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What is GIST?

GIST stands for gastrointestinal stromal tumours. These fall under the category of soft tissue sarcomas that can develop in any part of the digestive system, especially the stomach and the small intestine. The cancer originates from the nerve cells that line the walls of the digestive system and form a part of the autonomic nervous system.

What are the symptoms that you need to look out for?

While smaller GISTs are usually asymptomatic, larger ones can produce a number of symptoms that include:

  • Anaemia
  • Abdominal pain and discomfort
  • Feeling nauseated
  • Vomiting
  • Traces of blood in vomit and stools
  • Unexplained loss of appetite
  • Unintended loss of weight
  • Swallowing difficulties

What causes GIST?

Though the exact cause of GIST is not known, it has been found to be related to mutations in the expression of the KIT protein. The cells start to grow and multiply uncontrollably and accumulate to form a tumour. These can gradually start spreading to the surrounding structures, including the peritoneum and the liver.

What are the various risk factors associated with GIST?

There are very few known factors that can elevate the risks of developing GIST

  • Age – It has been found that GISTs are quite common in people lying in the age group of 50 to 80 years and extremely rare in those lying below 40 years of age.
  • Genes – It has been found that GISTs can be caused by genetic mutations that a person is born with. These include neurofibromatosis 1, familial gastrointestinal stromal tumour syndrome and succinate dehydrogenase (SDH) gene mutations.

Screening and diagnosis

The various state of the art modalities available for the diagnosis and screening of GIST include:

  • Contrast - enhanced computerized tomography (CT) scan – This involves the use of contrast material for adding to the visibility of the images generated by the x-rays.
  • Upper endoscopy – The inner lining of the oesophagus, stomach and upper portion of the small intestine is examined using a narrow and flexible endoscopic probe. You will be given some sedatives intravenously, to relieve any kind of discomfort.
  • Endoscopic ultrasound (EUS) – This is somewhat similar to endoscopy, the only difference being that the device has an endoscopic probe at its tip. The technology uses soundwaves to generate images of the organs present in the abdominal cavity.
  • Biopsy – Biopsy is carried out on a sample of tissue collected from the tumour. This is done with the help of fine-needle aspiration which is performed along with the endoscopic ultrasound. In case it is not possible to collect the cells using this approach, the biopsy can be directly carried out on the tumour after it is extracted surgically.


Surgery – Surgery aims at removing the tumour along with the surrounding healthy tissues. It is usually recommended for large, localized and symptomatic GISTs. If cancer has spread to other areas of the body and cannot be extracted completely, surgery is either delayed or avoided. GIST’s can be extracted using a minimally invasive approach by laparoscopic means.

Targeted drug therapy – As the name suggests, the therapy works on specific weaknesses of the cancerous cells and blocks them. This helps to destroy the cancer cells. These drugs primarily target and attack tyrosine, an enzyme that is responsible for the growth of cancerous cells.

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