Treatment of Gastrointestinal Stromal Tumours in Israel

What are Gastrointestinal Stromal Tumours?

Gastrointestinal stromal tumours (GIST) are neoplasms of mesenchymal origin, localized in various parts of the gastrointestinal tract. GIST were classified as a separate nosological unit relatively recently — about 20 years ago, but during this time, doctors from medically developed countries such as the USA, Israel, and Germany have thoroughly studied these neoplasms, resulting in a high effectiveness of treatment for gastrointestinal stromal tumours today.

GIST have a specific feature that distinguishes them from true smooth muscle and neurogenic neoplasms. GIST cells are involved in the overexpression of the oncogene KIT (CD117) — a tyrosine kinase receptor — with subsequent hyperactivation. Depending on the type of cells predominant in the tumour, GIST are divided into epithelioid, spindle cell, and mixed types of neoplasms. Although morphological studies of biopsy samples taken from GIST may show the tumour as benign, medical professionals assert that neoplasms in this group have a high malignant potential and the ability to metastasize. The tumour most commonly affects the stomach (60%), small intestine (25%), and large and rectum (5%); in other, extremely rare cases, GIST localizes in the esophagus, omentum, retroperitoneal space, or mesentery.

Symptoms of Gastrointestinal Stromal Tumours

GIST do not manifest themselves in the early stages of the disease; however, in later stages, the tumour may cause the following symptoms depending on its location:

• Gastrointestinal bleeding;
• Anemia and, consequently, weakness and rapid fatigue;
• Abdominal bloating;
• Nausea, vomiting, abdominal or intestinal pain;
• Melena;
• Skin rash.

As you can see, the clinical picture of GIST is not very informative; similar signs can manifest in almost any gastrointestinal disease, which is why gastrointestinal stromal tumours are often discovered accidentally during laparoscopy, CT scans, or surgeries for other reasons. This is quite unfortunate, as 15—50% of patients with GIST already have metastases in various organs of the abdominal cavity, bones, or lungs at the time of diagnosis. The doctors at the Top Ihilov Medical Center want to remind you that you should never ignore even the slightest changes in your body's functioning. In the case of any seemingly insignificant, unexplained deterioration in well-being, you should urgently consult a specialist.

Treatment of GIST at Top Ihilov

At the Top Ihilov Medical Center, the treatment of GIST is carried out in accordance with international standards. The success of treating gastrointestinal stromal tumours is due to the use of comprehensive therapy, which includes the following treatment measures.

Surgical removal of the tumour. GIST is removed without exception, even if the patient already has metastases in other organs. Surgery is only not performed if the patient is deemed inoperable. The surgeons at the Top Ihilov Medical Center follow these principles to enhance the effectiveness of the operation:

• The tumour is removed with at least 2 cm of surrounding unchanged tissue;
• In most cases, the greater omentum is removed;
• The neoplasm is removed very carefully to exclude the possibility of damaging the tumour capsule and disseminating cancer cells throughout the abdominal cavity;
• The surgeons conduct a thorough revision of the abdominal cavity.

Targeted therapy. At Top Ihilov, an innovative method of treating GIST with the drug Imatinib (GLIVEC) is actively practiced. The use of this drug statistically reduces the risk of GIST recurrence so significantly that its prescription is a standard worldwide.

Diagnosis of Gastrointestinal Stromal Tumours

Rapid and accurate diagnosis of GIST plays a significant role in the effectiveness of treatment. At the Top Ihilov clinic, a highly informative diagnostic program is used for examining patients with gastrointestinal stromal tumours, which includes the following types of examinations:

• Immunohistochemical analysis. The main diagnostic method that allows the determination of the overexpression of the oncogene CD117 through special studies (almost 100% proof of the presence of GIST in the body);
• X-ray, CT;
• Endoscopic biopsy;
• Endosonography.

In some cases, the tumour may not express CD117 sufficiently, making diagnosis difficult. In such cases, Israeli specialists use optional research methods: molecular biological studies to identify activating mutations of PDGFR, etc.

For any questions regarding the treatment of GIST, our specialists will answer you online. Here, on our website, you can also submit a request for the treatment of gastrointestinal tumours at Top Ihilov.