Treatment
After having tests to diagnose and assess a GIST, your doctor
will discuss your treatment options with you. Treatment options are
determined at a weekly meeting of specialists where all the test
results are discussed. A lot of different doctors are involved in
making these decisions, including surgeons, oncologists (cancer
specialists), radiologists (imaging specialists), histopathologists
(experts in tissue analysis) and cancer nurse specialists. This
meeting is called the 'Multi-Disciplinary Team' (MDT) meeting. This
means that the right decisions can be made with you based on the
specific details of you and your test results.
The main factors determining your treatment include the site of
the GIST, its size, your fitness for treatment, and whether there
is any evidence of spread. In general, the treatment options
available are explained below.
Watchful waiting
Small GISTs may not require any treatment. In this case, the
team may recommend that a further scan is performed after a period
of time (such as one year) has elapsed to see if it is growing or
not. Some GISTs will either not grow, or only grow very slowly, and
may never need any form of treatment.
Surgery
Once a GIST reaches a certain size, the team may recommend
surgery. Many GISTs that affect the stomach can be treated by
removing a limited portion of the stomach, often by key-hole
surgery, although a bigger cut may be needed to remove the tumour
from inside the abdomen. However, bigger GISTs, and those affecting
certain parts of the stomach, can be more difficult to remove,
requiring more major surgery, or open surgery. As the nature of the
required surgery is variable, the risks and consequences are also
quite variable. Your doctor will tell you more about your
particular tumour, and what will be involved if surgery is
recommended as well as the associated risks.
Chemotherapy
In some cases, the team may recommend treatment with specific
medication (imatinib, or a similar drug) which acts directly on the
GIST. This is a very focused treatment, and therefore has fewer
side effects than more common forms of chemotherapy. Your doctor
can explain this treatment in more detail.