Who is at Risk? |
History & Physical Examination
Family History |
The goal for management of these patients is to diagnose them prior to the development
of cancer, when they have precancer or dysplasia, and to perform a complete pancreatectomy.
Timing is of vital importance for determining when a patient warrants surgery; if the patient
is diagnosed too late, he or she dies of pancreatic cancer. It is vital to know the histologic
diagnosis of the patient before considering major surgical options. High risk patients who
have an abnormal endoscopic ultrasound and abnormal pancreatic ducts on ERCP, may warrant a
tissue diagnosis to confirm that precancerous changes are present in the pancreas. This can
be done by using a laparoscope to obtain a sample of the pancreas for histologic evaluation.
If carcinoma-in-situ is present (also called PanIN III or high grade dysplasia) a consideration
for total pancreatectomy is discussed with the patient. If performed too early, the patient is
put through a major operation and he or she will be diabetic. At the operation, the entire pancreas
is removed because the precancerous changes can involve the whole organ--any pancreas that is left
behind can potentially develop cancer.