Surgery for thymus cancer (thymectomy)
Surgery is the most common treatment for thymus cancer. The type of surgery you have depends on the size of the cancer and where it is in your body.
Thymectomy
The main treatment for thymus cancer is surgery. The surgeon removes all of the thymus, or as much of it as possible. This operation is called a thymectomy.
If the cancer has not spread outside the thymus, this may be the only treatment you need. If the cancer has spread outside the thymus, the surgeon may need to remove nearby tissue around the lungs or heart.
If the cancer comes back in the same area, it may be possible to remove it using surgery.
Your surgeon will explain more about the operation you will have.
For the types of surgery mentioned below, you will usually have a general anaesthetic. We have more information about preparing for surgery.
There are different ways in which a thymectomy can be performed. These include:
Video-assisted thoracoscopic surgery (VATS)
If the tumour is small, it can sometimes be removed using a type of keyhole surgery called video-assisted thoracoscopic surgery (VATS).
The specialist surgeon makes several small cuts at the side of the chest and passes a thin tube called a thoracoscope through one of the cuts. The tube has a tiny camera on the end which shows a picture of the area on a screen. The surgeon removes the thymus using small instruments that they pass through the cut.
VATS can also be used to remove the thymus by making a cut through the breastbone (sternum).
Open surgery
If the tumour is large or has spread outside the thymus, you need open surgery. The surgeon makes a slightly bigger cut down the middle of the chest to remove the thymus and sometimes nearby tissue. This is called a sternotomy.
Robotic surgery
Robotic surgery is when keyhole surgery is helped by a machine. Instead of the surgeon holding the laparoscope and the surgical equipment, these are attached to robotic arms. The surgeon controls the robotic arms, which can move very precisely.
This is very specialised surgery and only available in some hospitals in the UK.
Recovery after surgery for thymus cancer
How long you are in hospital for depends on the operation you have. You are usually cared for on the ward but may be in a high dependency unit for a short while. This will depend on the type of surgery you have.
If you had open surgery, you may stay in hospital for up to 7 days. With keyhole surgery, you recover more quickly, so you may only need to stay in hospital for 1 or 2 days.
If you had open surgery, you usually have a drip (infusion) giving you fluids until you are able to drink normally. You may also have 1 or more tubes in the wound on your chest to drain fluid and air into a big bottle. This is called a chest drain. Your chest drain is usually removed 2 to 3 days after surgery.
After your operation, the nurses and physiotherapist will encourage you to start moving around as soon as possible. This will help prevent complications such as a blood clot or chest infection.
After surgery, it is normal to have some pain or discomfort. There are different ways it can be managed. Your nurse will assess you to make sure your pain is well controlled. If you are in pain, let your doctor or nurse know, so they can change your painkillers.
The stitches, clips or staples are usually removed from your wound about 7 to 10 days after surgery. If you have dissolvable stitches, they disappear over a few weeks.
It takes time to recover from surgery and you may feel tired for several weeks. Before you go home, your doctor or nurse will give you advice about your recovery.
We have more general information about what to expect after surgery.
About our information
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References
Below is a sample of the sources used in our thymus cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
ESMO Annals of Oncology. Thymic Epithelial Tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up: 2015. Available from https://www.esmo.org/guidelines/guidelines-by-topic/lung-and-chest-tumours/thymic-epithelial-tumours (accessed July 2021)
Marx A, Chan JK, Coindre JM, et al. The 2015 World Health Organization Classification of Tumours of the Thymus: Continuity and Changes. Journal of Thoracic Oncology 2015; 10: 1383-95 (accessed July 2021)
International Thymic Malignancy Interest Group (ITMIG): About Thymic Tumours - symptoms, staging, standard treatment options. Available from https://itmig.org/about-thymic-tumors (accessed July 2021)
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr David Gilligan, Consultant Clinical Oncologist.
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