Gastrointestinal stromal tumor (GIST) is a disease in which abnormal cells form in the tissues of the gastrointestinal tract. The gastrointestinal (GI) tract is part of the body’s digestive system. It helps to digest food and takes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from food so they can be used by the body. The GI tract is made up of the following organs:
- Stomach
- Small intestine
- Large intestine (colon)
Gastrointestinal stromal tumors (GISTs) may be malignant (cancer) or benign (not cancer). They are most common in the stomach and small intestine but may be found anywhere in or near the GI tract. Some scientists believe that GISTs begin in cells called interstitial cells of Cajal (ICC), in the wall of the GI tract.
Signs & Symptoms
These and other signs and symptoms may be caused by a GIST or by other conditions. Check with your doctor if you have any of the following:
- Blood (either bright red or very dark) in the stool or vomit
- Pain in the abdomen, which may be severe
- Feeling very tired
- Trouble or pain when swallowing
- Feeling full after only a little food is eaten
Treatment
Your OHC doctor will help you determine the best care plan for you.
Resectable gastrointestinal stromal tumors (GISTs) can be completely or almost completely removed by surgery. Treatment may include the following:
- Surgery to remove tumors that are 2 centimeters or larger. Laparoscopic surgery may be done if the tumor is 5 cm or smaller. If there are cancer cells remaining at the edges of the area where the tumor was removed, watchful waiting or targeted therapy with imatinib mesylate may follow.
- A clinical trial of targeted therapy with imatinib mesylate following surgery, to decrease the chance the tumor will recur (come back).
Unresectable GISTs cannot be completely removed by surgery because they are too large or in a place where there would be too much damage to nearby organs if the tumor is removed. Treatment is usually a clinical trial of targeted therapy with imatinib mesylate to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
Metastatic and Recurrent Gastrointestinal Stromal Tumors: Treatment of GISTs that are metastatic (spread to other parts of the body) or recurrent (came back after treatment) may include the following:
- Targeted therapy with imatinib mesylate
- Targeted therapy with sunitinib, if the tumor begins to grow during imatinib mesylate therapy or if the side effects are too bad
- Surgery to remove tumors that have been treated with targeted therapy and are shrinking, stable (not changing), or that have slightly increased in size. Targeted therapy may continue after surgery
- Surgery to remove tumors when there are serious complications, such as bleeding, a hole in the gastrointestinal (GI) tract, a blocked GI tract, or infection.
- A clinical trial of a new treatment
Refractory Gastrointestinal Stromal Tumors: Many GISTs treated with a tyrosine kinase inhibitor (TKI) become refractory (stop responding) to the drug after a while. Treatment is usually a clinical trial with a different TKI or a clinical trial of a new drug.
