Treatment
Treatment for GISTs depends largely on the stage of the disease, the location of the tumor, and your general health. It also depends on whether the tumor is resectable, unresectable, metastatic and recurrent, or refractory. A resectable tumor can be removed by surgery, while unresectable tumors cannot be completely removed by surgery. Metastatic and recurrent tumors have spread to other parts of the body and/or have come back after prior treatment. Refractory tumors have gotten better with treatment. The main treatments for GIST tumors are surgery and targeted therapy. Chemotherapy and radiation therapy are very rarely used to treat GISTs. Here are some of the procedures your doctor may recommend:
Click Image to Enlarge.
Surgery
Surgical removal of the tumor is the primary treatment for most GISTs, especially if they are still localized. Your doctor will remove the cancerous section of your gastrointestinal tract and a healthy section on either side of it, and sometimes reattach the two healthy sides. Your doctor may be able to remove small tumors laparoscopically, and make only three or four small incisions in your abdomen. For larger tumors, your doctor may recommend targeted therapy first (called neoadjuvant therapy) to shrink the tumor before surgery. If your tumor is high risk, you may receive targeted therapy after surgery to reduce the risk of the cancer returning (called adjuvant therapy).
Click Image to Enlarge.
Targeted Therapy
GISTs often contain cells with mutated KIT or PDGFRA genes in the cancer cells, which cause the cancer to grow more aggressively. Targeted therapy specifically targets these cells, slowing growth and sometimes killing the cells. Your doctor may give targeted therapy before or after surgery to remove your GIST, or as your primary treatment for more advanced cases. There are different targeted therapies approved for the treatment pf GIST and are aften based on the type of mutation present in the cancer cell.
Clinical Trials
Clinical trials are studies of new cancer treatments that show promise but have not yet been proven effective in treating the disease. Clinical trials allow patients to try a new treatment before it is available to the general public. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.
GISTs are not very responsive to chemotherapy or radiation therapy, so doctors rarely use these treatments. Radiation therapy may sometimes be used as a palliative treatment to stop bleeding and otherwise relieve symptoms.
