The team announced Wednesday that Pitkanen will have a CT scan Thursday to judge how much his broken left heel has healed.
Pitkanen sustained the injury April 2 when he fell into the boards during a game against the Washington Capitals.
"He was having trouble standing on [his heel]," Hurricanes general manager Jim Rutherford told the team's website. "We're pretty sure he's not starting the season. It's a real serious injury, and this could go a long time.
"I'm getting prepared for the worst at this point."
It would be tough for the Hurricanes to replace Pitkanen, who had nine points in 22 games and was second on the team with an average ice time of 22:49 per game. He’s averaged more than 23 minutes per game since the 2005-06 season.
"When you take a guy out of the lineup that played that many minutes, you really have to look at your defense," Rutherford said. “What [coach] Kirk [Muller] might have to do is balance [the minutes] out more, which I do think we have a better chance of doing with the addition of [Andrej] Sekera and [Mike] Komisarek."
In addition, the Hurricanes could look to increase the minutes for rookie Ryan Murphy, the 12th pick of the 2011 NHL Draft, who could fill Pitkanen's role on the top power-play unit.
"We don't know how long it's going to be that he's going to be out," Rutherford said of Pitkanen. "Is he going to be out a couple of weeks? A month? Half a year? A whole year? I don't know. So until we get a better idea of how long he's out, we’re going to try to replace him with what we have."