Gastrointestinal Stromal Tumour (GIST) Surgery

Dr. Tan Chun Hai
Upper Gastrointestinal Specialist, Dual Fellowship Trained Surgeon
MBBS (Melbourne), Masters of Medicine (Surgery), FRCS (Edinburgh), FAMS (General Surgery)
Table of Content
Introduction
What are gastrointestinal stromal tumours?
Gastrointestinal stromal tumours (GISTs) are a type of cancer that can form anywhere along the digestive tract, usually the stomach or small intestine.
GISTs are thought to be the growth of cells that form from a special type of nerve cells. These cells are present in the walls of the digestive organs.

Treatment for gastrointestinal stromal tumours
When the tumours are large or involve other organs, targeted treatments may be prescribed to shrink the tumours prior to surgery. For GISTs that are smaller than 2cm and present no symptoms, your doctor may put you under monitoring to look out for changes.

Genetic Risk Factors
Possible genetic risk factors of GIST that have been identified by researchers include:
- Primary familial GIST syndrome – Caused by an abnormal KIT gene passed from parent to child.
- Neurofibromatosis type 1 (or von Recklinghausen disease) – Caused by a defect in the NF1 gene, which may have been inherited from a parent. In some cases, the change occurs before birth and not inherently.
- Carney-Stratakis syndrome – Caused by a change in one of the succinate dehydrogenase (SDH) genes passed from parent to child. People with this rarely inherited syndrome have an increased risk of GISTs as well as nerve tumours known as paragangliomas. GISTs may develop when these people are in their 20s (or younger). There is also an increased chance of having more than 1 GIST.
Other risk factors may include tobacco use, excess weight and poor nutrition, although they are not standalone risk factors of GIST. Statistics also show that people who refrain from smoking, maintain a healthy weight and sustain a balanced diet have a lower overall cancer risk.

Symptoms of GIST
Most cases of GIST present no symptoms and are discovered through diagnostic procedures such as an endoscopy or CT scan. When they do, symptoms of GIST include:
- Gastrointestinal bleeding
- Abdominal pain or discomfort
- A mass or swelling in the abdomen
- Symptoms of anaemia such as fatigue, dizziness and shortness of breath upon exertion

GIST Risk Factors
At present, very few GIST risk factors are known. Among them are advanced age. While GIST has been diagnosed in people of all ages, the condition is rare in people younger than 40 and more common in those ages 50 and above.
In rare cases, GISTs have been found in members of the same family who have inherited a gene mutation that can lead to GISTs.
Experiencing digestive disorders or possible symptoms of GIST? Make an appointment to consult our specialist today.
For emergencies after clinic hours, head to Gleneagles Urgent Care centre (UCC) and request for Dr. Tan Chun Hai.
Diagnosis
How are gastrointestinal stromal tumours diagnosed?
1. Endoscopy
An endoscopy is usually the primary method to diagnose patients with gastrointestinal bleeding. Your doctor will insert a thin flexible tube (an endoscope) into your digestive tract to look for abnormalities. Built into the endoscope is a camera and tools to obtain tissue samples, which will then be sent for a biopsy to confirm the presence of cancers or other health conditions.
2. Endoscopic Ultrasound
An endoscopic ultrasound (EUS) can be used to find the location and size of a GIST and find out how deeply the GIST has grown into the walls of the digestive tract and other organs. It can also be used to guide and enable a precise and deeper biopsy of the tumour.
3. CT Scan
A CT scan is an imaging procedure to investigate swelling within the abdomen, find the location and size of a tumour, as well as to see if the disease has spread to other parts of the body.
20+ Years of Clinical Experience
Dr Tan Chun Hai (陈俊海医生)
Upper Gastrointestinal, Bariatric & General Surgeon
Endoscopy & Minimally-Invasive Surgery Specialist
Dr. Tan Chun Hai is a dual fellowship-trained specialist in Laparoscopic (keyhole) Stomach Cancer Surgery and Bariatric & Metabolic Surgery. He is proficient in minimally invasive surgical techniques, treating conditions such as gallstones, appendicitis, GERD, and upper gastrointestinal cancers of the stomach and oesophagus.
In addition to his surgical expertise, Dr Tan specialises in performing endoscopies and managing a wide range of digestive disorders. These include abdominal pain, bloating, heartburn and dysphagia (difficulty swallowing).
When applicable, Dr. Tan provides same-day treatment within a few hours of diagnosis. Dr. Tan subscribes to a less invasive practice, promoting less postoperative pain and shorter hospital stays.
Have a concern?
Send us your enquiry or give us a call at 6250 5610
For emergencies after hours, send us a text via WhatsApp > head to Gleneagles Urgent Care Centre and request for Dr. Tan Chun Hai
Our Clinic: 6A Napier Road, Gleneagles Hospital Annexe Block, #05-36A, Singapore 258500