Gastrointestinal Stromal Tumor (GIST)

Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal tract. They originate in the cells of the autonomic nervous system, that part of the nervous system that regulates body processes such as food digestion. About 60 percent of GISTs begin in the stomach; 30 percent arise in the small intestine. Some are found in the esophagus, colon and rectum. GISTs can be benign (non-cancerous) at first, but many can turn into cancer and these are then called sarcomas. Surgery is the usual treatment if the tumor has not spread.

Surgeons specializing in gastrointestinal stromal tumors at Brigham and Women’s Hospital (BWH) are the surgical team for the Gastrointestinal Cancer Treatment Center at Dana-Farber Brigham Cancer Center, a unique center uniting the world’s best gastrointestinal cancer experts. Our board certified surgeons are leaders in minimally invasive surgery, performing laparoscopic techniques in combination with targeted drug therapy.

Learn more about gastrointestinal stromal tumor (GIST).

Gastrointestinal Stromal Tumor (GIST) Topics

Risks Factors for Gastrointestinal Stromal Tumor (GIST)

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk.

Risk factors for gastrointestinal stromal tumors include the following disorders:

  • Retinoblastoma
  • Neurofibromatosis type 1 (NF1, von Recklinghausen disease)
  • Tuberous sclerosis (Bourneville disease)
  • Familial adenomatous polyposis (FAP, Gardner syndrome)
  • Li-Fraumeni syndrome
  • Werner syndrome (adult progeria)
  • Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
  • Carney-Stratakis syndrome
  • Familial history of GIST
Symptoms of Gastrointestinal Stromal Tumor (GIST)

Gastrointestinal stromal tumors may cause the following symptoms:

  • Abdominal discomfort or pain
  • Blood in stools
  • Vomiting
  • Feeling full after eating only a small amount
  • Loss of appetite or weight loss
  • Fatigue due to anemia
Diagnosis of Gastrointestinal Stromal Tumor (GIST)

Sometimes gastrointestinal stromal tumors are found by chance or seen on an exam for another problem. If you are having symptoms of GIST, your surgeon will ask about your health history, your family’s history of cancer and risk factors. Diagnostic tests may include:

Learn more about diagnostic tests for GIST.

Samples will be taken from the primary tumor, lymph nodes, and other suspicious areas. A pathologist views the tissue under a microscope to look for cancer cells and to find out the grade of the tumor. The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the cells are dividing. High-grade tumors usually grow and spread more quickly than low-grade tumors.

Pathologists at Dana-Farber Brigham Cancer Center are among the best and most experienced in the world with special expertise in providing an accurate diagnosis for complex cases. In many instances when asked to review a case to provide a second opinion, the diagnosis and treatment plan is changed.

Stages of Gastrointestinal Stromal Tumor (GIST)

After GIST has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body. This process is called staging.

Learn more about the stages of gastrointestinal stromal tumors.

Treatment for Gastrointestinal Stromal Tumor (GIST)

Surgical Treatment

Surgery—which removes the tumor from your body—is the primary treatment for a gastrointestinal stromal tumor (GIST) that hasn’t spread. Surgical oncologists at BWH are surgical specialists who are on the faculty at Harvard Medical School. They are among the national leaders in GIST surgery with special expertise in metastatic GIST surgery. The oncology surgeons at BWH are well known for having perfected many progressive surgical procedures including:

  • Laparoscopic surgery for small GISTS. Your surgeon makes several small incisions and inserts a thin lighted tube (with a tiny video camera) called a laparoscope through one of the incisions. He or she then uses long, thin surgical tools to remove the tumor through the other incisions.
  • If the tumor is large or growing into other organs, your surgeon could still remove it entirely. He or she might have to remove parts of organs (such as sections of the intestines) and GISTs that have spread elsewhere in the abdomen, such as the liver.
  • Transabdominal Inferior Retroperitoneal Approach (TIRA): a state-of-the-art minimally invasive, robotic surgical technique that removes GIST tumors with remarkable accuracy. This groundbreaking approach eliminates the need to create a large, open incision or reposition organs during surgery, which means less blood loss, faster recovery times and fewer complications for patients.

    Through strategically placed dime-sized incisions, this procedure provides an alternative to the more complex Whipple surgery, which is also known for being the standard surgery for pancreatic cancer. (It should be noted that TIRA is not suitable for pancreatic cancer.)

    TIRA was specially developed for treating GIST tumors, specifically those located in the duodenum or near the aorta and vena cava, where removing a significant amount of surrounding tissue is typically required. By using the TIRA approach, only a small amount of surrounding tissue needs to be removed for effective treatment.

Non-surgical Treatment

  • Targeted therapy drugs
    • Gleevec (imatinib) is used for patients with advanced-stage GIST, and may help patients with earlier-stage tumors, either before or after surgery.
    • Sutent (sunitinib) targets the KIT and PDGFRA proteins.
  • Radiation therapy is used to shrink the tumor before surgery or kill cancer cells that are left after surgery. It can sometimes be the main treatment if surgery isn’t an option.
  • Chemotherapy drugs can also be used with or instead of surgery and are often the first treatment when the cancer has spread.

Radiation Therapy


What You Should Expect

You will receive a thorough diagnostic evaluation to determine your course of treatment. Careful monitoring and the involvement of an experienced surgical oncologist are important to the successful outcome for patients with GIST.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be cared for in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with GIST. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

The Center for Sarcoma and Bone Cancer at Dana-Farber Brigham Cancer Center provides advanced and innovative multidisciplinary care for patients with sarcoma, including gastrointestinal stromal tumors. Our treatment team includes surgical oncologists, pathologists, medical and radiation oncologists, plastic surgeons, nutritionists and anesthesiologists. In addition, patients have full access to BWH's world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.


Learn more about gastrointestinal stromal tumor (GIST) in our health library.

Learn more about treatment for GIST at Dana-Farber Brigham Cancer Center.

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Visit the Weiner Center for Preoperative Evaluation.

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