Familial tendencies
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thanks patricia for the post..
I have just come across this article on pubmed:
Family history of gallstones and the risk of biliary tract cancer and gallstones: A population-based study in Shanghai, China.Hsing AW, Bai Y, Andreotti G, Rashid A, Deng J, Chen J, Goldstein AM, Han TQ, Shen MC, Fraumeni JF Jr, Gao YT.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD.Cancers of the biliary tract arise from the gallbladder, extrahepatic bile ducts and ampulla of Vater. Although relatively uncommon, the incidence of biliary tract cancer rose more than 100% in Shanghai, China between 1972 and 1994. Gallstones are the predominant risk factor for biliary tract cancers, with over 60% of the cancer cases having gallstones. A familial tendency to gallstones has been reported and may elevate the risk of gallbladder cancer further. As part of a large population-based case-control study of biliary tract cancers in Shanghai, China, we examined the association between a family history of gallstones and biliary tract cancers as well as biliary stones. A total of 627 biliary tract cancers (368 gallbladder, 191 bile duct, 68 ampulla of Vater), 1,037 biliary stone cases (774 gallbladder, 263 bile duct) and 959 healthy subjects randomly selected from the population were included in this study. Information on family history of gallstones among first-degree relatives (i.e., parents, siblings, offspring) was obtained through a self-reported history during in-person interviews. A family history of gallstones was associated with increased risks of biliary stones [odds ratio (OR) = 2.8, 95% confidence interval (CI) = 2.1-3.8], gallbladder cancer (OR = 2.1, 95% CI = 1.4-3.3) and bile duct cancer (OR = 1.5, 95% CI = 0.9-2.5), after adjustment for age, gender, marital status, education, smoking, alcohol drinking and body mass index. For gallbladder cancer, subjects with gallstones but without a family history of gallstones had a 21-fold risk (95% CI 14.8-30.1), while those with both gallstones and a positive family history had a 57-fold risk (95% CI 32.0-110.5). Significant risks for gallbladder cancer persisted after additional adjustment for gallstones, and when the analysis was restricted to subjects with first-degree relatives whose gallstones were treated with cholecystectomy. The significant associations with a family history of gallstones were seen for all first-degree relatives, including parents, siblings and offspring, but not spouses. This large population-based study not only supports the role of gallstones in biliary carcinogenesis but also suggests that the underlying genetic or lifestyle determinants of stones within families contribute to the risk of biliary tract cancer. (c) 2007 Wiley-Liss, Inc.
I have seen a site where two brothers both in their thirties both contracted cc.
Not proof by a long way but with a very rare disease for two people in the same family to have it, does suggest a genetic predisposition.
In fact a google search shows that the family is that of mybrosister, who posts on this site. The link is http://www.band-of-brothers.ca
Patricia
I have found a trial (ref to above) – note that this one is aimed at patients with a suspected bilary malignancy.
I have similar concerns regarding a genetic link. My Dad had a cousin who suffered from liver cancer – we do not know if it was specifically cc although I think it could have been. About a year after my Dad was diagnosed I went to see someone to discuss potential genetic screening for myself – I was told there was no genetic link proven (however so little research has been carried out for cc how can they be so sure?). TXgal (who is on this site sometimes and over on John Hopkins) has had her gallbladder removed as a precuation. I can understand your concerns. There does not appear any adequate screening for cc although I do remember reading somewhere about ERCP guided brushing to take samples of the bile duct wall. (I believe this was in a clinical trial setting for close reletives of cc patients).
My Dad enjoyed jogging to keep fit – participating in half marathons etc. He was always so strong – never had a day off work. Always ate healthily etc.. it is so hard when this disease strikes someone who was so active and took care of themselves.
Jules
Thanks Betty. Even though Ken passed away in Dec, I know that this will always be part of my life and I continue to check this site everyday. This is a great way for people to learn new things and hopefully make big strides in dealing with this cancer.
TerriTerri – I’m certainly not an expert but I do know that there has to be some family gene connection. Sam’s daughter has ulcerative colitis which is a risk factor for CC and his granddaughter has Chrohn’s disease.
The other coincidence that Nancy Sloan and I noticed was that so many of these that had CC were long-distance runners. We thought that to be odd also. I doubt if this helps you much but thought I would pass it along to you.
Betty JohnsonWhen my husband Ken was first diagnosed with CC- one of the first questions I remember asking the doctor is if we need to worry about our daughters having a chance of being diagnosed with CC. His immediate response was “no” but as we have gone through this experience- I am not sure what to believe. Has anyone else asked that question?
Thanks
Terri
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