Approximately 4,000 to 5,000 adults in the United States will be diagnosed with a gastrointestinal stromal tumor (GIST). Sixty percent of GISTs begin in the stomach, 30 percent in the small intestine, and the remaining cases mostly start in the rectum, colon, and esophagus.
As part of a research medical center, Siteman Cancer Center and Barnes-Jewish Hospital have access to a wide range of clinical trials to test new therapies as they emerge. Many of our doctors are principle investigators in these trials, which cover medical, surgical, and radiation therapies. Discuss with your physician how your cancer might benefit from clinical trials.
The standard treatments for gastric GI stromal tumors include surgery, chemotherapy, targeted therapy, active surveillance and supportive care, including radiation therapy. Clinical trials are testing many other approaches, some of which are becoming standard of care.
If the GIST has not spread and is in a place where surgery can be safely done, the tumor and some of the tissue around it may be removed. Sometimes surgery is done using a laparoscope (a thin, lighted tube) to see inside the body. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope is inserted into one of the incisions. Instruments may be inserted through the same incision or through other incisions to remove organs or tissues.
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
Tyrosine kinase inhibitors (TKIs) are targeted therapy drugs that block signals needed for tumors to grow. TKIs may be used to treat GISTs that cannot be removed by surgery or to shrink GISTs so they become small enough to be removed by surgery. TKIs are sometimes given for as long as the tumor does not grow and serious side effects do not occur.
Oncologists will keep a close eye on the tumor without giving treatment until signs or symptoms appear to change.
If a GIST gets worse during treatment or there are side effects, supportive care is usually given to prevent or treat the symptoms of a disease, side effects caused by treatment, and psychological, social, and spiritual problems related to the disease or its treatment. Supportive care helps improve the quality of life of patients who have a serious or life-threatening disease. Radiation therapy is sometimes given as supportive care to relieve pain in patients with large tumors that have spread.
Different combinations of therapies may be used depending on the stage of the cancer and the health of the patient. New combinations of therapies are always being tested in clinical trials and are available at Siteman Cancer Center before other places may have access to them.