Gastrointestinal Stromal Tumor (GIST) Treatment Program

Overview

The Mass General Cancer Center offers a collaborative and caring approach to the diagnosis and treatment of patients with confirmed or suspected GIST. Consistently ranked as one of the best in the country by U.S. News & World Report, we provide the latest, most effective treatments including many innovative approaches to clinical care and promising new therapies, including:

• Expertise in minimally invasive surgery for GIST, including laparoscopic tumor resections, as well as in complex surgery for metastatic GIST
• Innovative endoscopy approaches, provided by New England’s only Advanced Endoscopy Service in collaboration with Mass General’s Digestive Healthcare Center
• Rapid diagnosis and staging of all biopsied tumors by pathologists who special in stromal tumors

Expertise in Diagnosing and Staging GIST

Our pathologists sub-specialize in GI cancers, and are internationally recognized and consulted on the diagnosis of GIST. They participate in weekly tumor board meetings, sharing information about each patient’s unique cancer with the entire care team to help guide treatment planning.

All members of our diagnostic radiology team are nationally recognized for expertise in using the most advanced imaging tools to diagnose and stage GIST cancers and to detect changes in tumors. Our imaging technologies include:

• High-speed two- and three-dimensional CT studies
• Positron Emission Tomography/Computed Tomography (PET/CT)
• Magnetic Resonance Imaging (MRI)
• Intraoperative Ultrasound
• Lymphotrophic Nanoparticle Enhanced MRI (Molecular Imaging)
• Other services include:
• Tumor perfusion imaging with CT and MRI
• Spectral imaging with CT
• 3D imaging for pre-surgical planning and for monitoring treatment effects

Medical Oncology

For many patients diagnosed with GIST, chemotherapy may be the most effective treatment. Some new cancer therapies that are currently available or in development are designed to block mutations and pathways that cause tumor cells to proliferate. By targeting tumor gene mutations with these “smart drugs”, our doctors are beginning to understand how to eradicate malignant cells in some patients' tumors without using standard chemotherapy and radiation. GIST tumors often respond to oral anti-tumor drugs that have very few side effects.

Excellence in Surgical Care

GISTs may be locally advanced at the time of diagnosis. The disease typically involves the stomach and intestinal tract. Aggressive drug therapy is implemented to shrink the tumor prior to surgery to permit optimal tumor resection with preservation of normal organ function. Our surgeons specializing in GIST have pioneered many now-standard procedures and minimally invasive surgical techniques that aid in rapid recovery, such as laparoscopic resection of GIST tumors of the Gastroesophageal Junction.

In addition, our surgeons have extensive expertise in performing complex, multi-organ resections for locally advanced and metastatic GISTs. Our surgeons' high-volume experience and advanced laparoscopic skills help ensure the best outcome for each patient. We also offer one of the few operating rooms specially designed to facilitate complex procedures, allowing physicians and surgeons of different subspecialties to work side-by-side.

Surgical options that may be discussed for your care include:

• Resections
• Percutaneous Portal Vein Embolization
• Neoadjuvant Chemotherapy

Multidisciplinary Patient Care

Our team approach ensures that every patient benefits from an individualized, coordinated and compassionate treatment plan, with care provided by leading experts from many specialties. We consider patients and their family and friends involved in their care to be part of this team. Depending on the stage and other characteristics of your GIST this treatment plan may include surgery, chemotherapy, radiation, or a combination of these therapies.

Your care team may include:

• Pathologists and radiologists who sub-specialize in gastrointestinal (GI) cancers to provide a precise diagnosis of your cancer
• Surgeons and Surgical Oncologists who are leading the way in performing and developing the most advanced surgical approaches for GIST
• Gastroenterologists specializing in digestive health
• Endoscopists skilled in performing minimally-invasive diagnostic and interventional procedures
• Medical Oncologists who plan the most effective chemotherapy and immunotherapy treatments
• Radiation Oncologists who specialize in delivering the optimal therapeutic dose while protecting healthy tissue
• Oncology nurses and nurse practitioners who care exclusively for patients with cancer
• Oncology psychiatrists and social workers experienced in helping with the cognitive side effects of cancer and treatment, as well the emotional and spiritual aspects of the cancer experience
• A nutritionist to help you with questions about diet and nutrition during treatment
• Palliative care providers to improve quality of life

Members of your care team meet regularly with you and your referring physician to ensure clear communication and seamless coordination of care.

Our multidisciplinary team of gastrointestinal stromal tumor cancer (GIST) specialists provides individualized care and compassionate support services tailored to the needs of each patient. Care for GIST at Mass General combines clinical expertise with the most advanced medical technologies, research and clinical trials available to offer every patient the most appropriate therapies. We are dedicated to ensuring that patients fully understand their diagnosis and treatment options.

Patients are usually seen within one week of referral.

Developing Better Therapies through Research

Our research program in gastrointestinal stromal cancer is a multifaceted effort designed to better understand cancer biology, discover new therapies and improve treatment. The research program in GIST and all GI cancers is one of New England's largest, allowing us to bring promising new treatments to patients as quickly as possible.

Patient Education

For many patients diagnosed with GIST, chemotherapy may be the most effective treatment. Some new cancer therapies that are currently available or in development are designed to block mutations and pathways that cause tumor cells to proliferate. By targeting tumor gene mutations with these “smart drugs”, our doctors are beginning to understand how to eradicate malignant cells in some patients' tumors without using standard chemotherapy and radiation. GIST tumors often respond to oral anti-tumor drugs that have very few side effects.

Clinical Trials

The Cancer Center is a leading provider of clinical trials in New England for GISTs, making clinical trial evaluation of new therapies a key treatment option. The goal of the clinical trial is to seek and answer scientific questions and to find better ways to prevent, diagnose or treat cancer. 

View clinical trials.