Have pancreatic cyst - the type that often turns malignant

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Hello everyone.

I hope you don't mind me joining your forum even though I do not (yet) have pancreatic cancer. 

I am having chemo for an aggressive breast cancer. I will then have surgery, radiotherapy and possibly further chemo. It had spread to my lymph nodes, but no evidence of further spread, so Grade 3, Stage 3.

On the body CT they discovered a pancreatic cyst on the Head of the Pancreas. 

They said it is currently not cancer, but it is the type that can turn malignant, so the Upper GI MDT will check it again next year. 

That is all they told me, and I am getting myself in a total state it. 

My breast cancer is HER2 +++, an aggressive form, and the treatment plan is harsh. I suppose that it why they didn't want to bother me about the pancreatic cyst, but it's the cyst and the unknown that keeps me awake at night. 

I would love to hear from you. Maybe you have tips or advice about what I need to ask the hospital. I intend to ask for more info about this cyst soon or I will lose the plot. 

Best wishes. 

  • Can a cyst on the Head of the pancreas be removed without the whole Whipple procedure being done? 

    Do pancreatic (head) cysts get removed, generally, before malignancy but due to the risk? Mine is the most likely type to become cancer, apparently, and with all the chemo I am on for the HER2 cancer, I won't have much resilience left for more.

    I read that some people with pancreatic cancer are put on nab-paclitaxel, which is the same chemo I am now on except I am on the cheaper Paclitaxel (higher risk of allergy version). I am also on 2 monoclonal antibodies and was previously on Epirubicin and Cyclophosphamide (very tough combination). 

    Really hope someone kind can advise me.

  • Hi GarageYoga

    Did you get any answer to your query as I also have a cystic lesion in the tail of  my pancreas which they told me is benign  and was found from a CT/MRI scan which I had done due to weight loss and gastric issues which I have had for the last 4/5 years with various tests and scans done over this time which have all been clear. I've been told they want to monitor the lesion and I have to have another scan in 3 months time. This makes me suspect that it could be precancerous and like you I am losing sleep thinking I've got pancreatic cancer. I would also like to know why it can't be removed before it becomes malignant.

    On top of this they by chance picked up a lung nodule whch the respiratory consultant believes could be a slow growing cancer and has asked if I would consider having surgery to remove it. I am now undergoing tests to see if I would be fit for surgery as I am 74 and due to the gastric issues I have lost quite a lot of weight and am feeling quite weak. I think they caught this early as I have no symptoms of lung cancer and a PET scan done in October did not light up any area of concern.

    Like you I feel I am battling on 2 fronts and if you have had any answers to your query about the pancreatic cyst it would perhaps help.

    Take care and good luck with your chemo for the breast cancer. Slight smile

  • Hi Pepper12

    I'm sorry to hear you are also in this scary position - I am wondering exactly the same as you about removing the pancreatic cysts before they become malignant. I think it's a big operation with lasting effects, so maybe why they don't do it immediately (?) in addition to NHS waiting lists etc but that's just me guessing. 

    I had a full body CT scan yesterday which should show the pancreatic cyst again 6 months after the scan when it was found. The scan will also show the lymph nodes affected by my breast cancer, so it was also done for that  - in fact, mainly for the lymph, but they did say it'd show the pancreas. (The breast MRI which is apparently more accurate doesn't show all the lymph nodes in my case because so many are involved). Once I get the results regarding the cyst I will update you.

    I finally managed to persuade the breast cancer team  I needed to see Upper GI to ask them about the cyst. They referred me, so at some point i will have the chance to ask them about my cyst. In fact, I also have hepatic cysts, so will ask about those too. 

    The lung nodule sounds worrying, I'm so sorry to hear about that. Great they caught it early at least. That's hard isn't it, that you've lost weight and feel weak. I remember in the first 4 cycles of chemo I couldn't face any liquids at all, it was such a struggle to drink. Are they supporting you with nutrition in any way to help gain back some weight and strength?

    Thanks for your good wishes - apparently my breast cancer is responding to the chemo. Not sure it will be as much as a pathological complete response, but better than nothing and next up is surgery and radiotherapy. 

    You take care too. Rose I have only just realised there are emoticons on this website, thanks to you! Trophy Slight smile

  • Thanks for your reply GarageYogs. Like you I wondered why they don't offer any treatment to prevent the benign cyst becoming malignant without it having to be a full whipple operation. Seems strange they want to monitor it presumably to catch any malignancy early but what treatment would be offered at that stage. I did read of a trial being carried out by Oxford Teaching Hospital where they were looking at targeted radiotherapy on benign pancreatic cysts using  an MRI guided endoscopic camera which would seem to make sense but I don't know what the criteria for joining the trial is and whether the trial is still open. It would help end the stress of having to wait for the results of monitoring scans. If you get any answers please let me know and I'll do the same.

    My GP has prescribed food supplement drinks and at.my appointment with the respiratory consultant she advised what foods I should be eating to try and put on weight but the pancreas wasn't really her field. The GI team have not really offered me any advice on diet or how to deal with my gastric issues just that the cystic lesion would need close monitoring. It just sends your brain into overdrive.

    Again good luck with your ongoing breast cancer treatment and glad I was of help with the emojis.Blush ThumbsupFour leaf clover

  • https://www.ucl.ac.uk/surgery/research/situ-trials/radiocyst/radiocyst-study-information

    This is the link to the trial I referred to in my reply below. Its the UCL who are carrying out the trial not Oxford Teaching Hospital although they must be doing something because it stuck in my mind. It might be keyhole surgery for the removal of pancreatic cysts. I have looked at so much I lose track of who is doing what. Blush

  • Certainly no expert or experience of this, but when you have your meeting with Upper GI ask about Cyberknife procedures.

    I understand that it can be used to treat cysts and tumours.

    Ian