Requesting Extra Pathology Samples from Your Surgery

If you are scheduling surgery for your gastrointestinal stromal tumor (GIST cancer), you have the opportunity to ensure that plenty of tissue samples will be saved. You might need mutation testing later, and tissue would be needed for that purpose. Also, you might someday need a new analysis of new cell markers that researchers may identify. You may also want to donate samples to a GIST tissue bank.

Your surgeon is the physician who can request extra pathology samples to be saved. You can ask your surgeon to put in a request with the pathology department for extra samples beyond the pathologist’s immediate needs. The pathologist would need this information in advance.

In your pre-op visit, discuss with your surgeon your desire to have extra samples saved. You might request the following:

• extra paraffin blocks of tissue
• a frozen sample (the best type for mutation testing if you need that later)

Pathology departments retain tumor samples for 10 years, so these extra samples will be available through the pathology department of the hospital where your surgery is done.

Mutation testing is not done routinely on specimens and must be ordered by the surgeon. It is not needed for every GIST. Identification of exon 9 GISTs (which comprise about a third of GISTs arising from the small bowel) is helpful for determining the best dose of imatinib in the event of a recurrence or metastasis. Therefore, if your GIST has developed from the duodenum or the small intestine, especially if it is 5 cm or larger, then you might ask your surgeon to order mutation testing on your surgical sample.