Surgery to remove all the tumour, or tumours, is usually the first choice. The tumour, with part of the organ it is attached to, will be removed. The aim is always to remove as much of the surrounding tissues as necessary to ensure that all the GIST cells have gone.

In cases where complete surgical removal of the tumour is not feasible, it may be possible to use surgery to reduce the size of the tumour ("debulking").

• GIST in the Stomach This will mean removing part or all of the stomach and possibly the spleen as well. The surgeons will try not to remove all the stomach unless it is absolutely necessary, because life after a total gastrectomy is much more difficult than life after a partial gastrectomy. Loss of the spleen is not a big problem: the patient just has to be careful as bacterial infections develop very fast. The patient may be put on antibiotics for life.

There is a very good description of stomach surgery available at http://www.cancerhelp.org.uk/. Follow the links for surgery for stomach cancer.

• GIST in the intestines Again, the tumour will be removed with as much of the gut as is necessary to be sure that it has all gone. Losing part of your gut is not usually much of a problem afterwards.

• GIST in the liver GISTs do not usually affect the liver first. GISTs in the liver are almost always secondaries from the stomach or gut. Liver surgery has only been possible fairly recently. Great advances are being made in the methods used, and it is now sometimes possible to remove GISTs from the liver surgically. It is also sometimes possible to use a new technique called Radio Frequency Ablation (or RFA). This is done through a tiny hole, and is much less invasive than surgery, but is only used on small tumours.