At Mayo Clinic, a team of experts works together to provide you with exactly the care you need.
Your Mayo Clinic care team
At Mayo Clinic, specialists in gastroenterology and hepatology work with experts in oncology, surgery, radiology, rehabilitation and pathology to form a multidisciplinary team to provide whole-person care for those with GISTs. Other professionals are included as needed.
Advanced diagnosis and treatment
Mayo Clinic doctors have access to the latest diagnostic and treatment techniques to make a diagnosis quickly and precisely.
Tests and procedures used to diagnose GISTs include:
- Imaging tests. Imaging tests help your doctor determine the location and size of a tumor. Tests may include a CT, MRI and positron emission tomography (PET).
Using a scope to see inside your digestive tract. During an upper endoscopy, a gastroenterologist or surgeon looks into your esophagus, stomach and small intestine using a thin lighted tube with a small video camera at the tip. Small samples of tissue (biopsies) may be taken if an abnormality is found.
A biopsy may not identify GISTs that lie beneath the lining of the gastrointestinal tract, and other tests may be needed, such as an endoscopic ultrasound. During this procedure, an ultrasound probe is passed down your throat. The probe emits high-frequency sound waves that generate images of the inside of your stomach and intestine. This may help reveal a tumor not evident with an upper endoscopy alone.
- Swallowing a pill-sized camera. A capsule endoscopy is a procedure that involves swallowing a pill-sized camera that takes photographs as it passes through your digestive system. A capsule endoscopy helps doctors examine the small intestine for abnormalities.
Collecting cells for laboratory analysis. A biopsy may be used to collect suspicious cells for testing in a lab. The cells can be collected by passing special tools down your throat during an endoscopy procedure.
In the lab, pathologists use advanced techniques to examine the cells to determine whether they're cancer and to understand their characteristics. Staining your tissue sample with a special dye can show the presence of an abnormality that appears in almost all GISTs.
Your care team will work with you to determine which treatment options are best for you based on your individual case and your personal preferences. Treatment for GISTs may include:
Surgery. Removal of the tumor is the primary treatment for GISTs. Mayo Clinic surgeons remove small tumors through small incisions using laparoscopic surgery.
If your GIST is large or attached to other organs, a more-extensive operation may be necessary and may involve removing parts of the affected organs. The surgeon may also remove small amounts of tissue outside your GIST to avoid tumor rupture and prevent future obstruction to your digestive tract.
You may receive targeted therapy before surgery to reduce tumor size or after surgery to destroy any remaining cancer cells.
Targeted therapy. Targeted therapy is a drug treatment designed to target certain aspects of your cancer cells that allows them to thrive. For instance, treatment that blocks a pathway called tyrosine kinase may cause GIST cells that overproduce tyrosine kinase to die. Imatinib (Gleevec) targets tyrosine kinase and is a common targeted therapy used to treat GISTs.
Other targeted drugs used to treat GISTs include sunitinib (Sutent) and regorafenib (Stivarga).
If your tumor is too large or invasive to be removed with surgery, your doctor may use targeted therapy to shrink the tumor enough to make surgery possible. If your tumor is removed, your doctor may recommend targeted therapy to reduce the risk of recurrence.
- Radiofrequency ablation. During radiofrequency ablation, your doctor inserts a thin needle guided by ultrasound or CT scan into your tumor and generates heat to destroy cancer cells. Your doctor may recommend radiofrequency ablation if you have several tumors or liver tumors that can't be removed, or to relieve symptoms of GISTs such as pain.
Mayo Clinic also offers palliative care, which is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. At Mayo Clinic, palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care.
Because GISTs may recur after treatment, you'll visit your doctor periodically after your initial treatment to monitor for recurrence. Follow-up care usually involves imaging studies that allow your doctor to detect changes or tumors that may require further treatment.
April 28, 2016
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- Feldman M, et al. Gastrointestinal stromal tumors (GISTs). In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed April 15, 2016.
- Gastrointestinal stromal tumors treatment – Patient version (PDQ). National Cancer Institute. http://www.cancer.gov/types/soft-tissue-sarcoma/patient/gist-treatment-pdq. Accessed April 15, 2016.
- Soft tissue sarcoma. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed April 15, 2016.
Gastrointestinal stromal tumors (GISTs)