Gastrointes­tinal Stromal Tumor (GIST)

A gastrointestinal stromal tumor grows when cells in your digestive system multiply out of control. You can get one anywhere in your GI tract — from your food tube (esophagus) to your anus.

A GIST can cause different symptoms in different people. You may have stomach pain, vomit or poop blood. You might not be hungry or be able to swallow food. Or, you might not have any symptoms at all. It depends on where the tumor is in your GI tract and how big it is. It’s important to pay attention to what your body’s telling you. And to share all of this with your healthcare providers.

What to expect at your first visit

At your first appointment, your provider will ask you to share what’s been happening and how you’re feeling. They’ll want to know:

• What kind of symptoms you’re having.
• How long you’ve had them.
• If they’re getting worse.
• How they’re affecting your life.
• If you’ve had any other GI conditions.
• If you’ve had any other kinds of cancer or tumors.
• If anyone else in your family has had cancer.

You’ll also have a physical exam so your provider can look for noticeable GIST symptoms. And they’ll also likely order other tests to help them confirm a diagnosis, like:

• Blood tests for cancer.
• Abdominal ultrasound.
• CT scan (computed tomography scan).
• MRI (magnetic resonance imaging).
• Upper endoscopy. 
• Biopsy.

Second opinions for gastrointestinal stromal tumor

When you’re diagnosed with a gastrointestinal stromal tumor, you may feel emotional and overwhelmed. And you’ll probably have a lot of questions. But one thing’s certain — you’ll want to be sure you get care from expert providers who understand how to treat this rare condition. That’s why we encourage second opinions. 

Getting a second opinion can make you feel more in control of your care. It can give you peace of mind knowing you have skilled, experienced providers taking care of you. When you come to us for a second opinion, we’ll help you better understand your diagnosis and go over the right treatment options for you. And because we know cancer doesn’t wait, we’ll try to meet with you as soon as possible. 

Meet Our Gastrointestinal Stromal Tumor Team

Your Cleveland Clinic team includes experts from different specialties who work together to make sure you get the most personalized care. You may see:

• Oncologists.
• Gastroenterologists.
• Surgeons.
• Social workers.
• Palliative care specialists.
• Pathologists.

Because GIST affects everyone differently — and can grow in many different places — your treatment will be highly personalized.

You may have a small tumor that doesn’t need to be treated right away. So, we might do “watchful waiting” and keep a close eye on what’s going on. Or maybe your tumor’s more aggressive (fast-growing) and needs more in-depth treatment. Your care team will work with you to find the best treatments for your needs and unique diagnosis. 

Surgery, ablation and embolization

Surgery is the main treatment for gastrointestinal stromal tumors. Some GISTs can be treated very successfully by surgery if we can remove all of the tumor. The specific type of surgery depends on the size of the tumor and where it is in your GI tract.

We can also treat some GISTs with ablation and embolization. Ablation uses heat, cold or chemicals to destroy cancer cells. Embolization limits blood flow to the tumor to slow its growth.

Targeted therapy

Targeted therapy is a new treatment that uses medications to target certain characteristics of GIST cells — and destroy them. And it doesn’t damage your healthy cells like chemotherapy does. 

We may recommend targeted therapy before or after surgery. This can improve your chance of a successful outcome and lessen the chance of the cancer coming back (recurrence). We can also use targeted therapy without surgery to improve your symptoms and slow cancer growth. This therapy can cause certain side effects, so we’ll keep a close eye on you. Targeted therapy medications for GIST include:

• Imatinib (Gleevec^®).
• Sunitinib (Sutent^®).
• Regorafenib (Stivarga^®).
• Avapritinib (Avakit^®).

Taking the Next Step

If you find out you have a gastrointestinal stromal tumor, you might have lots of questions and concerns about your diagnosis, treatment and long-term follow-up care. Our compassionate Cleveland Clinic providers are here to make sure you feel confident about moving forward with each step. Our team offers expert, personalized care and all the support you need — physically, emotionally and mentally — from day one.