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Thymoma

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What are thymoma and thymic carcinoma?

Thymoma and thymic carcinoma are diseases in which cancer (malignant) cells are found in the tissues of the thymus. The thymus is a small organ that lies under the breastbone. It makes white blood cells called lymphocytes that travel through the body and fight infection. Thymoma is usually a slow-growing tumor that does not spread beyond the thymus. Thymic carcinoma, however, is difficult to treat and generally spreads to other parts of the body. People with thymoma often have other diseases of the immune system, most commonly myasthenia gravis, a disease in which the muscles become weak.

A doctor should be seen if a person has the following symptoms:

  • A cough that wonft go away.
  • Pain in the chest.
  • Weakness in the muscles.

If there are symptoms, the doctor may take an x-ray of the chest. The doctor may also do a CT scan, a special x-ray that uses a computer to make a picture of part of the body.

The chance of recovery (prognosis) and choice of treatment depend on the stage of the cancer (whether it is just in the thymus or has spread to other places), the types of cells found in the cancer, and the patientfs general state of health.

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Stage Explanation

Stages of thymoma

Once thymoma is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following staging system may be used for thymoma:

  • Stage I: Cancer is found only within the thymus gland and the sac that surrounds it.

  • Stage II: Cancer has spread into fat surrounding the thymus or into the lining of the lung cavity.

  • Stage III: Cancer has spread into organs near the thymus, such as the lung, the sac around the heart, and the blood vessels.

  • Stage IVa: Cancer has spread deeper into the sac around the heart or lungs.

  • Stage IVb: Cancer has spread through the vessels carrying blood or lymph.

Stage I thymoma is also called noninvasive thymoma. Stages II through IVb thymoma are also called invasive thymoma.

Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the thymus or in another part of the body.

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Treatment Option Overview

How thymoma and thymic carcinoma are treated

There are treatments for all patients with thymoma and thymic carcinoma. Three kinds of treatment are used:

  • Surgery (taking out the cancer in an operation).
  • Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells).
  • Hormone therapy (using hormones to stop cancer cells from growing).

Chemotherapy (using drugs to kill cancer cells) is being studied in clinical trials.

Surgery to remove the tumor is the most common treatment. A doctor also may take out additional tissue around the cancer.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation treatment for thymoma or thymic carcinoma usually comes from a machine outside the body (external-beam radiation therapy). Radiation therapy can be used alone, following surgery, or combined with chemotherapy.

If the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given radiation therapy after surgery to kill any cancer cells that are left. Radiation therapy given after an operation when no cancer cells can be seen is called adjuvant radiation therapy.

Hormone therapy uses hormones to stop cancer cells from growing. Hormones called steroids may be given to stop the tumor from growing.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the thymus.

Treatment by stage

Treatment of thymoma and thymic carcinoma depends on the stage of the disease, and the patientfs age and overall condition.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information.

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Noninvasive Thymoma and Thymic Carcinoma

Treatment may be one of the following:

  1. Surgery to remove the cancer.
  2. Radiation therapy in rare cases.

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Invasive Thymoma and Thymic Carcinoma

Treatment may be one of the following:

  1. Surgery to remove the cancer followed by adjuvant radiation therapy.
  2. Radiation therapy alone, if the cancer cannot be removed by surgery.
  3. A clinical trial of chemotherapy.
  4. A clinical trial of chemotherapy followed by surgery.
  5. A clinical trial of chemotherapy combined with radiation therapy if the cancer cannot be removed by surgery.

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Recurrent Thymoma and Thymic Carcinoma

Treatment may be one of the following:

  1. Surgery to remove the cancer, with or without radiation therapy.
  2. Radiation therapy.
  3. Hormone therapy using steroids.
  4. A clinical trial of chemotherapy.

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Thymoma