Below, week by week, is what OnCo's record of Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors says about the first two months: the order is typical, the timing is yours to ask about. Intraductal papillary mucinous neoplasms are fluid-filled growths in the pancreatic ducts that make mucus and can slowly turn into pancreatic cancer, one of the few chances to catch pancreatic cancer before it starts. Most are watched with scans for years, and surgery is reserved for the ones with warning signs such as a widened main duct, a solid nodule inside the cyst or jaundice. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Resection (pancreatoduodenectomy or distal pancreatectomy) for obstructive jaundice, an enhancing mural nodule of 5 mm or more, a main duct of 10 mm or more, or positive cytology, in patients fit for surgery.
Characterise with MRI and MRCP or pancreas-protocol CT; endoscopic ultrasound with fluid analysis when the cyst type is unclear or worrisome features are present.
Endoscopic ultrasound and fluid sampling; resection or short-interval surveillance depending on findings, age and fitness.
Staged and treated as pancreatic ductal adenocarcinoma with resection and adjuvant chemotherapy.
MRI or endoscopic ultrasound at intervals set by cyst size, continued while the patient remains a surgical candidate; the remaining pancreas is followed after resection.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.