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Precursors to Pancreatic Cancer

Intraductal Papillary Mucinous Neoplasms (IPMN or IPMT)

IPMNs are a special type of abnormal tumor in the pancreas that have been identified as common precursors to pancreatic cancer. IPMNs are called "mucinous" because they produce large amounts of mucus within the pancreatic ducts. This mucus can clog and enlarge the ducts, sometimes causing pain and jaundice. However, IPMN can be present for long periods of time without spreading or causing any detectable symptoms. Often, IPMN is detected incidentally on imaging studies meant to explore an unrelated health issue.

If IPMN is detected early enough, there is a good chance for a cure with surgery. Sometimes, the recommended course of action for IPMN is a total pancreatectomy, in which the entire pancreas is removed. While guaranteeing cancer in the pancreas will not develop in the future, a total pancreatectomy also means that the patient will become an insulin-dependent diabetic. If diagnosed with IPMN, you should talk to your doctor carefully about your treatment options.

IPMNs have very distinct features and behave unlike most pancreatic tumors. Because of this, researchers are focusing on IPMNs and their genetic makeup in the hope of better understanding how pancreatic tumors form. This research could lead to new ways of diagnosing and treating the more common forms of pancreatic cancer.

Pancreatic Intraepithelial Neoplasia (PanIN)

PanIN lesions, like IPMNs, are recognized as precancerous lesions. PanIN lesions can also affect the cells lining the pancreatic ducts, but are normally found in the smaller, side-branches and not in the main pancreatic duct. PanIN lesions are too small to detect with the naked eye and are often diagnosed by pathologists using microsopes after a biopsy.

There are several grades of PanIN lesions. As the grades progress, the lesions become more severe and more direct indicators of pancreatic cancer. PanIN-1A are the most benign types of PanIN lesions and PanIN-3 are the most severe. PanIN-3 lesions show a high level of dysplasia, or cellular abnormalities, and often evolve into pancreatic cancer. Surgery is the typical treatment plan for PanIN-3 lesions. However, since invasive surgery can disrupt a patient's quality of life, a doctor may choose to monitor detected PanIN lesions closely and only operate if deemed necessary.