Intraductal papillary mucinous neoplasms. You may not be familiar with the term, but these lesions in the pancreas, an organ that releases digestive enzymes and hormones, are actually very common. They affect 10 to 40 percent of people, for most of whom these ominous-sounding lesions are nothing to worry about. However, for a small number, these lesions can become cancerous.
About 48,960 people will be diagnosed with cancer of the pancreas this year, and 40,560 will die, according to the American Cancer Society. While it’s a fairly rare cancer, the National Cancer Institute notes that cancer of the pancreas is the fourth most common cause of cancer-related death in the U.S., due in part to the fact that it’s usually found in advanced stages, when chances of survival are lower.
So it’s hard for both patients and doctors to feel reassured when imaging techniques like MRIs (magnetic resonance imaging) or endoscopic ultrasounds (which involve mounting a camera on a tube and inserting it into the digestive tract) reveal these lesions, no matter how common—and unlikely to lead to cancer—they are. The discovery of these lesions usually prompts scans to monitor growth, cell biopsies (removals) to check for the presence of cancer, and possibly surgery.
To help determine which patients at risk of developing pancreatic cancer, a group of international researchers led by a team at Mayo Clinic in Jacksonsville, Florida reviewed data on patients with these pancreatic lesions. Their findings were recently published in Digestive and Liver Disease.
Who Is at Risk?
Luckily for patients, "The vast majority of these lesions will not develop into pancreatic cancer, which is why it is so important to identify who is a higher risk," stresses Michael B. Wallace, MD, MPH, Professor of Medicine at Mayo Clinic, and one of the study’s authors. He says precise estimates are lacking, but probably less than 1% to 2% of lesions will progress to cancer.
By identifying people at high risk, doctors can screen and biopsy these patients’ lesions more frequently; meanwhile, they can recommend that low-risk patients skip the frequency (and stress) of unnecessary tests.
The 7 Factors That Raise Your Risk of Pancreatic Cancer
The study’s researchers examined data on 1,126 people with pancreatic lesions. The 84 people who developed invasive pancreatic cancer shared some or all of the following traits:
- A history of smoking.
- A history of obesity.
- Jaundice (yellowing of the eyes and skin).
- Steartorrhea (fat droplets in the stool, due to the pancreas not producing enough digestive enzyme).
- Cysts (liquid-filled growths) in the main pancreatic duct.
- Large cyst size on an imaging scan. (Cysts bigger than 3 cm. are a cause for concern, according to the American Gastroenterological Association.)
- Nodules, or small growths, on the cyst wall.
What Can You Do if You’re at High Risk?
Basically, you should follow general advice on cancer prevention, even the less-proven diet advice, says Wallace. So make an effort to:
- Lose weight.
- Stop smoking.
- Eat a diet high in fruits and vegetables.
- Eat less processed foods and charred meat.
"These changes only help prevent cancer; they don’t directly change outcomes once it is diagnosed," explains Wallace. However, there is one exception: quitting smoking. “Any major surgical procedure is more risky in someone actively smoking. Quitting will likely reduce surgical risks."
Michael B. Wallace, MD, MPH, reviewed this article.
Sources
Michael Wallace, MD, MPH. Email interview, June 19, 2015.
"What Are the Key Statistics About Pancreatic Cancer?" American Cancer Society. Updated January 9, 2015.
Maria Morris, Massimo Raimondo, Timothy A. Woodward, Verna Skinner, Paolo G. Arcidiacono, Maria C. Petrone, Claudio De Angelis, Selene Manfrè, Pietro Fusaroli, Michael B. Wallace. "Risk Factors for Malignant Progression of Intraductal Papillary Mucinous Neoplasms." Digestive and Liver Disease 47, 6 (2015): 495-501. Published online April 10, 2015.
"A Snapshot of Pancreatic Cancer." National Cancer Institute. Page updated November 5, 2014.
"International Consensus Guidelines on the Management of Pancreatic Mucinous Neoplasms." American Gastroenterological Association. June 1, 2014.
