Well the atrophy means you don't produce the enzymes. And yes, it's a higher risk of pancreatic cancer. It's good they are monitoring your cysts. I just had a number of biopsies and all ok thank goodness. I was put on replaced enzymes. But if your not having the classic symptoms like foul smelling gas and shiny, greasy stools then maybe it's not that bad yet? Mine is severely atrophic and I had the strange new symptoms for about 5 months before it was found on CT. So your gut will tell you if you're having problems digesting. And you will know when you eat something like desert or chocolate which I loved. It's a pretty big change in the bowels you can't ignore. It's very foul to say the least. I'm on an enzyme called Creon now and it's derived from pigs of all things. But I couldn't even stand to smell it myself and was happy I live alone so let your gut do the talking, lol. Good luck.