Treatment
Thymic epithelial tumours
There are different types of treatment for thymic epithelial tumours. It is usually treated with a combination of surgery, chemotherapy and radiotherapy. Chemotherapy might be given before surgery to shrink the tumour. The surgeon will remove as much of the tumour as possible. Then, radiotherapy is used to try to kill of any cancer cells left behind.
Your treatment will depend on the stage (how far the cancer has spread), and your overall health.
Staging
Staging is a way of describing the size of a cancer and if it has spread. The most used staging systems for thymic epithelial tumours are TNM (tumour, node and metastasis) staging and number staging.
T describes the size of the tumour. This is usually a number between 1 and 4. T1 is a small cancer. T4 is a larger or more advanced cancer.
N describes whether the cancer has spread to the lymph nodes. The number can be between 0 and 3. T0 means there are no cancer cells in the lymph nodes. N3 means more lymph nodes are affected by cancer.
M describes whether the cancer has spread to another part of the body. This is known as metastatic or secondary cancer. The number is either 0 or 1. M0 means the cancer has not spread to other parts of the body. M1 means it has spread.
Stage 1
The cancer is inside the thymus gland and has not spread.
Stage 2
The cancer has spread through the outer lining of the thymus gland or into the fat around it.
Stage 3
The cancer has spread into nearby organs such as the lungs or the lining of the heart (pericardium). It may have also grown into the blood vessels near the heart.
Stage 4A
The cancer has spread widely into the lining of the lungs (pleura) and the lining of the heart (pericardium).
Stage 4B
The cancer has spread to other distant organs, such as the liver.
Treatment
Your doctor or nurse will explain the different treatments and their side effects.
Surgery
Surgery is used to remove all of the cancer, or as much as possible. If the cancer has spread outside of the thymus gland, the surgeon may also need to remove nearby areas of tissue around the lungs or heart.
Surgery is also used to remove any cancer that has come back in the same area after previous treatment. The way the surgeon removes the cancer will depend on the size and stage of disease. If the cancer has spread outside of the thymus gland, you may need open surgery.
Smaller tumours may be removed using video-assisted thoracic surgery (VATS). During VATS the surgeon makes a small cut at the base of the neck and uses thin, flexible tubes with a camera and surgical instruments on the end to remove the thymus gland.
Radiotherapy
Radiotherapy uses high energy rays to destroy cancer cells, while doing as little harm as possible to healthy cells. Radiotherapy is given to reduce the risk of the cancer coming back after surgery, or to treat cancer that cannot be removed with surgery.
You have treatment as a series of short, daily sessions (called fractions) from a machine similar to a large X-ray machine. Your clinical oncology team will let you know many sessions you will need, as this can vary. Radiotherapy only treats the area of the body that the rays are aimed at. Radiotherapy may also be used to control symptoms such as pain if the cancer has spread to other areas of the body. In this case you may only need a few days of treatment.
Side effects of radiotherapy
You may have side effects during radiotherapy. These usually disappear gradually over a few weeks or months after treatment finishes. Your radiotherapy team will let you know what to expect. You must tell the team about any side effects you have. There are often things that can be done (such as medicines) to manage the side effects.
Radiotherapy can cause difficulty swallowing and make your throat sore and dry. You may also have heartburn. We might refer you to a dietitian for advice. You might require dietary supplements to add extra energy and protein to your diet.
The treatment area may include parts of the lungs or heart near the thymus gland, causing swelling and soreness. This can make you feel more breathless, give you a dry cough, or chest pain. This can start during treatment or in the weeks afterwards. It usually improves with time.
It can be common to have a skin reaction in the area of the chest wall being treated. The radiotherapy team will give you advice about skin care during treatment. The skin may become sore and red. This usually starts 2 to 3 weeks after treatment starts and may last for 3 to 4 weeks after you have finished treatment.
Most of these side effects get better when treatment ends. However, radiotherapy can cause other long-term effects to the heart or lungs. Long-term effects are not common, but they can happen months, or even years, after your treatment.
For more information about side effects, please speak to your doctor or nurse.
Chemotherapy
Chemotherapy uses anti-cancer (cytoxic) medicines to destroy cancer cells throughout the body. You may have this treatment to shrink the tumour before having surgery.
Side effects of chemotherapy
Chemotherapy side effects depend on the medicine or combination of medicines given. Your doctor and nurse will explain any treatment you are offered and what to expect.
Chemotherapy can reduce the amount of white blood cells in your blood during treatment. This will make you more prone to infection. Your doctor or nurse will give you advice about what to do if this happens. Chemotherapy can cause other side effects and these will be discussed with your doctor or nurse.
Trials
If you are eligible, you may be offered to part in a clinical trial. This might take place at another hospital. There is ongoing research into treatments for thymoma and thymic carcinoma. However, this type of cancer is rare and there may not be a suitable trial for you to join. If there is a suitable trial, your doctor or nurse will can give you more information about this, and can refer you.
You can withdraw from the trial at any time, but you will still receive the best treatment.
Resource number: 4348/VER3
Last reviewed: January 2025
Next review due: January 2028