First of all I hope you are well !

Update from the new gastro :

None of my scans indicate any cancer risks and they are as certain as they can be able that at the moment.

Why are you recommending EUS/FNA?

There are 3 reasons why:

1. We are still not sure what kind of cyst those are ? There is still a small chance that those are simple cysts. A CEA test will confirn the type of cyst (nothing else)
2. If they are an IPMN we want to check the liquid and understand if the cyst will most likely remain benign (low risk) or if it of a higher risk
3. Check for nodules inside the cyst . The MRI has shown none but we want to have a better look

Other information that he shared:

IPMN are very common these days but it is sitll a very new medical finding. A lot of unknowns still and lack of history. My IPMN could have been there for decades and unfortunately we will never be able to find that. The overall risk of IPMN turning to maligant is 1 in 300 so the risks overall are small. Another thing to be aware is that IPMN cancer is different from the known pancreatic cancer and it has a much better prognosis. They are not directly related but in some rare situations IPMN cancer can lead to pancreatic duct cancer. IPMN Cancer can be caught easily and "cured" by surgery very efficiently but surgery is the last resort (more on that below).

The fact that I do have numerous cysts does not raise my possibility of cancer as each cyst has its own history and future. As well he will not remove fluid from any cyst that is less than 2cm as the volume is not high enough to undertaking any testing. So we will only drain the large 4cm cyst.

I am not seen as a risk patient at the moment so my EUS/FNA will not be booked in for 2 - 6 weeks and COVID is not helping here.

Been Mario I jumped the gun and asked about surgery. He was taken back by my question and he wasnt comfortable talking about it but I did push him as it is my right to know.

Very very risky operation and always the last resort ! I knew it was risky and major but his face completely scared the crap out of me. And he was wearing a mask !!!!
Diabetes 3c is not even close to Diabetic Type 1. It is much more agressive and deadly (Why did I ask 🙂 ) .. The risks to my life after total removal increase dramatically and while yes I "can" live another 20 - 30 years it wont be an easy life at all, if I make it that far.

That is why doctors around the world dont operate on each IPMN or cyst find , it is too risky and no benefits.

He did want to stop the conversaton there but I wouldnt have it so I asked him to refer me to a surgeon ,which he will do but again his recommendation is against it as we are not going down that path yet at all . You guys might understand better but its not as easy for someone to take it step by step , or maybe I am wrong please tell me.I am an engineer by trade so my brain is trained to think of all angles and steps proactively. Overall again very "good" news and glad that someone gave me some stats such as there is 0.3% of a chance for an IPMN to turn and if it does we can still catch it. Not good about the surgery and the life after especially as I hoped with all the diabetic technological advancements it wont be as highy risky. For those that are diabetic , please allow me to say that I never stated that it is easy life been a diabetic but I am comparing to cancer ! Apologies if I have offended any one as that was not my intent.

As well I did receive a 2nd opinion from a top surgeon back in Greece. His response was exactly the same as the gastro specialist with the main difference was he was much more confortable about the surgery .His answer was again last resort but if we have to do so : "You will be in hospital for 10 days or so and then go home and manage your diabetes " 🙂 Greek people they are so relaxed , I wonder why I didnt pick up on that gene ...

Sorry for the long update and the humor (laughing is the best medicine) and happy to answer any queries you might have.

Mario