Treatment of Gastrointestinal Stromal Tumors in Israel

What are Gastrointestinal Stromal Tumors?

Gastrointestinal stromal tumors (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, which has led to a high effectiveness of treatment for gastrointestinal stromal tumors 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 tumor, GIST are divided into epithelioid, spindle cell, and mixed types of neoplasms. Although morphological studies of biopsy samples taken from GIST may show the tumor as benign, medical professionals assert that neoplasms in this group have a high malignant potential and the ability to metastasize. The tumor most commonly affects the stomach (60%), small intestine (25%), large intestine, and rectum (5%); in other, extremely rare cases, GIST is localized in the esophagus, omentum, retroperitoneal space, and mesentery.

Symptoms of Gastrointestinal Stromal Tumors

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

• 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 tumors are often detected accidentally during laparoscopy, CT, or surgery for another reason. 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. Doctors at Top Ichilov Medical Center want to remind you that you should never ignore even the slightest changes in your body's functioning. In case of any seemingly insignificant and unexplained deterioration in well-being, you should urgently consult a specialist.

Treatment of GIST at Top Ichilov

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

Surgical removal of the tumor. GIST is removed as a matter of course, even if the patient already has metastases in other organs. Surgery is only not performed if the patient is deemed inoperable. The surgeons at Top Ichilov Medical Center follow these principles to enhance the effectiveness of the operation:

• The tumor 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 avoid damaging the tumor capsule and disseminating cancer cells throughout the abdominal cavity;
• The surgeons conduct a thorough revision of the abdominal cavity.

Targeted therapy. At Top Ichilov, an innovative method for 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 Tumors

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

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

In some cases, the tumor does not express CD117 sufficiently, which complicates diagnosis. In such cases, Israeli specialists use optional research methods: molecular biological studies to identify activating mutations in PDGFR, etc.

For any questions regarding the treatment of GIST, our specialists will answer you online. Here, on our website, you can also submit an application for the treatment of gastrointestinal tumors at Top Ichilov.