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Thymoma - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Thymoma. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

Thymoma is a type of cancer that begins in the thymus. Located under the breastbone, also called the sternum, the thymus is a small organ that is part of the body’s immune system.

About the lymphatic system

The lymphatic system is made up of thin vessels that branch out to all parts of the body. These vessels carry lymph. Lymph is a colorless fluid that carries away waste and transports a type of white blood cell called lymphocytes. Lymphocytes fight germs throughout the body. B-lymphocytes, or B cells, make antibodies to fight bacteria. T-lymphocytes, or T cells, destroy foreign cells and trigger the B cells to make antibodies.

Early in life, the thymus is involved in the development and maturation of white blood cells, in particular T-lymphocytes. T-lymphocytes eventually travel to lymph nodes and around the body. In adulthood, the thymus is quite small and often replaced by fat.

Within the lymphatic system, there are several other structures. Lymph nodes are tiny, bean-shaped organs that filter the lymph fluid. Lymph nodes are found in clusters in the neck, underarms, abdomen, pelvis, and groin. When bacteria get into the lymph nodes, they swell. Other lymphatic organs include the spleen, which makes lymphocytes and filters blood, and the tonsils, located in the throat.

About thymoma and thymic carcinoma

Cancer begins when healthy cells change and grow uncontrollably, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

The thymus contains two main types of cells:

  • Epithelial cells. Thymic epithelial cells are the cells that line the thymus. This is where thymoma and thymic carcinoma start.

  • Lymphocytes. If lymphocytes become cancerous, they can develop into lymphoma. Learn more about Hodgkin lymphoma and non-Hodgkin lymphoma.

Rarely, another type of tumor called a carcinoid tumor can develop in the thymus.

Thymoma is generally a slow-growing tumor that does not usually spread outside of the thymus. Occasionally, it can spread to the lining of the lung, called the pleura. Less often, it can spread to other parts of the body.

Thymic carcinoma (see Stages) also starts in the thymus, but it is more likely to spread to the lining of the lungs and other parts of the body. Thymic carcinoma can also be more difficult to treat.

About 30% of people with thymoma also have a condition called myasthenia gravis. Myasthenia gravis is an autoimmune disorder caused by antibodies or T-cells that attack molecules, cells, or tissues of the person producing them. The main symptom of myasthenia gravis is fluctuating weakness in various muscles. It may affect any muscle that is under voluntary control, such as those that control eye movements, chewing, swallowing, coughing, and facial expression. Muscles that control breathing and movements of the arms and legs may also be affected in more severe cases. Myasthenia gravis may appear before thymoma is diagnosed or it may develop during or after treatment.

In addition to myasthenia gravis, people with thymoma may have other groups of syndromes, called paraneoplastic syndromes. These may include severe low red blood cell count or anemia, called pure red cell aplasia, or low levels of antibodies known as immunoglobulins in the blood, called hypogammaglobulinemia.

The next section in this guide is Statistics and it helps explain how many people are diagnosed with this disease and general survival rates. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Thymoma - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find information about how many people are diagnosed with this type of cancer each year and some general survival information. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

Most tumors that begin in the thymus are thymoma. This cancer is uncommon, with less than 400 cases per year in the United States. Thymic carcinomas are much rarer and make up less than 1% of tumors that start in the thymus. Thymic carcinoid tumors are more rare.

Thymoma usually occurs in people between the ages of 40 and 60, but can occur at almost any age. Survival rates are different depending on several factors, including the stage and classification of thymoma (see Stages).

Cancer statistics should be interpreted with caution. Estimates are based on data from many people with this type of cancer in the United States, so the actual risk for a particular individual may be different. It is not possible to tell a person how long he or she will live with thymoma. Learn more about understanding statistics.

Sources: American Cancer Society and the National Cancer Institute.

The next section in this guide is Risk Factors and it explains what factors may increase the chance of developing this disease. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find an explanation of risk factors and how they are involved in the development of most types of cancer. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

Currently, there are no known risk factors for thymoma.

The next section in this guide is Symptoms and Signs and it explains what body changes or medical problems this disease can cause. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

Some people with thymoma experience symptoms, but many do not. Below is a list of common signs or symptoms that may accompany thymoma:

People with thymoma may experience the following symptoms or signs. Sometimes, people with thymoma do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer.        

  • Persistent cough

  • Shortness of breath

  • Pain or pressure in the chest

  • Muscle weakness

  • Drooping eyelids

  • Double vision

  • Arm or facial swelling

  • Difficulty swallowing

  • Anemia (low red blood cell count)

  • Frequent infections

  • Fatigue

  • Dizziness

If you are concerned about one or more of the symptoms or signs on this list, please talk with your doctor. Your doctor may ask how long and how often you have been experiencing the symptom(s), in addition to other questions. This is to help find the reason for the symptoms, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis and it explains what tests may be needed to learn more about the cause of the symptoms. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose cancer and find out if it has spread to another part of the body, called metastasis. Some tests help determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread.

This list describes options for diagnosing this type of cancer, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition

  • Type of cancer suspected

  • Signs and symptoms

  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose thymoma or thymic carcinoma:

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. A biopsy is not usually the first test done for thymoma. Usually a person will first have imaging tests (see below), such as CT, MRI, or PET scan.

    The type of biopsy performed will depend on the location of the cancer. A needle biopsy is the use of a thin needle that is inserted into the tumor to remove a piece of tissue. Depending on the location of the tumor, surgery may be needed to get enough tissue to make a diagnosis. Also known as the Chamberlain procedure, this type of surgery is performed by making a two-inch cut next to the breastbone and removing a sample of the tumor.

  • Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. A CT scan of the chest is the most common test used to look for and evaluate thymoma. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow. Magnetic resonance imaging and positron emission tomography may provide more information but are not always needed (see below).

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer; this is called staging.

The next section in this guide is Stages, and it explains the system doctors use to describe the extent of the disease. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Staging

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancers.

The most commonly used staging system for thymoma is called the Masaoka system, and it classifies thymoma into the following stages:

  • Stage I: The cancer is located only in the thymus and the capsule that surrounds the thymus.

  • Stage II: The cancer has spread into fat surrounding the thymus or into the lining of the lung next to the tumor, called the mediastinal pleura.

  • Stage III: The cancer has spread to other organs near the thymus, such as the lung, blood vessels, and the sac around the heart, called the pericardium.

  • Stage IVA: The cancer has spread more extensively into the lining of the lung or the sac around the heart.

  • Stage IVB: The cancer has spread to organs further away from the thymus, or has spread through the vessels carrying blood or lymph.

Classification

In addition to stage, thymoma can be classified into different categories developed by the World Health Organization (WHO). These categories are based on what the tumor cells look like under a microscope:

  • Type A thymoma. This is also called spindle cell thymoma or medullary thymoma. The chance of recovery for people with type A thymoma is good. Nearly 100% of people with this type live at least 15 years after diagnosis.

  • Type AB thymoma. Also called mixed thymoma, type AB thymoma is similar to type A thymoma. However, type AB thymoma has lymphocytes in the tumor. The chance of recovery for people with type AB thymoma is also good. About 90% of people with this type live at least 15 years after diagnosis.

  • Type B1 thymoma. This is also known as lymphocyte-rich thymoma, lymphocytic thymoma, predominantly cortical thymoma, and organoid thymoma. This type of thymoma has many lymphocytes in the tumor, but the cells of the thymus appear healthy. The chance of recovery for people with type B1 thymoma is also good. About 90% of people with this type live at least 20 years after diagnosis.

  • Type B2 thymoma. Type B2 thymoma also has many lymphocytes, like type B1 thymoma. However, the thymus cells do not appear healthy. Type B2 thymoma is also known as cortical thymoma and polygonal cell thymoma. About 60% of people with this type live at least 20 years after diagnosis.

  • Type B3 thymoma. Type B3 thymoma is also known as epithelial thymoma, atypical thymoma, squamoid thymoma, and well-differentiated thymic carcinoma. This type of thymoma has few lymphocytes, and the thymus cells look abnormal. Approximately 40% of people with this type live at least 20 years after diagnosis.

  • Thymic carcinoma (Type C thymoma).  Thymic carcinoma is more aggressive. Thymic carcinoma cells do not look like healthy thymus cells but like cancers that start in other parts of the body. This type of tumor is often advanced when diagnosed. About 35% of people with thymic carcinoma live at least five years after diagnosis and around 28% live at least 10 years. Thymic carcinoma is sometimes classified into two categories:

    • Low grade. Low grade thymic carcinoma is linked with a better chance of recovery. Low-grade thymic carcinoma includes basaloid, mucoepidermoid, and well-differentiated squamous cell types.

    • High grade. High grade thymic carcinoma is more likely to grow and spread quickly. High-grade thymic carcinoma includes anaplastic/undifferentiated, clear cell, poorly differentiated squamous cell, sarcomatoid, and small cell/neuroendocrine types.

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States, so the actual risk for a particular individual may be different. It is not possible to tell a person how long he or she will live with thymoma. Because survival statistics are measured in multi-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer. Learn more about understanding statistics.

Source: National Cancer Institute.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will learn about the different ways doctors use to treat people with this type of cancer. To see other pages, use the menu on the side of your screen.

This section outlines treatments that are the standard of care (the best known treatments available) for this specific type of cancer. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study to test a new approach to treatment to evaluate whether it is safe, effective, and possibly better than the standard treatment. Clinical trials may test such approaches as a new drug, a new combination of standard treatments, or new doses of current therapies. Your doctor can help you review all treatment options. For more information, see the About Clinical Trials and Latest Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Descriptions of the most common treatment options for thymoma are listed below. Treatment options and recommendations depend on several factors, including the classification and stage of cancer, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Surgery is the most common treatment for early-stage thymoma. For thymoma, surgery is usually done by a thoracic surgeon, a doctor who specializes in surgery of the chest.

For early-stage thymoma, surgery is often the only treatment needed. The most common type of surgery for thymoma is called a median sternotomy. During a median sternotomy, the breastbone is split, and the thymoma and the tissue surrounding the tumor are removed. Sometimes, for smaller, early-stage tumors, a less invasive type of surgery using smaller incisions and a laparoscope may be an option. A laparoscope is a thin, lighted tube with a small camera on the end. With some laparoscopes, the surgeon can work with small instruments through the tube.  

Later-stage thymoma treatment options may include surgery to remove as much of the tumor as possible when the entire thymoma cannot be removed with surgery. This is called debulking surgery and may provide some relief of symptoms. If the thymoma has spread to the lining of the lung, surgery may also include the removal of the lung lining or a portion of the lung.

Talk with your surgeon beforehand about possible side effects, which are based on the extent of surgery. You should also ask what you can expect during recovery from surgery.

Learn more about the basics of cancer surgery.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.

External-beam radiation therapy can be used as the only treatment, following surgery, or in combination with chemotherapy in the treatment of thymoma. For patients with later-stage disease, radiation therapy is often recommended after the thymoma has been surgically removed.

Side effects from radiation therapy may include fatigue, mild skin reactions, difficulty swallowing, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.

Learn more about the basics of radiation therapy.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time. Common drugs for thymic tumors include:

  • Carboplatin (Paraplatin)

  • Cisplatin (Platinol)

  • Cyclophosphamide (Neosar)

  • Doxorubicin (Adriamycin)

  • Etoposide (Toposar, VePesid)

  • Ifosfamide (Ifex)

  • Octreotide (Sandostatin)

  • Paclitaxel (Taxol)

  • Pemetrexed (Alimta)

The common drug combinations for thymoma include:

  • Carboplatin and paclitaxel

  • Cyclophosphamide, doxorubicin, and cisplatin

  • Etoposide and cisplatin

These chemotherapy combinations are sometimes used to shrink the tumor before surgery if the thymoma is found at a later stage. Chemotherapy may also be used for people who have stage IVB/advanced thymoma or recurrent thymoma that cannot be completely removed with surgery. Recurrent thymoma is thymoma that has come back after treatment (see section below).

The side effects of chemotherapy depend on the individual, the type of drug, and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps doctors better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.

For thymic tumors, anti-angiogenesis therapy may be an option. Anti-angiogenesis therapy is a type of targeted therapy. It is focused on stopping angiogenesis, which is the process of making new blood vessels. Because a tumor needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor. The two targeted therapies used for thymic tumors include:

  • Everolimus (Afinitor)

  • Sunitinib (Sutent)

Talk with your doctor about possible side effects for a specific medication and how they can be managed.

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in your treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care.   

Metastatic thymoma

If cancer has spread to another location in the body, it is called metastatic cancer. Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about getting a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials.

Your health care team may recommend a treatment plan that includes a combination of surgery, radiation, and chemotherapy. Sometimes, when thymoma is metastatic and growing very slowly, your health care team may recommend no treatment for a period of time. However, when thymoma has spread to another location in the body, it is unlikely that any of the treatments will make the cancer go away forever. Palliative care is also important to help relieve symptoms and side effects.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED. 

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.  

People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

If treatment fails

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and advanced cancer is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials and it offers more information about research studies that are focused on finding better ways to care for people with cancer. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Thymoma - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with thymoma. To make scientific advances, doctors create research studies involving volunteers called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was previously tested in clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments, such as new chemotherapy, before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and manage the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are only way to make progress in treating thymoma. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with thymoma.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” However, placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for thymoma, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide. 

The next section in this guide is Latest Research and it explains areas of scientific research currently going on for this type of cancer. Or, use the menu on the side of your screen to choose another section to continue reading this guide.    

Thymoma - Current Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of cancer and how to treat it. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about thymoma, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

  • New drugs. Researchers are currently studying several new treatments and treatment methods for patients with thymoma and thymic carcinoma. For patients with advanced thymoma or thymic carcinoma, several new drugs are being studied in clinical trials, including amrubicin, belinostat (Beleodaq), buparlisib, pembrolizumab (Keytruda), PHA-848125AC (milicilib), and saracatinib. Additionally, a new drug that targets stem cells, BBI608, is being researched.

  • Different combinations of treatments. For patients with advanced thymoma or thymic carcinoma that has not been previously treated, researchers are looking at combining chemotherapy with radiation therapy before surgery, and combining chemotherapy with cetuximab (Erbitux) before surgery to increase the effectiveness of chemotherapy and to make surgery possible for more people with advanced thymoma.

  • Cancer vaccines. Cancer vaccines are treatments that help a person’s immune system fight cancer. For thymoma, researchers are studying the effectiveness of an experimental vaccine combined with the chemotherapy drug cyclophosphamide and the anti-inflammatory drug celecoxib (Celebrex).

  • International collaboration. Rare diseases like thymoma are a challenge for researchers because of the small number of patients who have the disease. Because of this, doctors and researchers around the world are working together to study thymoma, collect information, and design clinical trials through the International Thymic Malignancy Interest Group.

  • Myasthenia gravis research. Studies are underway to learn more about this condition (see Overview), its link with thymoma, and ways to treat it.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current thymoma treatments in order to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding thymoma, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Side Effects and it offers some guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Thymoma - Coping with Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of cancer, but it may help to know that preventing and controlling side effects is a major focus of your health care team. This is called palliative care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

There are possible side effects for every cancer treatment, but patients don’t experience the same side effects when given the same treatments for many reasons. That can make it hard to predict exactly how you will feel during treatment. Common side effects from each treatment option for thymoma are described in detail within the Treatment Options section. Learn more about the most common side effects of cancer and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the cancer’s stage, the length and dosage of treatment(s), and your overall health.

Talking with your health care team about side effects

Before treatment begins, talk with your doctor about possible side effects of each type of treatment you will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them.

And, ask about the level of caregiving you may need during treatment and recovery, as family members and friends often play an important role in the care of a person with thymoma. Learn more about caregiving.

In addition to physical side effects, there may be emotional and social effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies, including concerns about managing the cost of your cancer care

During and after treatment, be sure to tell the health care team about the side effects you experience, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

The next section in this guide is Follow-up Care and it explains the importance of check-ups after cancer treatment is finished. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will read about your medical care after cancer treatment is completed, and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

The recovery from treatment for thymoma can vary depending on the stage of thymoma and the treatment used. In general, recovery is faster for people who received only surgery, compared with people who received a combination of treatments.

Care for people diagnosed with thymoma doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. Follow-up care depends on the stage of thymoma. Regular visits to the doctor and follow-up CT scans are often recommended, particularly for people diagnosed with later stages of thymoma. Follow-up physical examinations and regular CT scans may be part of lifetime care for some people.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of cancer originally diagnosed and the types of treatment given.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

There may be some risk for a second type of cancer particularly for people who received radiation therapy. In these situations, there is a small risk that a new type of cancer will develop many years later in the part of the body that received radiation therapy.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship and it describes how to cope with challenges in everyday life after a cancer diagnosis. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Survivorship

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. To see other pages, use the menu on the side of your screen.

What is survivorship?

The word survivorship means different things to different people. Two common definitions include:

  • Having no signs of cancer after finishing treatment.

  • The process of living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

In some ways, survivorship is one of the most complex aspects of the cancer experience because it is different for every person.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain of how to cope with everyday life.

Survivors may feel some stress when frequent visits to the health care team end following treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing,

  • Thinking through solutions,

  • Asking for and allowing the support of others, and

  • Feeling comfortable with the course of action you choose.

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the center where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from thymoma are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

In addition, it is important to have recommended medical check-ups and tests (see Follow-up Care) to take care of your health. Cancer rehabilitation may also be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: This 44-page booklet (available as a PDF) helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including for survivors in different age groups.

The next section offers Questions to Ask the Doctor to help start conversations with your cancer care team. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • What type of thymoma do I have?

  • What stage is the thymoma?

  • What is the classification of this tumor?

  • Can you explain my pathology report (laboratory test results) to me?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are open to me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • Who will be part of my health care team, and what does each member do?

  • Who will be coordinating my overall treatment?

  • What are the possible side effects of this treatment, both in the short term and the long term?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs related to my cancer care, who can help me with these concerns?

  • What support services are available to me? To my family?

  • Whom should I call for questions or problems?

  • Is there anything else I should be asking?

Questions to ask about having surgery

  • What type of surgery will I have?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • What are the possible long-term effects of having this surgery?

Questions to ask about having radiation therapy, chemotherapy, or targeted therapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the risk of the cancer returning? Are there signs and symptoms I should watch for?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be coordinating my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources, and it offers some more resources on this website beyond this guide that may be helpful to you. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Thymoma - Patient Information Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 04/2015

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Thymoma. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

This is the end of the Cancer.Net’s Guide to Thymoma. Use the menu on the side of your screen to select another section to continue reading this guide.