A gastrointestinal stromal tumor (GIST) is an infrequent form of cancer, belonging to the category of soft tissue sarcomas, frequently originating in the abdominal region. Prior to 1998, doctors categorized GIST as either leiomyosarcoma, gastrointestinal autonomic nerve tumor (GANT), or a combination of these two tumor types.
It may not cause symptoms, but when it does, symptoms can include belly pain, blood in the stool, and vomiting blood. Surgery is the most common treatment to remove a GIST. Sometimes, surgery can cure the condition, but these tumors can return.
What are Gastrointestinal Stromal Tumors (GISTs)?
Gastrointestinal stromal tumors (GISTs) are malignant growths that develop in the walls of the digestive tract. As a type of soft tissue sarcoma, they can vary in size, with some being as small as a pencil eraser and going unnoticed. Larger GISTs, however, can cause symptoms and health problems. The primary treatment is usually surgery to remove the tumors.
- Gastrointestinal stromal tumors (GISTs) can develop in different parts of the digestive tract, with varying frequencies:
- Approximately 50 to 60% of GISTs occur in the stomach.
- The small intestine accounts for 30 to 35% of cases.
- About 5% of GISTs are detected in the colon and rectum.
- Less than 1% originate in the esophagus.
What Are the Symptoms of a GIST?
Gastrointestinal stromal tumors (GISTs) might not cause symptoms, especially if they are small. Often, they are discovered incidentally during tests or surgeries for other conditions. When symptoms do appear, they can include:
- Abdominal (belly) pain
- Blood in or on your stool
- Constipation
- Fatigue
- Unintentional weight loss
- Loss of appetite
- Vomiting blood
What Causes Gastrointestinal Stromal Tumors?
GISTs typically occur due to mutations in the KIT gene, which cause cells in the digestive tract to multiply uncontrollably. This mutation is acquired during a person’s lifetime and is not inherited.
The KIT gene directs cells to produce a protein (KIT CD117) that regulates cell growth in the digestive tract. In GIST, the mutated cells grow abnormally and form tumors.
- Certain inherited conditions can also lead to the development of GISTs, including:
- Familial GIST syndrome: In rare cases, abnormal KIT genes can be inherited from a parent, increasing the risk of developing GISTs at a young age and potentially resulting in multiple tumors.
- Neurofibromatosis type 1: This condition causes the growth and multiplication of certain cells, leading to tumors throughout the body.
- Carney-Stratakis syndrome: This rare inherited condition increases the risk of developing GISTs.
How Are GISTs Diagnosed?
When diagnosing gastrointestinal stromal tumors (GISTs), a healthcare provider will start by asking about your symptoms and their duration. They will perform a physical examination and may conduct the following tests:
- Upper Endoscopy: This procedure allows the doctor to view the inside of your digestive tract.
- Computed Tomography (CT) Scan: A CT scan provides detailed images of your abdominal area.
- Positron Emission Tomography (PET) Scan: This imaging test helps to detect cancerous cells in your body.
- Biopsy: When a tumor or abnormal tissue is discovered, your doctor may conduct a biopsy. Biopsies are frequently performed during endoscopy, but tissue samples can also be obtained during surgery or through a needle inserted through the skin into the digestive tract.
- Following sample collection, a pathologist examines it for cancer cells and studies its molecular composition. If cancer is detected, further tests are conducted on tissue samples to analyze the genetic makeup and other cellular details.
Treating Gastrointestinal Stromal Tumors: What Are the Options?
The primary treatment for gastrointestinal stromal tumors (GISTs) is surgery, but the approach can vary based on factors such as tumor size, location, and whether it has metastasized (spread to other parts of the body).
Surgery: For smaller tumors, surgery may be sufficient. An oncology surgeon can remove the tumor, and this might be the only treatment necessary.
Targeted Therapy: For larger tumors, oncologists might use targeted therapy to shrink the tumor before performing surgery. This approach helps make the surgery more effective and less invasive.
Treatment plans are tailored to each patient based on the specific characteristics of their tumor and overall health.
Understanding Your GIST Diagnosis: What to Expect
If you have been diagnosed with a gastrointestinal stromal tumor (GIST), your oncologist will continue to monitor your recovery and overall health even after treatment is completed. Follow-up appointments are typically scheduled every three to six months and may include several types of tests to ensure the tumor has not returned and to monitor your response to treatment.
Common follow-up tests include Computed Tomography (CT) Scans: To check the liver and pelvis for any signs of recurrence.
Magnetic Resonance Imaging (MRI) Scans: To get detailed images of the body and monitor for tumor recurrence.
Positron Emission Tomography (PET) Scans: To assess the effectiveness of targeted therapy and monitor the tumor’s status.
What’s the Survival Rate for Someone with GIST?
The survival rate for individuals with GIST varies based on several factors, including the size and activity of the tumor at diagnosis, the overall health of the patient, and how well the tumor responds to treatment. According to data from the U.S. National Cancer Institute (NCI), approximately 85% of people with GIST are alive five years after their diagnosis.
Regular monitoring and follow-up care are crucial to maintaining health and managing any potential recurrence of the tumor.
Taking Care of Yourself: Essential Tips
Protecting your overall health during and after treatment for gastrointestinal stromal tumors (GISTs) is essential. Here are some key ways to take care of yourself:
Eat Well: Focus on a balanced diet that includes a variety of high-protein, low-fat foods. Incorporate leafy greens and fruits into your daily meals to ensure you get essential nutrients.
Get Some Exercise: Regular light exercise can help manage stress and support your recovery. Before resuming or starting a new exercise routine, consult with your healthcare provider to ensure it’s safe for you.
Avoid Tobacco: Steer clear of all forms of tobacco, including electronic cigarettes. Using tobacco can increase your risk of developing new cancers or experiencing a recurrence of GIST. Prioritize a tobacco-free lifestyle to protect your health.
GIST belongs to the group of soft tissue sarcomas. Check the link to find out more about sarcomas.
Resources:
Yale Medicine
Cleveland Clinic
