Surgery for thymus cancer

Whenever possible, surgery is used to treat thymus cancers. If you have thymus cancer, one of the first things your doctor will do is to try to determine whether or not the cancer is completely resectable (removable) with surgery.

The most common surgery for thymus tumors is complete removal of the thymus (including any tumor). This is called a thymectomy. In most cases the surgery is done through a median sternotomy, an incision down the middle of the chest that splits the sternum (breast bone), permitting thorough removal of the thymus and tumor.

If the tumor has grown into nearby structures, the surgeon may also need to remove parts of those structures in order to remove all areas of tumor spread. This could mean removing parts of the pleura (tissue coating the lung), pericardium (the sac containing the heart), nerves, the superior vena cava (a large vein leading to the heart), and/or lung.

Some doctors may advise surgery even if the tumor is not completely resectable, as is the case with many stage III thymomas and with most stage IV thymomas. In these cases, the doctor might remove as much tumor as possible (called debulking), and then recommend further treatment with radiation therapy and/or chemotherapy. But not all doctors agree that surgery helps people live longer in these situations. In some cases, chemotherapy or radiation therapy may be given before surgery to try to shrink the tumor so that it can be more easily removed completely.

Possible side effects of surgery

Possible complications depend on the extent of the surgery and your health beforehand. Serious complications can include excessive bleeding, wound infections, and pneumonia.

You will need to stay in the hospital for several days after the surgery. Because the surgeon usually will have to open your chest for the operation, the incision will hurt for some time after surgery. Your activity will be limited for at least a month or two.

Some people may need to have part or all of a lung removed. If your lungs are in good condition (other than the presence of the cancer) you can usually return to normal activities after a lobe or even an entire lung has been removed. If you already have lung problems such as emphysema or chronic bronchitis (which are common among heavy smokers), you may become short of breath with activities after surgery.

For more general information about surgery, please see the separate American Cancer Society document, Understanding Cancer Surgery: A Guide for Patients and Families.