Gastrointestinal Stromal Tumour (GIST)

What is a Gastrointestinal Stromal Tumour (GIST) ?

This is a rare form of tumour that most commonly occurs in the stomach. Although only comprises 1% of stomach cancers.

Where else can a Gastrointestinal Stromal Tumour (GIST) be found ?

  • 50% occur in the stomach
  • 30% in the small bowel (jejunum or ileum)
  • 5% in the rectum or duodenum

How does a Gastrointestinal Stromal Tumour (GIST) occur?

  • A condition where the GIST expresses a mutation in the c-Kit (CD117) or PDRFA receptor. This results in tyrosine kinase mutations

What symptoms can a patient who has a Gastrointestinal Stromal Tumour (GIST) present with?

  • Upper gastrointestinal (UGI) bleeding
  • Symptomatic anaemia
  • Malaena (black colour stools through your back passage)
  • Haemetemesis (vomiting blood)
  • Abdominal Pain
  • Abdominal mass
  • Bowel obstruction

How is a Gastrointestinal Stromal Tumour (GIST) diagnosed ?

A complete history and clinical examination would usually guide a specialist as to what the differentials are for a patient’s given symptom or sign. This is usually followed by a gastroscopy or a radiological imaging which often is a CT scan of the abdomen. Both these investigations would reveal if you have a Gastrointestinal Stromal Tumour (GIST). Occasionally further investigations are required. Your specialist would be happy to discuss your symptoms with you.

How is a Gastrointestinal Stromal Tumour (GIST) treated?

The main treatment for GIST is surgery. Dr. Niruben has specialised in laparoendoscopic surgery to be able to provide a ‘key hole’ method of removing these tumours that occur in the upper gastrointestinal system. This will vary with individual patients circumstances , comorbidities and disease process.

What is Laparoendoscopic surgery ?

This is advanced ‘key hole’ surgery which utilises the gastroscope in addition to the standard laparoscopic ‘key hole’ surgery. This method is particularly useful for Gastrointestinal Stromal Tumours (GISTs) that occur in the stomach. Dr. Niruben has a high success rate in getting these out with ‘key hole’ surgery. In certain circumstances the size of the Gastrointestinal Stromal Tumour (GIST) may not allow this to be possible.

What is my prognosis with a Gastrointestinal Stromal Tumour (GIST)?

This is individualised to 3 components in regards to the Gastrointestinal Stromal Tumour (GIST)

  • Size
  • Mitotic rate
  • Site (location of GIST)

What other treatment will I need if I have a GIST ?

In most cases, if possible, surgery should be performed first. In certain circumstances surgery might only be able to be done after targeted therapy. Targeted therapy drugs work slightly different to standard chemotherapy drugs. Targeted therapy targets the gene changes in Gastrointestinal Stromal Tumour (GIST). The drug that is used for this is called Gleevec. This is subsidised by the Medicare benefits scheme if you meet the set criteria.
Gastrointestinal Stromal Tumour (GIST) are not common and is an area of great interest to Dr. Niruben. Please click here to make an appointment.