Thymoma
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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 wonft 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 patientfs general state of health.
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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 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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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 of thymoma and thymic carcinoma
depends on the stage of the disease, and the patientfs 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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Treatment may be one of the following:
- Surgery to remove the cancer.
- Radiation therapy in rare cases.
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Treatment may be one of the following:
- Surgery to remove the cancer followed by adjuvant radiation
therapy.
- Radiation therapy alone, if the cancer cannot be removed by surgery.
- A clinical trial of chemotherapy.
- A clinical trial of chemotherapy followed by surgery.
- A clinical trial of chemotherapy combined with radiation therapy if the cancer
cannot be removed by surgery.
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Treatment may be one of the following:
- Surgery to remove the cancer, with or without radiation
therapy.
- Radiation therapy.
- Hormone therapy using steroids.
- A clinical trial of chemotherapy.
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