Is your stomach ache not just a stomach bug? Let's talk about GIST (Gastrointestinal Stromal Tumor)!

Do you also sometimes have an upset stomach, or a stomach ache, or a feeling of heaviness? Sometimes we think that a food is bad, "gastric upset", or just "flatulence". But, think about it, sometimes there can be a more serious story behind such small symptoms. One such, not so common, but very important to know about cancerous condition is GIST, which stands for Gastrointestinal Stromal Tumor . Let's talk about this in a little more detail, but very simply, okay?

What is this gastrointestinal stromal tumor (GIST)?

Simply put, GISTs are cancerous tumors that form in the walls of your digestive tract —the part of your body where food and drink travel from your mouth to your stomach and then through your intestines to be digested. These tumors, to be precise, fall into what doctors call a ' soft tissue sarcoma.'

Now think about it, some GIST tumors are very small, like a pencil eraser or a pea. If it's a very small tumor, you may not even notice it or feel any pain. However, some tumors start to grow over time. That's when these GISTs can start to cause you various symptoms and other health problems. Most of the time, doctors treat this GIST condition by performing surgery to completely remove the tumor or tumors.

How common is this condition called GIST?

In fact, GIST is a very rare type of cancer . Even when compared to other countries in the world, it is the same. For example, in a country like the United States, only 4,000 to 6,000 new cases of GIST are diagnosed each year. So you can imagine how rare this condition is. That's why it's important to be aware of it, so that if you experience symptoms, you can seek medical advice quickly.

What are the symptoms of a GIST?

As we mentioned earlier, if GIST tumors are very small, you may not experience any symptoms. Most of the time, a GIST tumor is discovered incidentally during a test, such as an abdominal scan, or during another surgery.

However, as the lump gets larger, or depending on its location, some symptoms may appear. These are the most common symptoms:

• Feeling a stomach ache or discomfort . This can simply be a feeling of fullness or something stuck in your stomach.
• Blood in your stool or blood-stained stool. Sometimes the stool can be dark black, which is also a sign of internal bleeding.
• Constipation means not having a bowel movement for several days.
• AlwaysFeeling very tired and exhausted . As if there is no life in the body.
• Losing weight without you trying.
• Anorexia means not wanting to eat.
• Vomiting blood . This is a somewhat serious sign.

If you've been experiencing one or more of these symptoms for a while, it's wise to see a doctor and get checked out, rather than just wondering, "What's that?"

What are the causes of GIST?

Most of the time, GIST develops when there is a change, or mutation, in a gene called KIT in our body. Think of it this KIT gene is like a little messenger that tells some cells in our digestive system to "divide and multiply." So, when there is a defect in this gene, those cells start dividing and multiplying too quickly and uncontrollably. That lump, or GIST, is formed when those cells grow uncontrollably. This gene mutation usually occurs after we are born, during our lifetime. It is not something that is inherited from parents to children.

This KIT gene tells cells to make a protein called KIT CD117 . This protein stimulates the division of cells in the digestive system. In GIST, this process goes awry, causing tumors to form.

However, although very rare, some hereditary conditions may slightly increase the risk of developing GIST. Some of these conditions include:

• Familial GIST syndrome: This is very rare. What happens here is that a defect in the KIT gene is inherited from parents to children. If this happens, the risk of developing GIST increases. Also, GIST can develop at a younger age than usual and more than one tumor can develop.
• Neurofibromatosis type 1: This is also a genetic disease. It causes certain types of cells to grow out of control and form tumors in various parts of the body. GIST is one type of tumor that can develop in this way.
• Carney-Stratakis syndrome: This is also a very rare, hereditary condition. People with this condition are also at higher risk of developing GIST than others.

How is GIST diagnosed?

When you go to see a doctor with the symptoms mentioned above, he will first ask you about your symptoms, how long they have been present, and then he will do a physical examination . This means things like feeling your stomach.

In addition, your doctor may order several other tests to confirm whether you have a GIST, its size, and whether it has spread. The main ones are:

• Upper endoscopy:This involves inserting a tube with a small camera through your mouth and examining the inside of your throat, esophagus (food pipe), and stomach. This allows you to see directly if there is anything, such as a lump.
• CT scan: This uses X-rays to take detailed pictures of the inside of your abdomen. This can help determine the size and location of the lump.
• Positron emission tomography (PET) scan: This is also a special type of scan. It helps find out how active the cancer cells are and whether they have spread to other parts of the body.
• Biopsy: This is the test that is used to confirm whether you have GIST. This involves taking a very small piece of tissue from the lump and having it examined under a microscope by a pathologist . This will help determine if it is GIST or something else. Sometimes the biopsy can be done at the same time as the endoscopy.

How is GIST treated?

The main person who treats GIST is an oncologist . GIST is usually treated with surgery to remove the tumor. However, the type of treatment that is right for you will depend on what the tests find. This means that doctors will look at things like the size of the tumor, where it is located, and whether it has spread (metastasized) from where it first started.

For example:

• If the lump is very small, your oncology surgeon may be able to remove it completely with surgery. Then, no other treatment may be needed.
• But if the tumor is very large or in a difficult-to-operate location, your oncologist may decide to give you a type of medication called targeted therapy to shrink the tumor before surgery. These medications target and attack specific things that help the GIST cells grow. This shrinks the tumor and makes it easier to operate on. Sometimes, these targeted therapies can be continued after surgery to stop GIST from coming back.

Remember, not all GIST patients receive the same treatment. Your medical team will discuss with you the best treatment plan for your situation.

What are the side effects of the treatment?

As with any medical treatment, GIST treatment can cause some side effects.

Some possible side effects of targeted therapy:

• Obstruction
• Diarrhea (stomach ache)
• Tiredness and fatigue
• Muscle cramps
• Nausea (feeling like vomiting)

Common side effects that may occur during surgery:

• Reactions to anesthesia (e.g., dizziness, vomiting)
• Pain at the surgical site
• Bleeding

These side effects do not happen to everyone the same way. Some people may experience several of them, while others may not experience any. If you feel any discomfort, be sure to tell your doctor or nurse. Most side effects can be managed.

What should I expect next if I have a GIST?

Even after treatment is complete, your oncologist will continue to monitor you. This means that you will be asked to come in for follow-up appointments at regular intervals to check on your recovery and general health. These appointments are usually every three to six months.

During these visits, your doctor will ask you about your symptoms, examine you, and may also do other tests, such as scans, to see if the GIST has come back or how it is responding to treatment. Common tests include:

• CT scans of the liver and pelvis.
• MRI scans (Magnetic resonance imaging (MRI) scans) .
• PET scans to see the response to targeted therapies.

Your doctor will decide how often you should have these tests, depending on your condition.

What is the survival rate with GIST?

This is a sensitive issue. The survival rate for someone with GIST varies from person to person. There are several factors that go into determining this. For example, the size of the tumor when GIST is diagnosed, how active it is, your overall health, and how the tumor responds to treatment.

According to data collected from institutions such as the US National Cancer Institute (NCI) , about 85% of people with GIST are still alive five years after the disease is diagnosed.

However, when you see statistics like this, you should keep a few things in mind:

• These are just estimates: they are based on the experiences of many people who have had GIST before. Your situation may be very different. For example, your age and whether you have other medical conditions can affect these numbers.
• These numbers are historical: data is collected about every five years. So, the impact of the latest treatments is not included in these numbers. With new treatments, these numbers could get even better.
• Survival rates and life expectancy are two different things: A survival rate does not tell you how long you will live. Life expectancy data is especially difficult to obtain for people with GIST.

So, don't get overwhelmed by these numbers. If you have any questions, ask your oncologist. He or she will be able to explain how these statistics apply to your situation.

How do you take care of yourself?

Taking care of your overall health is the best thing you can do for yourself, both during and after treatment for GIST.

• Eat well: Try to eat a varied diet that is high in protein, low in fat, and as much as possible. Include greens, vegetables, and fruits in your daily diet. A balanced diet will give your body the energy to recover quickly.
• Get some exercise: Being sick can be stressful. While you're recovering from treatment, light exercise (like walking) can help you reduce stress. However, you should always talk to your doctor before starting a new exercise routine or before you resume an exercise routine you've been doing.
• Avoid smoking completely: Using any type of tobacco product (including electronic cigarettes) increases the risk of developing a new cancer, as well as the risk of a GIST recurring.

A condition like GIST may not cause any major symptoms at first. Even if you do, you may think it's just indigestion or the stomach flu. So, finding out that you have a rare cancerous tumor like this can be a huge shock. If you have this condition, take some time to educate yourself about this rare disease and your treatment options. In many cases, treatment can relieve your symptoms and even cure GIST. You will have many questions. Your medical team will be there to answer all of them and support you.

Finally, things to remember

Although GIST is something to be afraid of, it is a condition that can have good outcomes if you are aware of it and receive timely treatment.

• Don't ignore: If you have any unusual, persistent stomach pain, signs of bleeding, or unexplained weight loss, seek medical advice.
• Accurate diagnosis is important: Special tests are needed to diagnose GIST. Therefore, seek a specialist opinion.
• There are treatments: There are effective treatments for GIST, such as surgery and targeted therapy.
• You are not alone: ​​your medical team, family, and friends will help you on this journey.

The most important thing is to stay strong and follow medical advice.

` Gastrointestinal stromal tumor, GIST, cancer, digestive system, KIT gene, surgery, targeted therapy