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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.