If You Have Thymus Cancer

Cancer can start any place in the body. Cancer that starts in the thymus is called thymus cancer. It starts when cells in the thymus grow out of control.

Cancer cells can spread to other parts of the body. Cancer cells in the thymus can sometimes travel to lungs or other parts of the body and grow there. When cancer cells do this, it’s called metastasis. Even if thymus cancer spreads to the lungs (or any other place), it’s still thymus cancer.

What is thymus cancer?

Cancer is always named for the place where it starts, because when the cancer cells grow in a new place, they still look the same as the cells where the cancer started. So when thymus cancer spreads to the lung (or any other place), it’s still called thymus cancer. It’s not called lung cancer unless it starts from cells in the lung.

What is the thymus?

The thymus is an organ just behind your breastbone in the front of your chest. It's part of your immune system. It helps make special immune cells called T cells.

Types of thymus cancer

There are 2 main types of thymus cancer. Your doctor can tell you more about the kind you have.

• Thymomas tend to grow slowly, but they can still sometimes spread to other parts of the body. Most thymus cancers are thymomas.
• Thymic carcinomas tend to grow faster and are more likely to spread to other parts of the body.

Other types of cancer can also start in the thymus, but these are rare.

Some people with thymus cancer don't have any symptoms. The tumor is sometimes found when a person gets an x-ray or other type of scan for some other health problem.

In some people, the tumor in the chest gets big enough to press on blood vessels and/or the windpipe, when this happens, it can cause symptoms like trouble breathing, cough, or chest pain. Thymus cancers can also cause autoimmune diseases (where a person’s immune system attacks parts of their body), which can also lead to symptoms.

If the doctor thinks you might have a thymus tumor, they will ask you questions about your health and do a physical exam.

Questions to ask the doctor

• Why do you think I have a thymus tumor?
• Is there a chance I don’t have a thymus tumor?
• How do you know I have thymus cancer?
• Would you please write down the kind of tumor you think I have?
• What will happen next?

How does my doctor know I have thymus cancer?

If signs are pointing to a thymus tumor, more tests will be done to make a sure diagnosis. Here are some of the tests you might need.

Blood tests: Blood tests alone can’t tell for sure if you have thymus cancer. But they can help find out more about your overall health.

Chest x-ray: This might be the first test done. It can often show thymus tumors.

CT scan (CAT scan): This is a special kind of x-ray test that makes detailed pictures of the thymus and can show if the cancer has spread.

MRI scan: This test uses radio waves and strong magnets instead of x-rays to make pictures. MRI scans can be used to look closely at the thymus, as well as to look for cancer that has spread.

PET scan: In this test, you are injected with a special type of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” in areas where the cancer is found. This test is often done at the same time as a CT scan.

Biopsy: For most types of cancer, a biopsy is the only way to tell for sure if you have cancer. In a biopsy, the doctor takes out small pieces of a tumor, which are checked in the lab for cancer cells.

But for thymus cancer, imaging tests are often all that's needed to know there's a thymus tumor. The thymus (including the tumor) is taken out during surgery, and then it's tested to see if there are cancer cells in it. But if a person can’t have surgery, a biopsy might be done.

Questions to ask the doctor

• What tests do I need?
• Where will they be done?
• Who will do these tests?
• How and when will I get the results?
• Who will explain the results to me?
• What do I need to do next?

How serious is my cancer?

If you have thymus cancer, the doctor will want to find out how far it has spread. This is called staging. Figuring out the stage of your cancer can help your doctor decide what type of treatment options are best for you.

The stage describes the growth or spread of the cancer in the thymus gland. It also tells if the cancer has spread to nearby areas, or to other organs farther away.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more advanced cancer. Be sure to ask the doctor about the cancer stage and what it means for you.

Questions to ask the doctor

• Do you know the stage of the cancer?
• If not, how and when will you find out the stage?
• What does the stage mean in my case?
• Based on the stage of the cancer, what treatment options are best for me?
• What will happen next?

What kind of treatment will I need?

There are many ways to treat thymus cancer, but surgery is often the main treatment. The treatment plan that’s best for you will depend on:

• The type and stage of the cancer
• The chance that all the cancer can be taken out with surgery
• Your age and overall health
• Your feelings about the treatment and the side effects that come with it

Depending on the type and stage of your thymus cancer, you may need more than one type of treatment.

Surgery

Most people with thymus cancer have some type of surgery to take out the tumor and all of the thymus. Sometimes lymph nodes are taken out, too.

Side effects of surgery

Any type of surgery can have risks and side effects, such as pain, bleeding, or infection. Be sure to ask your doctor what you can expect. If you have problems, let your doctors know.

Radiation treatments

Radiation uses high-energy rays (like x-rays) to kill cancer cells. This treatment may be used to:

• Kill any cancer cells that may be left after surgery
• Kill the cancer cells if surgery can’t be done for some reason
• Ease problems the tumor causes, if it’s pressing on other structures like nerves or blood vessels

Side effects of radiation treatments

If your doctor suggests radiation treatment, talk about what side effects you might have. Side effects depend mainly on where the radiation is aimed. The most common side effects of radiation for thymus cancer are:

• Skin changes where the radiation is given
• Sore throat
• Trouble swallowing and eating
• Nausea (sick stomach) and throwing up
• Feeling very tired (fatigue)
• Lung damage

Most side effects get better after treatment ends. Some might last longer. Talk to your cancer care team about what you can expect.

Chemo

Chemo, or chemotherapy, is the use of drugs to fight cancer. These drugs go into the blood and spread through the body. Chemo is given in cycles or rounds. Each round of treatment is followed by a break. Most of the time, 2 or more chemo drugs are given. Treatment often lasts for many months.

Chemo may be given to:

• Kill any cancer cells that may be left after surgery
• Help shrink a tumor so that it can be taken out with surgery
• Treat cancer that has spread beyond the thymus
• Help radiation work better

Side effects of chemo

Chemo can make you feel very tired and sick to your stomach. It might also cause your hair to fall out. But these problems tend to go away after treatment ends.

There are ways to treat most chemo side effects. If you have side effects, be sure to talk to your cancer care team so they can help.

Targeted drugs

Some newer, targeted drugs may be an option for thymus cancers. This is not the same as chemo because these drugs mainly affect cancer cells and not the normal cells in your body. They might work even if other treatments don’t.

Side effects of targeted drugs

The side effects of targeted drugs depend on which drug is used. Talk to your cancer care team about what you can expect.

Clinical trials

Clinical trials are research studies that test new drugs or treatments in people. They compare standard treatments with others that may be better.

Clinical trials are one way to get the newest cancer treatment. They are also the best way for doctors to find better ways to treat cancer. If your doctor can find a clinical trial for the type of cancer you have, it’s up to you whether to take part in it. If you do sign up for a clinical trial, you can always stop at any time.

If you would like to be in a clinical trial, start by asking your doctor if your clinic or hospital conducts clinical trials.

What about other treatments I hear about?

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these might help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking of using, whether it’s a vitamin, a diet, or anything else.

Questions to ask the doctor

• What treatment do you think is best for me?
• What’s the goal of this treatment? Do you think it could cure the cancer?
• Will treatment include surgery? If so, who will do the surgery?
• What will the surgery be like?
• Will I need other types of treatment, too?
• What’s the goal of these treatments?
• What side effects could I have from these treatments?
• What can I do about these side effects?
• Is there a clinical trial that might be right for me?
• What about special vitamins or diets that friends tell me about? How will I know if they are safe?
• How soon do I need to start treatment?
• What should I do to be ready for treatment?
• Will my insurance cover treatment?
• How much will I have to pay?
• Is there anything I can do to help the treatment work better?
• What’s the next step?

What will happen after treatment?

Most people do very well after treatment, but you may need follow-up care for many years after treatment. Your cancer care team will tell you what tests you need and how often they should be done.

Be sure to go to all of your follow-up visits. You might have exams, blood tests, and other tests to see if the cancer has come back. At first, your visits may be every few months. The longer you’re cancer-free, the less often you’ll need visits.

Sometimes treatments may not cure your cancer. You many need to keep getting treatment and care. From time to time, tests will be done to see how your treatment is working.

Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health.

Call us at 1-800-227-2345 for 24/7 support. Or talk to your cancer care team to find out what you can do to feel better.

You can’t change the fact that you have cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.