. “Generally, there are no symptoms of a pancreatic cyst,” he says, but some exceptionally large cysts can cause abdominal pain or jaundice.
About 80–90 percent of cysts do not need interventions such as surgery—some patients may just require additional screening and/or an endoscopy and a biopsy of the fluid. But for the other 10–20 percent, more drastic measures may be deemed necessary. “We want to operate on patients at the most opportune time and don’t want to undertake any unnecessary surgery, because pancreatic surgery carries morbidity and a potential mortality rate,” the doctor says. If the patient receives a pancreatic cancer diagnosis, he or she undoubtedly needs to undergo surgery, but if removing a cyst is merely to reduce the risk of developing cancer, that’s where it becomes a bigger conversation. “We only operate on patients who have high-risk features as deemed by international guidelines or changing characteristics [of their cyst],” Dr. Langan adds. But those who do potentially require surgery and/or have a pancreatic cancer diagnosis can rest assured that they’re getting top-notch care from a multidisciplinary team of experts at a high-volume pancreatic center. “My team and I participate with the Rutgers Cancer Institute of New Jersey’s weekly pancreatic tumor board team conference, where the patients are presented to a panel of surgeons, medical oncologists, radiation oncologists, gastroenterologists, radiologists, pathologists and geneticists to discuss how to manage their conditions,” Dr. Langan says. “If the patient does need to have surgery, it is important that it be done at a high-volume pancreatic cancer center with highly-specialized surgeons who perform these operations often, like Saint Barnabas Medical Center.”
To learn more about the Pancreatic Cyst Surveillance Program at Saint Barnabas Medical Center, call 973.322.6652 or visit rwjbh.org/sbmc.