Gallbladder cancer is a rare malignancy of the biliary tract with a poor prognosis, frequently presenting at an advanced stage. While rare in the United States overall, gallbladder cancer has an elevated incidence in geographically distinct locations of the globe including Chile, North India, Korea, Japan and the state of New Mexico in the United States. People with Native American ancestry have a much elevated incidence of gallbladder cancer compared to Hispanic and non-Hispanic white populations of New Mexico. Gallbladder cancer is also one of the few bi-gendered cancers with an elevated female incidence compared to men. Similar to other gastrointestinal cancers, gallbladder cancer etiology is likely multi-factorial involving a combination of genomic, immunological, and environmental factors. Understanding the interplay of these unique epidemiological factors is crucial in improving the prevention, early detection, and treatment of this lethal disease. Previous studies have failed to identify a distinct genomic mutational profile in gallbladder cancers, however, work to identify promising clinically actionable targets is this form of cancer is ongoing. Examples include, interest in the HER2/Neu signaling pathway and the recognition that chronic inflammation plays a crucial role in gallbladder cancer pathogenesis. In this review, we provide a comprehensive overview of gallbladder cancer epidemiology, risk factors, pathogenesis, and treatment with a specific focus on the rural and Native American populations of New Mexico. We conclude this review by discussing future research directions with the goal of improving clinical outcomes for patients of this lethal malignancy.

Chronic lymphocytic leukemia (CLL) is the most common leukemia in Western countries. The frequency of symptomatic central nervous system (CNS) involvement is unknown but thought to be a rare phenomenon. Currently there are no known risk factors for CNS involvement. We describe a clinically staged low-risk CLL case that presented with symptomatic CNS involvement and progressed rapidly to death. Evaluation of the surface adhesion molecules identified a markedly altered expression pattern of the integrin, CD49d, and the tetraspanin, CD82, in the index case when compared to similar low-risk CLL cases. We found that the early Rai clinical stage CLL patients showed linear correlation for the co-expression of CD82 and CD49d. In contrast, this unique index case with CNS involvement, which has the same Rai clinical stage, had a significantly lower expression of CD82 and higher expression of CD49d. These data suggest that the expression profile of CD49d and CD82 may represent potential biomarkers for patients with increased propensity of CNS involvement. Moreover, this study illustrates the critical need for a better mechanistic understanding of how specific adhesion proteins regulate the interactions between CLL cells and various tissue sites.

Young breast cancer survivors often develop post-breast surgery pain syndrome (PBSPS). Despite potential benefit from physical activity, access to in-person programs is often limited by competing work and caregiving responsibilities. We assessed the feasibility and acceptability of a remotely delivered physical activity intervention for young Hispanic breast cancer survivors with PBSPS. Our single-arm, 12-week feasibility study enrolled Hispanic women aged ≤60, at least 3 months post-treatment for invasive breast cancer or ductal carcinoma in situ (DCIS), with PBSPS. Using a Fitbit Inspire 3 activity tracker and health coaching, the program encouraged whole-of-day movement to increase activity. Feasibility outcomes included recruitment, retention, and adherence. Secondary outcomes assessed pain measures, daily steps, and quality of life (QOL). Twenty-five breast cancer survivors enrolled (mean age 47.4 years [SD 6.3]), with 76% selecting Spanish-language health coaching. Retention at 12 weeks was 79% (19/24). Engagement with health coaching was high, with 95% completing at least 4 of 5 pre-planned calls. The mean change in daily step count was 1502 (−348, 3353), with twelve (66.7%) increasing in step count (median 2334.5, range: 14, 13,422). Each additional 1000-step increase was associated with a 2.67-point increase in pain self-efficacy scores (β = 2.669, 95% CI: 0.884 to 4.454, p = 0.006). A remotely delivered, health coaching physical activity intervention was feasible and acceptable for young Hispanic breast cancer survivors with PBSPS. This supports further evaluation in a larger trial. Accessible survivorship interventions for young breast cancer patients in their preferred language are needed.