What is Gastrointestinal Stromal Tumor?
Gastrointestinal stromal tumor (GIST) is a soft tissue sarcoma that can be found in almost all parts of the digestive system. The most common locations are stomach and small intestine.
Gastrointestinal stromal tumor (GIST) is a rare tumor in the GI tract. The earliest Tumor appears in one part of the digestive system called interstitial cell of Cajal (ICC).
ICCs are the cells of the autonomic nervous system, part of the nervous system that regulates body processes such as food digesting. ICCs are sometimes called “pacemakers” of the gastrointestinal tract because they signal the muscles in the gastrointestinal tract to contract to move food and fluids.
GIST starts in the special nerve cells located on the walls of your digestive system. These cells are part of the autonomous nervous system. The specific changes in the DNA of one of these cells, which controls the process of digestion such as the movement of food through the intestines, giving rise to GIST.
Not chronic GIST usually does not cause symptoms, and this disease can grow very slowly so as not to have any serious effects.
Factors causing Gastrointestinal stromal tumor
The cause of gastrointestinal stromal tumors is unknown, but some factors influencing it, are:
- Age – the most common GIST sufferers are persons over 50 years old
- Genetics – Although most GISTS are not inherited, but in very rare cases, GIST is found in some people in one family.
- According to research, a condition called neurofibromatosis (NF) can increase the risk of GIST.
Symptoms of Gastrointestinal Stromal tumors
The symptoms of this tumor appear depending on the position, size and stage of the tumor. Common symptoms are:
- Abdominal pain or discomfort
- Blood in the stool
- Anemia
- Lump in the stomach
- Vomiting, sometimes bleeding
- Fatigue and weakness
- Fever and night sweats
- Weight loss.
Is GIST cancer?
GIST can be benign or cancerous. The larger the GIST size, the more likely it is cancer. However, GISTS that are small and seemingly benign can behave like malignant cancers.
Gastrointestinal stromal tumors can spread to other parts of the body, most often to the peritoneum and liver. The only way to determine whether GIST is benign or cancerous is by removing it surgically. The doctor then examined the tumor to determine the risk of recurrence. High-risk features for relapses are:
- Large size
- High mitosis count or number of active cells splitting and expanding
- Rupture or spill
- Positive surgical margins
How to prevent Gastrointestinal Stromal Tumor
There is no way that it can completely prevent the GIST because it is related to genetic disorders in the composition and mutation of genes within the body.
Prevention can only be done through lifestyle changes, especially in people who often have gastrointestinal complaints and old age. Poor living habits such as smo**king and consuming alco**hol should be discontinued as one of the triggering factors of GIST.
How to treat Gastrointestinal Stromal tumors?
Small GIST only need periodic observation by the expert doctor. But for larger tumor size, surgical action and anti-tumor drug therapy.
The only non-surgical treatment is given therapy of the tyrosine kinase inhibitors (TKI) Imatinib Mesylate. The use of imatinib is chosen in the conditions:
- Treatment of non-resectionable, metastasis GISTS, or both
Pre-surgical treatment of GIST that can be reseeded with negative margins, but with significant morbidity risk - Additional treatment after complete GIST resection, to reduce relapse
- The use of imatinib can be guided by the genotype of KIT mutations and PDGFRA.
The drug is administered for approximately 1 month at a dose of 800 mg per day. Other drugs, sunitinib Malate can be given to imatinib resistant GIST.
In large-size or symptomatic GIST should be removed through surgery unless it is too large or involves too much organ and tissue to resection. Resection should be avoided in people who have risk of health care or who have a metastatic GIST.
GIST resection can use minimally invasive surgery, by inserting a laparoscope and surgical instrument through a small incision in the stomach.
Read also: What is Gastroenteritis: Signs, Symptoms, Causes, and Transmission
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