New treatments improve outlook for patients with rare intestinal tumour

The Nation on Sunday

BANGKOK: -- The Thai Society of Clinical Oncology (TSCO) on Friday looked back on a decade of advancement in the technologies used to treat patients with Gastrointestinal Stromal Tumour (GIST), a cancerous tumour of the gastrointestinal tract that has long been difficult to diagnose and cure.

GIST patients tend to face recurrences of the disease after treatment, and the tumour cells can spread to other organs as well. But thanks to recent medical advancements, a new treatment called "targeted therapy" has been developed that reduces the risk of GIST recurrence, thereby prolonging the lives of patients.

TSCO president Dr Sudsawat Laohavinij said GIST, first identified around 30 years ago, differs from other gastrointestinal tract cancers because it arises from precursor cells, or cells that control the digestive tract's muscular contractions; hence, it can be found in various parts of the gastrointestinal tract. The most frequent sites for GIST are the stomach and small intestine.

There are 4,000 to 5,000 cases of GIST a year in the US, and about 250 cases a year in Thailand. These figures are regarded as very low when compared with other gastrointestinal tract cancers, but the rate is increasing.

GIST has long been considered difficult to diagnose and cure because patients rarely show any symptoms when the tumour develops in the abdominal cavity in the first phase. It is frequently found that tumours have become large by the time of diagnosis and that the cancer has spread to various organs, such as the liver and peritoneum.

Many treatment methods have been used; some patients undergo an operation to remove the tumour from the abdominal cavity, but there is a high risk of recurrence and some use chemotherapy and radiation. However, GIST patients are often found to be resistant to chemotherapy and radiation treatment, making recurrence or spread of the cancer to other organs likely. Nevertheless, GIST treatment has improved with the use of additional treatment called "adjuvant therapy" following complete surgical resection of GIST tumours, without the disease spreading. New research suggests that adjuvant therapy can reduce the risk of recurrence.

Country president of Novartis (Thailand) Ltd, Richard Abela, said the firm is pleased to cooperate with TSCO. In line with its commitment to support the government's health policies, the firm is engaged in enhancing knowledge provision on GIST to Thais and supporting scientific programmes to develop medical personnel's skills in GIST diagnosis and treatment in Thailand.

Since GIST is an uncommon condition, requiring expert skills to diagnose accurately, the firm has established the GIST Alliance Initiative. Its programmes include GIST public education provision through media, patients and caregivers; the GIST Sure campaign to increase efficiency of GIST diagnosis among pathologists and radiologists; disease and patient management in a multidisciplinary team approach; as well as supporting scientific meetings.

The firm has also initiated programmes to enhance affordability and access to medicines and treatments. The International Patient Assistance Programme (GIPAP) was launched in 2002 to provide the cancer drug Imatinib to CML (a type of leukaemia) and GIST patients who have financial difficulties, at no cost. There are over 50,000 patients in 80 countries participating in this programme.

In Thailand, Novartis has operated GIPAP for nine years since 2003. GIPAP has provided assistance to over 3,000 patients since then. At present, there are 52 GIPAP centres and 147 GIPAP physicians all over Thailand and over 1,600 patients are currently enrolled, including 524 GIST patients and 1,112 CML patients.

Samran Somjai, a GIST patient for over seven years, said he had a tumour in his stomach, but at first he simply thought he had gained weight. After developing a severe stomach ache, he was told by a doctor that he had GIST, and required treatment right away. Shocked and stressed about this news, he retired from work for two years, and his mother took care of him and encouraged him. The treatment helped him get through this terrible period, and he now takes good care of his health, taking his medicine on time and strictly complying with his doctor's instructions.

"I'm quite lucky because I have been well treated and received efficient medication, so I can live normally and also have a chance to look after my mother again," Samran said.

-- The Nation 2012-12-02

although genetics can tend to be a factor, the lack of maintaining a proper diet is the main culprit with those who contract Intestinal cancers....Eat cleaner and better..stay away from the McDonalds and other fast foods, ...bad oils, fatty foods, processed foods etc...Eat Right..Its that simple

It seems a lot of effort for 250 cases a year as opposed to standard cases of cancer. Lie pancreatic and liver cancer I would not wish it on anyone.