GIST (Gastrointestinal Stromal Tumor)

Overview of GIST (Gastrointestinal Stromal Tumor)

Gastrointestinal Stromal Tumour (GIST) develops anywhere in the gastrointestinal tract, at any age. The best way to prevent it is by adopting a healthy lifestyle.

Signs and Symptoms of GIST (Gastrointestinal Stromal Tumor)

A gastrointestinal stromal tumour (GIST) also known as (meday ka waram/ معدے کا ورم) is a soft tissue sarcoma located in the gastrointestinal tract, most commonly in the stomach (60%) or small intestine (35%). The interstitial cells of the gastrointestinal tract referred to Cajal (ICCs) or precursors of these cells start to replicate and cause GIST tumours. Moreover, the tumour can be malignant or benign, depending on the patient's condition.
Generally, it occurs in adults between the ages of 40 and 70; rarely exists in young adults.

Prevalence of Gastrointestinal Stromal Tumour (GIST)

The worldwide data of GIST is limited but the incidence rate is about 10-20% per million. Globally, 15-47% of cases were diagnosed with metastatic GIST.
Between the 2009 to 2015 years, an average 5 years survival rate with different types and stages, after being diagnosed, are below:

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Types of GIST (Gastrointestinal Stromal Tumor)

The size and location of tumours represent the symptoms of GIST. In some cases, a small lump of GISTs does not cause any symptoms. But if the tumour is larger, the main sign of GIST is bleeding. It can also be possible that blood appears in vomit and stool.

Other signs and symptoms may include:

  • Feeling of fullness after a few bites
  • Loss of appetite
  • Stomach pain
  • Feeling a lump in stomach
  • Bloody stool
  • Nausea
  • Difficulty in swallowing
  • Sudden weight loss

Causes of GIST (Gastrointestinal Stromal Tumor)

  • Adult GIST: It develops anywhere in the gastrointestinal tract especially for older patients, due to the mutated gene (PDGFRA). Sometimes, medicine becomes resistant to genes such as PDGFRA D842V mutation that is completely resistant to Gleevec and Sutent.
  • Pediatric GIST: It affects the children between the ages of 6 to 18 years old that results from the mutated genes (such as SDH gene). Carney’s triad is another name of pediatric GIST.
  • Wild-type GIST: People with wildtype GISTs are deficient from Succinate Dehydrogenase (SDH). Sometimes, this SDH may not be present in patients.
  • Familial GIST: This type causes germ-line mutation of specific genes. It means, people inherit it from their family and may pass it to their children.
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Risk Factors of GIST (Gastrointestinal Stromal Tumor)

GIST is mainly caused by genetic changes in one or several genes such as KIT and PDGFRA genes. About 80% of cases are reported with KIT gene mutations and 10% cases are reported with PDGFRA cases. Mostly KIT and PDGFRA gene mutations result in both familial and sporadic GISTs. Only a small number of people are affected by mutations in other genes.

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Prevention

Several risk factors that increase the onset of the tumour are below:

  • Genetic Syndrome- Another syndrome can increase the risk of GIST such as:
  • Neurofibromatosis type 1 (NF1).
  • Carney triad
  • Chemical Exposure- If people are being exposed to some chemicals accidentally, such as herbicides, arsenic and dioxin. This may increase the risk of GIST.
  • Radiation Exposure- Frequent exposure of radiation may trigger the risk of GIST like if a person had exposure to radiation for the treatment of other cancer or work in a radiation exposed area etc.
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Diagnosis

To prevent cancer, people should follow measures in their lifestyle:

  • Quit smoking
  • Avoid canned food
  • Add more vegetables in the diet
  • Take vitamin supplements such as vitC , vitD3, vitA and others
  • Use the fish oil or cod liver oil during cooking
  • Avoid artificial sweeteners
  • Do not drink carbonated beverages
  • Avoid conventional dairy products and beef as well.

Seek medical care if individuals are experiencing following signs of GIST:

  • Bleeding
  • Stomach pain
  • Feeling a lump in stomach
  • Bloody stool
  • Nausea
  • Weight loss

Treatment of GIST (Gastrointestinal Stromal Tumor) | When to Consult a Doctor

Doctors will ask questions regarding the symptoms and medical history, after that the complete physical examination test is conducted for the abdomen growth.  If doctors suspect that it may have GIST, then following tests are performed for determination of tumour.

  • Computerized Tomography (CT) Scan-This test is used for the detailed cross-sectional scan of abdominal organs, checking the size and position of the tumour.
  • Magnetic Resonance Imaging (MRI)- It also gives a detailed image of the abdomen but more visible than a CT scan.
  • PET Scan (Positron Emission Tomography Scan)-This is applicable for a malignant tumour. A small amount of radioactive glucose is injected into the vein. The area where malignancy is present becomes brighter and active because these cells have taken up a lot of injected glucose. It is easily determined.
  • Upper Endoscopy- From this test, doctors examine the inner lining of the oesophagus, stomach and the first part of the small intestine through a thin flexible, lighted tube (endoscope). This tube is inserted down through the mouth. IV sedatives are required for this procedure.
  • Endoscopic Ultrasound (EUS)- In this test, an endoscope is used with ultrasound probes that transmit the sound waves through the affected area. In this way, a detailed image of the abdomen and location of a tumour in it. This gives a precise result of the metastasized tumours and the affected organs connect with them. It means a complete determination of the extent of a tumour.
  • Fine-needle Aspiration Biopsy- A small fragment of tissue from the tumour is removed by the fine needle for GIST analysis. This method is done with the EUS.

If cancer is diagnosed, below tests may conduct to find the type and number of cancer cells:

  • Immunohistochemistry- A differential laboratory test is conducted to differentiate one type of cancer to another type of cancer. This method is conducted with the help of antibodies that recognize the antigen in the patient's tissue sample. These antibodies combine to an enzyme or fluorescent dye and then bind to the antigen. As an enzyme or dye becomes activated, this helps to mark antigen under a microscope.
  • Mitotic Rate- It measures the replication of cancer cells in affected tissue. It determines the number of dividing cells in cancer tissue.

After proper diagnosis, oncologists decide the appropriate line of treatment according to the patient’s condition.

Doctors to treat GIST (Gastrointestinal Stromal Tumor)

Last updated on Thursday 27/10/2022

Doctor

Dr. Amjad S.K Durrani

Oncologist | MBBS, AFSA, Medical Oncology, DMRT

Wazir Habib Cancer CenterRs 3500

8

Today’s Slots

98%

Satisfaction Rate

18

Years

Highly recommended. Very good doctor

Doctor

Dr. Bushra Ali

Hepatologist, Gastroenterologist | MBBS,MCPS,FCPS

National Hospital & Medical CenterRs 3000

Fatima Memorial HospitalRs 3000

0

Today’s Slots

99%

Satisfaction Rate

22

Years

It was a good visit. do not waited much and satisfied

Doctor

Prof. Dr. Khalid Mahmud Khan

Internal Medicine Specialist, General Physician, Gastroenterologist | MBBS, FCPS, MRCP

Doctors HospitalRs 3500

3

Today’s Slots

98%

Satisfaction Rate

25

Years

Overall satisfied.

All Doctors treating GIST (Gastrointestinal Stromal Tumor)