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Decisional regret post-prophylactic gastrectomy for Hereditary Diffuse Gastric Cancer (HDGC)

Nicholas J. Bartell, M.D - CGA-IGC Communications committee


In the newest episode of the CGA-IGC podcast Josie Baker, MS, LGC, genetic counselor at the Ohio State University, had an informative conversation with Jeremy Davis, MD a surgical oncologist at the National Cancer Institute.


Dr. Davis’ recent article published in the Journal of Medical Genetics  titled “Decision-making and regret in patients with germline CDH1 variants undergoing prophylactic total gastrectomy” was the main topic of discussion.


The management of patients with CDH1 pathogenic variants was a hot topic at the most recent CGA-IGC annual meeting in Las Vegas, and Dr. Davis’ work brings up many thought provoking questions. 


“As a surgical oncologist I tend to take out people’s stomachs, especially in the setting of a germline CDH1 variant. We found that people were expressing a lot of feelings related to ‘was that the right decision'”

As more people are getting multi-gene panel testing more individuals will be found with pathogenic mutations, and in the case of HDGC more patients will be referred for prophylactic gastrectomy. Dr. Davis highlights the need to take a patient centered approach when counseling these patients, and that decision making is not one size fits all.


This paper also underscores the need for more data on the natural history of HDGC patients, so more nuanced estimates of future risk could be provided, thereby reducing the ultimate risk of decisional regret.


Listen to the podcast HERE

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If you enjoyed this podcast, you may like others from the CGA-IGC Podcast Series (Seasons 3, 4, 5 & 6) presented by the CGA-IGC Education Committee. Or, explore our Expert Approach to Hereditary Gastrointestinal Cancers podcast series (Seasons 1 and 2).


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