Pancreatic Cyst Surveillance Clinic

by Columbia Surgery on January 22, 2013

Donald Garmon, NP

Donald Garmon, NP

This article been updated to reflect several changes this year. Please visit our more current article, Pancreatic Cyst Surveillance Clinic.

The Pancreas Center is dedicated to taking every step possible to help prevent, detect, and treat pancreatic cancer. This commitment has led to a continual flow of medical and surgical innovations at the center, a leading role in research and education, and cutting-edge protocols for early detection and genetic testing. Most recently, the center has established the novel Pancreatic Cyst Surveillance Clinic, a unique clinic specifically focused on managing pancreatic cysts so that they do not develop into cancer.

Pancreatic cysts are abnormal fluid-filled growths on or in the pancreas. There are several types of cysts, many of which are benign (non-cancerous) and some of which are associated with pancreatitis, or inflammation of the pancreas. Because some cysts become cancerous, it is very important that all pancreatic cysts are detected, evaluated, monitored, and if necessary, removed.

In the following interview, coordinator and nurse practitioner Donald Garmon talks about this unique surveillance clinic.

Q: How common are pancreatic cysts?

DG: Between one and two percent of the general population will develop an IPMN, or intraductal papillary mucinous neoplasm (pancreatic cyst), and research indicates the incidence is increasing. Most pancreatic cysts do not cause symptoms, so they are usually found incidentally during a CT scan or MRI that was ordered for another reason such as a kidney stone.

Q: How dangerous are pancreatic cysts?

DG: Some types are benign, with virtually no likelihood of becoming cancerous, while others are more likely to become malignant. Some forms have up to a 70% chance of becoming cancerous. For this reason, it is essential that all cysts be carefully evaluated. While it is possible to view a cyst on a CT scan or MRI, these tests do not tell us everything we need to know about what kind of cyst it is; in order to get a closer look, we have to extract cells with a needle, and a pathologist can then identify which type it is.

Q: How does the Pancreatic Cyst Surveillance Clinic work?

DG: This clinic takes place once each month at the Pancreas Center. We examine each patient and review his or her records and scans, and take new images if needed. Once the cyst has been clearly identified, a treatment plan is determined. In many cases, patients return for follow-up monitoring every 6 or 12 months. In some cases, additional biopsies may be needed, which are performed by our gastroenterologists and interventional endoscopist. After that point, treatment will depend on what the ultrasound and biopsy show. My role is essentially to serve as the hub of the wheel, ensuring that all relevant information is gathered from the patient and presented to the multidisciplinary team.

Q: How are patients referred to the Cyst Surveillance Clinic?

DG: Most of our patients have already been evaluated for pancreatic disease at our center. But anyone who has been diagnosed with a cyst can call for an appointment.

Q: Why was it important to create a special program just for management of pancreatic cysts?

DG: In the general population, pancreatic cysts often fall through the cracks because generalists – whether primary care physicians, gastroenterologists, or other – often are not expert in managing them. As a result, patients do not receive the frequent, close monitoring that they should. The Pancreas Center created this program in order to ensure that patients are thoroughly, continuously monitored, so that we can treat cysts before they become cancerous. Our multidisciplinary team includes experts in every specialty related to management of pancreatic disease, so we are fully prepared to monitor and treat not just cysts but every pancreatic condition.

Q: Do most hospitals have programs dedicated to management of pancreatic cysts?

DG: Ours is one of just two in the nation, so this is highly unique.

Q: Does the Cyst Surveillance Clinic participate in research at the Pancreas Center?

DG: Yes. In addition to providing patient care, we maintain a pancreatic cyst database. Using patients’ data in conjunction with their tissue specimens, we are able to conduct studies with goals such as identifying which patients may need surgery, determining which types of cyst have malignant potential and at what rate, predicting how particular cysts may react over time, and more.

{ 17 comments… read them below or add one }

Lisa T. January 22, 2013 at 7:42 pm

AMAZING!! Beyond excited to be a patient in your program. God Bless all your work & entire team.

Lourdes B. February 3, 2013 at 11:05 pm

I was told that I have a cyst in my pancreas and my gastro doctor has not follow-up or has sent me for any further exams. I would like to set-up an appt with your clinic if all possible. Thank you.

Columbia Surgery February 4, 2013 at 10:05 am

Thank you for your inquiry. I have forwarded your information along to the Pancreas Center and a person should contact you shortly.

In the rare event you do not hear from them, you can also contact their office directly at: 212.305.9467. Additional information about the center can be found on their website at:
http://pancreasmd.org

Professor Steve Wigmore March 6, 2013 at 5:38 am

I think this is a great innovation and will provide good data and clarity to inform future developments in the management of patients with pancreatic cysts. If you have a protocol I would be really interested to see it as we are trying to develop similar services in Scotland.

Columbia Surgery March 6, 2013 at 9:34 am

Thank you for your interest Professor Wigmore.

I am going to pass your email address onto the cyst clinic. Just in case you would like to reach out to them first, here is a link to the faculty with their contact information: http://pancreasmd.org/guide_pancreatic_cysts.html. The only person who is not listed on this page is Don Garmon and his phone number is 212.342.5601.

If you need anything else, please feel free to leave another message.

Renee D April 20, 2013 at 8:09 pm

I was diagnosed March 2013 with a 2.4 cm mucinous cyst. The surgeon wants to remove the cyst by cutting the portion off where the cyst is located near the spleen side of my pañcreas and resection it to the lower bowel. I told him I wanted it out, I’m fearful it will turn cancerous. Thank you.

Columbia Surgery April 22, 2013 at 10:28 am

Hi Renee,

Thank you for reaching out to us. I have forwarded your comment and contact information to the Pancreas Center. As soon as I hear a response from them, I will reply.

To contact the Pancreas Center directly, you may reach them at: 212-305-9467. You may also learn more about the Pancreas Center by visiting: http://pancreasmd.org

Columbia Surgery April 30, 2013 at 10:10 am

Renee,

I have received the following response from the Pancreas Center. As each case is different, they would be glad to review your patient records and get back to you as soon as possible. Records can be faxed to 212-305-1571. If you have any further questions please feel free to contact the New Patient Coordinators Lynette or Priscilla at 212-305-9467.

I hope this information helps. Please let me know if I can be of further assistance.

jane e May 2, 2013 at 11:23 am

Is it possible to e-mail or mail my mri results to you for your input and possibly becoming a pt.?

Columbia Surgery May 2, 2013 at 11:59 am

Jane,

Thank you for your interest in the Pancreas Center. We would be glad to review the patients records and get back to you as soon as possible. The records can be faxed to 212-305-1571. If you have any further questions please feel free to contact the New Patient Coordinators Lynette or Priscilla at 212-305-9467.

jane e. May 16, 2013 at 2:00 pm

I would like to mail the mri and ct disks to the appropriate address and att., for pancreatic cysts review. Would you pls provide the aforementioned. Thk-U

Columbia Surgery May 20, 2013 at 10:32 am

Hello, Thank you for your interest in the Pancreas Center. We would be glad to review the patients records and get back to you as soon as possible. The records can be faxed to 212-305-1571. If you have any further questions please feel free to contact the New Patient Coordinators Lynette or Priscilla at 212-305-9467.

F William M. July 25, 2013 at 5:29 pm

Donald Garmon

In the summer of 2011 I met with members of the Pancreas Center ( Dr Frucht) to participate in what I understood was a prevention screening program since I have a strong genetic connection to pancreatic cancer. I underwent an EDU at Columbia in September of 2011 and a small cyst was detected at that time. Since Dr Frucht was on leave during the summer of 2012 I was assigned to Dr Fay Kastrinos and, was asked to repeat the EDU last Sept. A needle biopsy was taken and I was told it was benign. I have tried to be in contact with Dr Kastrinos to determine what the appropriate next step would be this year. I am glad to learn about the new Cyst Survaillence program but I must say I have been very unimpressed with the follow up and my experience with the organization of the prevention aspect of the Columbia Pancreas Center. Based upon my experience, it is anything but a smooth and efficient patient experience. For example, it is unnecessarily difficult to get in touch with Dr Kastrinos or any team coordinator to find out about next steps, I have never had any interim exposure educational materials, patient briefs to about anything related to on going research or thingsbyou have learned’ related to any aspect of pancreatic cancer which I would have expected. I guess I thought from the outset any type of prevention program would be well defined, organized and there would be appropriate follow up. I take the program seriously since I know because of genetics and a growing cyst I am at considerable higher risk, but I have begun to wonder if I am in the wrong place. Sorry to vent on you, but while I think what you are doing with the Cyst Survaillence Clinic sounds interesting, I hope it will be more organized and effective from a patient point of view, than my experience at Columbia to date. So my question to you is, will I be automatically part of the clinics survaillence program and who will interact with me to know how you will be monitoring my situation? I look forward to your reply.

Bill M.

Columbia Surgery July 26, 2013 at 11:01 am

Bill:

Please accept my sincere apologies for your frustration and thank you for bringing this matter to our attention. Someone from our office will be calling you.

The Pancreas Center’s goal is to provide multi-disciplinary treatment from clinicians who reside in different specialty areas within NYP & Columbia. In doing so, we are crossing the traditional boundaries of medical care. The central point of contact for all Pancreas Center matters should be the main phone number, 212-305-9467. Think of it as our “311″. When you call, any one of the coordinators who answers will assist you and follow up with a particular clinician.

I hope this information helps. Thank you for bringing this matter to our attention. We will be calling you shortly.

Francine Castillo, MS
Administrative Director, Pancreas Center
212-342-3677

Columbia Surgery July 31, 2013 at 1:40 pm

Bill:

I just spoke with the Pancreas Center and I understand that you were able to touch base and make an appointment. I am so glad we were able to help you.

As a reminder, the phone number for the prevention program is 212-305-9337. If we can be of any further assistance, please feel free to leave another comment on the blog.

(I guess we can both say that social media works!)

Tammy S. December 29, 2013 at 1:13 am

since 2011 was the first cyst that was found by a ct scan by mere chance of other symptoms which led to these findings, I have been recieving treatment at Wake forrest Baptist hospital, up until the third cyst was recently found two weeks ago , which is acutally now larger than before and has come back from after stent placement was removed after two months and now after 9months this 4.3 cm cyst has grown from a 3.5, I feel that my dr was not following me closely enough as his recommendation was 1 yr follow up,my concerns are that if the cyst is reccuring and getting larger what is the next protocol,and other than an eus or ercp what can be done? My fear of this turning into cancer has been really bothersome and quite scary, I have now decided to try Chapel Hill Hospital in NC where Im from to see if the research there might be better and more helpful. I am glad to find this website where there is more research being done and more agressive follow up for patients. I come from ahigh rate of cancer in my family and feel that maybe genetic testing might be a good route to take, I have never had a pancreatic attack ,and no dr has been able to give me any answers as to why they keep returning. I need answers and help.Thank you for your time.

Columbia Surgery January 2, 2014 at 2:53 pm

Tammy:

I am so glad that you found this information helpful and I am certain that doctors at Chapel Hill can provide you with some additional assurances. Second opinions are a great way to take control of and actively manage your health.

Please feel free to call us at 212-305-9467 if we can ever be of any assistance to you.

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