Surgery: If the size of GISTs is small, the surgeon removes them, along with some healthy tissues, by making a small incision on the skin. As GISTs rarely spread to the lymph nodes, the surgeon does not remove them. In some small GISTs, laparoscopic surgery, a minimally invasive surgery, may also be performed. The surgeon may also entirely remove the large GISTs by removing part of the digestive system, such as an intestinal section. The surgeon may also remove the tumor that has spread to other parts of the gastrointestinal system, such as the liver. Surgery is generally not recommended in GISTs that have spread to distant organs. However, some surgeons may recommend surgery if the patient responds to targeted therapy and there are not many metastatic tumors.
Targeted therapy: Certain specific chemicals in the cancer cells are vital for their existence. Targeted therapy targets these chemicals and damages the cancer cells. The targeted therapy's main target for managing GISTs is tyrosine kinase, which is essential for the growth of these tumors. The cancer specialist recommends targeted therapy in several conditions, such as post-surgery to lower the risk of recurrence, before surgery to shrink the tumor for easy removal, as first-line therapy when cancer spreads to other body organs, and in case of recurrence.
Ablation and embolization: The oncologist destroys the cancer cells through heat, cold, or chemicals during the ablation process. As ablation destroys nearby healthy tissues, it is not the preferred option for managing tumors near the vital organs, such as the diaphragm, major blood vessels, and liver. Some common ablation techniques are ethanol ablation, radiofrequency ablation, cryosurgery, and microwave thermotherapy. Embolization is a technique in which the cancer specialist blocks or reduces the flow of blood to the tumor cells in the liver. The liver is unique for having been supplied by two blood vessels. While branches of the portal vein supply the healthy liver cells, branches of the hepatic artery feed the cancerous cells. Blocking the hepatic artery branches may cause the cancer cell to die. However, embolization is not viable for people suffering from other underlying liver conditions, such as cirrhosis, as blocking the blood supply may also affect healthy liver cells. The techniques for embolization include trans-arterial embolization, radioembolization, and chemoembolization.
Radiation therapy: Radiation therapy involves using high-energy radiation to kill cancer cells. However, as radiation therapy is not very effective in treating the GISTs, it is not generally used. It may sometimes be used to manage cancer symptoms, such as bone pain. Once the oncologist decides to give radiation therapy, the patient undergoes a comprehensive examination to decide the dose and the angle of radiation beams. This preparation is known as simulation. It involves the use of imaging techniques to obtain images.
Chemotherapy: Chemotherapy involves using drugs to kill the rapidly dividing cells of the body, including cancer cells. The patients may receive the blood through the mouth or injection. Before the targeted therapy, the cancer specialists try conventional chemotherapy. However, these were ineffective and rarely caused the GISTs to shrink. Thus, chemotherapy is not often used today.
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