Thymoma & Thymic Carcinoma Treatment

Like all cancers, thymoma and thymic carcinoma treatment is most successful when patients have an experienced care team. With only a few hundred thymus cancers diagnosed a year, many doctors will see only a handful of cases during their career.

These cancers are not rare to UT MD Anderson, though. Our doctors treat numerous thymoma and thymic carcinoma patients every year, from the newly diagnosed to patients with metastatic or recurrent disease. This gives them incredibly deep skill and expertise to draw from when caring for patients.

These doctors work together in multidisciplinary teams. Together, they discuss each case and coordinate surgery, radiation therapy and cancer drugs into a comprehensive treatment plan tailored to each patient.

As a leading cancer center, UT MD Anderson can also offer thymoma and thymic carcinoma clinical trials for patients at all stages of the disease. This includes trials for new drugs, including targeted therapy and immunotherapy options.

Treatment plans

While each cancer is unique, thymomas that are smaller than four centimeters are usually removed with surgery. During this procedure, the entire thymus is removed.

Patients with larger tumors are usually given chemotherapy before surgery. This is meant to shrink the tumor, increasing the chance of a successful procedure. Patients at high risk of the cancer returning after surgery may undergo radiation treatment following the procedure.

If the tumor has spread beyond the thymus, patients can receive radiation therapy and cancer drugs like chemotherapy. Surgery may still be performed at the primary site and at places where the disease has spread. These procedures may help relieve symptoms and improve patient outcomes. They are done in coordination with radiation therapy and chemotherapy.

Thymic carcinoma is usually diagnosed at an advanced stage. Patients are typically treated with chemotherapy, radiation therapy and possibly surgery.

Thymoma & thymic carcinoma surgery

Surgery for thymus cancer can involve removing part of the organ, called a thymomectomy, or the entire organ, a thymectomy.

Thymomectomy

During a thymomectomy, doctors remove the tumor and a small section of nearby healthy tissue. This is a minimally invasive procedure that requires just three to four small incisions under and to the side of the patient’s breast.

The surgeon then inserts a small camera and special and a surgical tools into the incisions to remove the thymus. This approach offers a short recovery time and less pain than an open surgery.

Patients undergoing a thymomectomy are put under general anesthesia. The procedure usually takes around two to three hours. Patients typically spend just one night in the hospital.

Patients often do daily tasks like cooking and cleaning the day they leave the hospital.

If the patient has a desk job, they usually return to work in just a few days. If the patient’s job involves physical labor, they generally can resume light-duty work a few weeks after surgery.

Thymectomy for small tumors

For other small tumors a complete thymectomy may be needed.

This procedure is similar to the thymomectomy requiring just three to four small incisions under and to the side of the patient’s breast. With the help of a camera, the surgeon then removes the thymus with robotic tools.

Patients are put under general anesthesia for this procedure. The surgery usually lasts about two to three hours. Patients usually spend one to two nights in the hospital. If the patient has myasthenia gravis, an autoimmune disease that can cause thymoma, they may stay longer.

In most cases, there are few restrictions following surgery. Patients often can do daily tasks like cooking and cleaning, the day they leave the hospital.

If the patient has a desk job, they usually return to work just a few days after surgery. Patients whose job involves physical labor can resume light-duty work a few weeks after surgery.

Thymectomy for larger tumors

Larger tumors often require a sternotomy. During this procedure, the surgeon opens up the middle of the chest by cutting through the breastbone. In rare cases, the patient undergoes a sternotomy combined with a thoracotomy, which involves an incision on one side of the chest between two ribs.

These surgeries are performed under general anesthesia and usually take four to six hours. Patients usually stay in the hospital for three to five nights.

At the end of a sternotomy, the patient’s breastbone is held in place with wires. New bone tissue forms, reconnecting the sternum. This process takes around two months.

During this period, patients must not put any pressure on the breastbone that could break the wires. Routine daily activities are allowed, but patients should not do any heavy lifting or hard pressing with their arms/chest.

Patients who work a desk job are usually able to return to work after around two weeks of recovery. Patients whose job requires physical labor cannot return to work for at least two months.

Chemotherapy

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.

Chemotherapy is often part of a treatment plan to cure thymoma and thymic carcinoma. In these cases, it is combined with surgery and possibly radiation therapy. It is also used to help relieve symptoms in patients with advanced disease.

Learn more about chemotherapy.

Getting chemotherapy

Thymus cancer patients get chemotherapy through an IV infusion. Patients get one infusion every three weeks and four to six total infusions. Sessions typically last between one and three hours.

Chemotherapy side effects

Short-term side effects include:

• Nausea and vomiting
• Fatigue
• Low blood counts
• Sores in the digestive tract

Long-term side effects of chemotherapy include:

• Neuropathy, which causes pain, tingling or numbness in different parts of the body
• Damage to ear tissue, which can cause hearing and balance problems
• Kidney damage

These side effects can typically be managed with medications and other interventions. Patients should talk to their care team about any side effects they experience.

Read more about chemotherapy side effects.

Targeted Therapy

Targeted therapy drugs are designed to stop or slow the growth of cancer on the cellular level. These drugs are designed to interfere with, or target, the molecules or the cancer-causing genes that create fuel the cancer’s growth.

Targeted therapy is a treatment for recurrent or metastatic thymic carcinoma. It is not used to cure the disease. Instead, it helps control the cancer’s spread.

Read more about targeted therapy.

Getting targeted therapy

Depending on the drug, targeted therapy for thymic carcinoma can be taken in pill form or delivered through an IV infusion.

Targeted therapy side effects

The side effects of targeted therapy include high blood pressure, fatigue, diarrhea and skin reactions on the hands and/or feet.

Learn more about the side effects of targeted therapy.

Immune checkpoint inhibitors

Immune checkpoint inhibitors are a type of immunotherapy. They stop the immune system from turning off before cancer is completely eliminated.

These drugs are used only in limited cases for thymoma and thymic carcinoma.

Learn more about immune checkpoint inhibitors.

Getting immune checkpoint inhibitors

Thymoma and thymic carcinoma patients receive immune checkpoint inhibitors through an IV infusion.

Immune checkpoint inhibitor side effects

Thymoma and thymic carcinoma patients may experience severe side effects from these drugs. These side effects include inflammation of the heart muscle and severe muscle inflammation. Patients with myasthenia gravis may experience a flare up of that condition.

Read more about immune checkpoint inhibitor side effects.

Radiation therapy for thymoma & thymic carcinoma

Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors use these to accurately target a tumor while limiting damage to healthy tissue. 

Radiation therapy can be part of a plan to cure thymus cancer. It can also be used to manage advanced disease and help relieve symptoms.

Learn more about radiation therapy.

Intensity modulated radiation therapy

Intensity modulated radiation therapy (IMRT) focuses multiple radiation beams of different intensities directly on the tumor for the highest possible dose. Volumetric modulated arc therapy (VMAT) is a type of IMRT that utilizes a rotating treatment machine to deliver radiation at multiple angles.

IMRT can be part of a plan to cure thymus cancer in combination with other treatments.

It is also used to control the growth of advanced cancers and help relieve symptoms.

IMRT patients with lung cancer typically get three to six weeks of treatment every Monday through Friday. Each session usually lasts less than 30 minutes.

Proton therapy

Proton therapy is similar to standard radiation therapy like IMRT, but it uses a different type of energy that may allow doctors to target tumors with much more accuracy. This limits damage to nearby healthy tissue.

Proton therapy is often recommended to thymus cancer patients because it can limit radiation exposure to the heart. It is used to cure the cancer, either on its own or in combination with surgery.

This treatment is given every Monday through Friday for three to six weeks. Treatment sessions usually lasts less than 30 minutes.

Learn more about proton therapy.

Stereotactic body radiation therapy

Stereotactic body radiation therapy (SBRT) uses several radiation beams of various intensities aimed at the tumor from different angles. It precisely targets tumors with very high doses of radiation.

SBRT is used to help relieve symptoms and improve the patient’s quality of life. In some cases it is used to kill cancer cells that remain after other treatments.

Patients typically get one to five SBRT treatments, all in consecutive days. Sessions generally last less than 45 minutes total.

Read more about SBRT.

Radiation therapy side effects

The short-term side effects of radiation therapy for thymus cancer include:

• Fatigue
• Cough
• Skin changes
• Lung inflammation

Long-term side effects can include:

• Scarring of the lung tissue
• Heart damage
• Thyroid dysfunction

Doctors design radiation treatment plans to prevent or limit these problems and will recommend radiation only when it is the best treatment for the patient.

Patients should talk to their care team about any side effects they experience. These side effects can often be prevented or minimized with treatment.

Thymoma & thymic cancer clinical trials

As a top-ranked cancer center, UT MD Anderson offers patients access to thymoma and thymic carcinoma clinical trials. These trials may be a new treatment, or a new combination of existing treatments. Learn more about clinical trials.