Gallstones are comparatively common and cancer of the gallbladder is relatively rare, but cancer never occurs in a gallbladder without stones first being present. Familial and nutritional factors are involved in gallstone formulation, producing the classical “fair, fertile, fat, and forty” stereotype.
Recently, however, there has been a marked increase in the incidence of gallstones in younger women, and there is fairly strong circumstantial evidence linking this increased incidence with the widespread use of oral contraceptives. Thus by a circuitous route today;s use of oral contraceptives may result in an increase in gallbladder cancer some 15 to 20 years hence.
The relationship between gallstones and subsequent gallbladder cancer is so strong that even symptomless gallstones should be prophylactically removed. Only very early cases of gallbladder should be prophylactically removed.
Only very early cases of gallbladder cancer are surgivally curable, because the tumor readily infiltrates into the adjacent liver, rending the whole situation irresectable. Radiotherapy and chemotherapy have nothing to offer in such circumstances.