Question About the Answer to Previous Question

Dear Dr. Kevin,

It is "ConcernedGB" again.  Thanks for previous answer.  I have a question about your answer to my question.  You stated that there is a "Genetic predisposition to Gall Bladder Cancer."  Could you provide me with a reference for this?  I've been researching and researching this connection with no luck.  So any references would help!

One more question.  Is it true that gall bladder cancer rarely occurs in persons without previous gall bladder disease?  You said in your answer to my question that gall bladder cancer is extremely rare, less than 5,000 cases diagnosed annually and that I should consider this fact in assessing my odds.  I am under my regular doctors care (internist), but should I lose sleep over this?

Finally, tell me if this is correct.  Assuming that gall bladder cancer "runs in the family" and I have inherited a predisposition for it, THIS DOES NOT MEAN I'LL GET IT.  Environment and diet, etc. have alot to do with the final outcome, right?

Sincerely,
ConcernedGB

[Kevin Pho, MD]

Hello - thanks for asking your question.

Regarding the genetic predisposition for gallbladder cancer:
"Worldwide, high rates of GBC are seen in South American countries, particularly Chile and Bolivia, and in Chile, mortality rates from GBC are the highest in the world. Genetic factors and lower socioeconomic status leading to delayed access to cholecystectomy for gallstones may explain some of these findings."
Serra, I, Calvo, A, Baez, S, Yamamoto, M. Risk factors for gallbladder cancer. An international collaborative case-control study. Cancer 1996; 78:1515.

Nothing is ever 100%, but yes - in general, people without gallbladder disease are less prone to develop gallbladder cancer.

As for your last point, even if you have a genetic predisposition, you are *not* guaranteed to develop it.  Other risk factors such as chronic gall bladder disease and gallstones increase risk.  So indirectly, by preventing gallstones, you are reducing your risk of gallbladder disease.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

Note that the reference speculates about genetics, but doesn't give data to suggest it. Gallstones are common. Gallstones run in families. GB cancer almost never occurs in someone who doesn't have stones. So where there are more stones, there is more cancer. But there's not definite evidence of a genetic link to cancer, per se. If you never get stones, it's extremely unlikely you'd get cancer. If you do get stones, it's still extremely unlikely you'd get cancer, even with a family history. Many people who have stones have no symptoms and never have surgery. It might be that if you were to get stones, you'd be more at peace if you had the gallbladder removed. But it's a personal decision, rather than a scientific one. I doubt you'd find a surgeon who'd support the idea of removing a normal gallbladder to prevent cancer, given its extreme rarity. But if you find yourself a nervous wreck no matter what, perhaps someone would go along with it.

[ConcernedGB]

Thanks so much for the post "surgeon."

I really appreciate the feedback.  I guess I'm feaked out about the hopelessness of gall bladder cancer with no recommended screening programs.  It just seems so unusual that both grandmother and mother had it.  I just have a fear that the tissue in my normal gall bladder will spontaneously mutate and turn into cancer.  Plus, I'm rather overweight.  I guess I'm still reeling from my mother's passing and the hopelessness felt in trying to find treatment for her.

Thanks again!