Thymoma and Thymus Cancer Symptoms and Causes
To achieve the best treatment outcomes, the North Shore-LIJ Cancer Institute engages a multidisciplinary team of medical oncologists, surgical oncologists, radiation oncologists, pathologists and nurses to diagnose, treat and support patients with thymoma.
Thymoma: An Overview
Thymoma is a tumor of the thymus, a small organ that is part of the lymphatic system. The thymus is located in the front part of chest, behind the breastbone. It runs from the lower neck to above the level of the heart. During development in the womb and in childhood, the thymus makes a type of white blood cell called a T-lymphocyte. T-lymphocytes are important to the immune system. They grow in the thymus and then travel to the lymph nodes where they help protect the body against infections and cancer.
What are the Different Types of Thymus Cancer?
Different types of thymus tumors can be identified by the way they look under a microscope. There are three main types of thymic tumors, all of them very rare.
- Thymomas — These are the most common type of tumor in the thymus. They begin in a type of cell called thymic epithelial cells. When a thymoma is found, the doctor usually looks at whether it has spread beyond the thymus and if so, how far. All thymomas are potentially cancerous. They often appear together with an immune or endocrine disease.
- Thymic carcinomas — These tumors also develop from epithelial cells in the thymus, but this type of cancer is more aggressive. It can spread to nearby tissues and sometimes to other parts of the body. Thymic carcinomas are divided into low-grade (less aggressive) and high-grade (more likely to grow and spread).
- Thymic carcinoids — These tumors are a very rare type and often spread outside of the thymus gland.
What Are the Symptoms of Thymus Cancer?
People with thymic tumors usually do not have symptoms until the tumor is big enough to press against air passages and blood vessels in the area of the thymus, or against the ribcage or breastbone. Here are some symptoms you might have if this happens.
- If the tumor presses against the trachea (windpipe), you may have shortness of breath.
- If the tumor presses against the veins that carry blood from your head and neck to your heart, your face or arms, or both, may swell.
- You may develop pain in your chest, particularly behind your breastbone.
- Rarely, swallowing can be difficult because of a growth or bleeding into the tumor.
Although these are symptoms of thymus cancer, they may also be caused by other, less serious medical problems. If you have any of these symptoms talk with your doctor.
Associated Syndromes of Thymoma
You may also have symptoms that are not related to pressure caused by the tumor. These are called associated syndromes. These syndromes are usually caused by what the tumor makes (such as hormones and immune products), rather than by the tumor itself. The syndromes can appear when the tumor is in the very early stages. They are important in the early diagnosis of thymus cancer.
These are the associated syndromes linked to thymus cancer:
- Myasthenia gravis is an autoimmune disease that can cause severe muscle weakness. The areas affected most often are the eyes, neck, throat and chest. This can cause blurred or double vision, difficulty keeping the eyes open or looking upwards. It may also lead to trouble swallowing and breathing. You may also have serious fatigue that usually gets worse as the day goes on. All people who have myasthenia gravis do not have thymus cancer. While the thymus is abnormal in 66% of people with myasthenia gravis, only a small percentage of these have thymomas.
- Red cell aplasia is a condition that occurs when the bone marrow does not make enough red blood cells. Red blood cells carry oxygen from the lungs to other body tissues. When your body doesn’t make enough red blood cells, you have a low red-blood-cell count, a condition called anemia. Anemia may cause weakness, dizziness, shortness of breath and fatigue. Close to 50% of people with red cell aplasia has thymomas.
- Hypogammaglobulinemia is a condition that occurs when the body does not make enough infection-fighting antibodies. This can make you more likely to get infections. About 10% of people with hypogammaglobulinemia also have thymomas.
If you have any one of these syndromes, you should talk to your doctor and get checked for a thymic tumor.
How Is Thymoma Diagnosed?
- Your doctor will do a physical exam which will include a health and family history workup.
- Imaging tests including:
- Computed Tomography (CT) Scan — This test takes many X-rays from many angles.
- Magnetic Resonance Image (MRI) — MRIs can show more detail than X-rays and can help a doctor figure out the location, size, and stage of the cancer.
How Is Thymus Cancer Treated?
Different types of treatment have different goals. You may have more than one of these treatments.
- Surgery — Surgery is a common treatment for thymus cancer. The goal of surgery is to remove the tumor and some of the tissue around it. In almost all cases, the doctor removes the whole thymus gland.
- Radiation therapy — The goal of radiation therapy is to kill cancer cells using X-rays. Doctors use this treatment most often to get rid of any remaining cancer cells after surgery. Doctors also use this therapy to treat recurrent disease. People with thymus cancer will usually get radiation along with other treatments.
- Chemotherapy — Chemotherapy is the use of anticancer drugs. Its goal is to kill cancer cells and reduce the chance that the cancer will spread to other parts of the body. Doctors may give chemotherapy either before, after or in place of surgery. They may also use it to treat the cancer if it has spread to other parts of the body.
Follow-up exams are an important part of treatment for thymus cancer. You will need tests and exams to monitor your health. Follow-up tests may include chest X-rays, CT (computed tomography) scans and blood tests. Sometimes your doctor may order other imaging tests, too.
Thymoma Clinical Trials
The North Shore-LIJ Cancer Institute offers a full array of clinical trials. The result of this research not only impacts survival, but also enhances the quality of life. For more information about clinical trials for Thymoma and Thymus Cancer, visit Cancer Clinical Trials.
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