Gastrectomy

Gastro-intestinal stromal tumours (GISTs) are cancers that form in a particular type of cell found in the wall of the digestive tract. It is a rare form of cancer that is often found when checking for another problem. Surgery may be recommended on its own or as part of combined treatment for GISTs.

What are gastro-intestinal stromal tumours (GISTs)?

Gastro-intestinal stromal tumours (GISTs) start in very early forms of the interstitial cells of Cajal (ICCs) in your digestive tract. These cells have a special role in signalling to the muscles in the digestive tract to contract to move food and liquid along.

GISTs can form anywhere along the digestive tract but are most often found in the stomach and upper intestine. Sometimes they are also found outside the digestive tract.

What are the symptoms of GISTs?

GISTs often do not cause any specific symptoms and are often found because you are having tests for other problems. GISTs may cause non-specific symptoms such as abdominal pain, difficulty swallowing, feeling bloated or unexplained blood loss. Tests will confirm if any of the symptoms may be caused by GISTs.

What are the treatment options for GISTs?

Treatment options for GISTs depend on many factors including the size and location of the tumour, how quickly it seems to be growing and the likelihood of the tumour coming back. Other individual factors, such as your age and overall health, are also important.

Staging

You will need to have a series of tests to confirm if your tumour/s are GISTs, their size and if they have spread. This is referred to as staging and helps your medical team to plan your treatment.

Surgery

Surgery is usually the main treatment for GISTs that have not spread. The type of surgery you have depends on the location and size of any tumours:

• For small GISTs, Dr Hopkins may use keyhole (laparoscopic) surgery to remove the tumours and surrounding tissue.

• For larger GISTs and GISTs that have started growing into other organs in your abdomen (eg stomach or intestines), Dr Hopkins may need to perform surgery to remove part of the affected organs as well.

• For GISTs that have spread to other parts of the body (metastasised), targeted drug therapy may be used before surgery is considered.

• For GISTs that have spread to the liver, other treatments such as ablation (exposure to extreme heat, cold or other substance) or embolisation (injecting a substance to cut off or reduce blood supply) may be used to destroy the tumours.

Targeted drug therapy

Some drugs can target certain proteins in GIST cells that help them divide and grow. These drugs work differently from chemotherapy drugs and are considered more helpful in treating GISTs. For GISTs that are larger or growing in places that are harder to reach by surgery, your treatment might start with targeted drug therapy to try to shrink the size of your tumours.

If you have any questions about your surgery or would like to make an initial appointment to see Dr Hopkins, please get in touch.