Thymus cancer, or type C thymoma, is a rare malignant tumor of the mediastinum that develops from the thymic epithelial cells. Both sensitive and specific for thymus cancer diagnostic methods include high-resolution computed tomography, selective angiography and radioisotope scanning. The optimal surgical treatment is thymectomy, while additional treatments may include radiation therapy, chemotherapy and targeted therapy. When treated by experienced oncologists and thoracic surgeons, the 5-year survival rate for this type of cancer reaches 68%.
Clinical manifestations of thymus malignancies
The symptoms of thymus cancer are nonspecific and, as a rule, indicate only the presence of a quite large neoplasm in the mediastinum. Myasthenia gravis, which is pathognomonic for thymus pathologies, can develop both in cancer and in benign neoplasms. Oncological alertness should arise in presence of the following signs:
- Retrosternal chest pain, feeling of pressure or squeezing in the chest
- Treatment-resistant chronic dry cough
- Shortness of breath with minimal physical activity
- Weak muscles in the upper body, difficulty chewing and swallowing, respiratory disorders (myasthenia gravis)
- Swelling of the face, hands and upper body; bluish complexion; expanded veins of the face, neck and chest (superior vena cava syndrome)
As a rule, low grade small tumors can be detected by chance during an X-ray examination for other diseases of the chest organs.
Given the rarity of thymic malignancies, their diagnostics and treatment are carried out by the specialized international organizations, such as the International Thymic Malignancy Interest Group (ITMIG), the European Association for Cardio-Thoracic Surgery (EACTS), the Japanese Association for Research on the Thymus (JART) and others.
A number of scientists consider the division of thymic neoplasms into benign and malignant conditional and not always dependent on the results of a histological examination. Thus, regardless of the histological structure, thymomas can be considered malignant when they go beyond their capsule and grow into the neighboring chest organs. At the same time, the neoplasms with histological signs of atypia can be considered benign in the absence of infiltrative growth and / or metastasizing.
The advanced diagnostics of thymus cancer includes:
- Contrast-enhanced MRI or CT scanning of the chest organs for assessing location of the tumor, detecting invasion into the neighboring organs and lymph nodes involvement. The alternative imaging methods for the anterior mediastinum examination include X-ray, mediastinography and gallium radioisotope scanning.
- Ultrasound examination of the supraclavicular areas for assessing the condition of the lymph nodes and fatty tissue.
- Assessing the patient's general condition: complete blood count, biochemical analysis with the assessment of kidney and liver function, coagulation profile, ECG, consultations of specialized doctors.
When possible, a preoperative immunohistochemical study is carried out to determine the subtype of the neoplasm and plan the individual treatment. The histopathologists evaluate the expression of p53 protein and bcl2, proliferative activity (Ki-67 index), as well as the morphological structure of the tumor (squamous, basaloid, mucoepidermoid, clear cell and others).
Selection of the optimal treatment method
When choosing a therapeutic technique, oncologists take into account the size of the tumor, the degree of its invasion into the surrounding organs, the presence of distant metastases, as well as the patient's general health state. The main treatment method is the surgical removal of the tumor, which can be supplemented by chemotherapy, radiation therapy or prescription of targeted agents.
In the case of small neoplasms without any signs of invasion into other organs of the mediastinum, oncologists prefer surgery – thymus resection or thymectomy. Both surgical procedures can be performed thoracoscopically, with the introduction of surgical instruments through small punctures in the chest. If a thoracic surgeon needs a more extensive surgical field, he will use an open access, with the chest opening and connecting the patient to a heart-lung machine. In modern surgical clinics, the risks of blood loss and excessive trauma to healthy tissues are minimized due to the use of ultrasonic scalpels, electric coagulators for blood vessels and devices for layer-by-layer suturing of surgical wounds.
Should there be an invasion in the surrounding organs and no metastases, oncologists make a choice between immediate surgical removal of the tumor and preliminary chemotherapy and / or radiation therapy. The operation can be performed when the surgeon considers it possible to remove the tumor totally.
When detecting local and distant metastases, doctors consider each of the metastatic foci as an independent tumor and plan treatment based on this. In such a situation, methods of choice are irradiation on the latest generation of linear accelerators and systemic therapy – the prescription of chemotherapeutic cisplatin-containing drugs and targeted therapy (for example, an oral multikinase inhibitor sunitinib).
Treatment of thymus cancer in specialized clinics with Booking Health
Thymus cancer is an extremely rare tumor, and therefore only a limited number of clinics specialize in its treatment. As a certified medical tourism operator, Booking Health helps with contacting specialized clinics and doctors who demonstrate the highest success rates in the treatment of this pathology.
The specialists of Booking Health will also help you with the following important issues:
- Direct communication with your attending physician
- Preliminary preparation of the examination and treatment program
- Control of the cost of clinic services, elimination of overpricing and additional coefficients for foreign patients (saving up to 50%)
- Making an outpatient appointment on the desired date, booking a patient room for inpatient treatment
- Independent control of the medical program at all its stages
- Insurance against the cost of treatment increase in case of complications (а coverage of 200,000 EUR, valid for 4 years)
- If necessary, assistance in buying and forwarding medicines
- Communication with the clinic after the completion of the medical program
- Control of invoices and compensation of unspent funds
- Organization of additional examinations, follow-up tests, distance consultations
- Top-class service: booking accommodation, tickets, transfer
- Services of a personal medical coordinator and an interpreter
Choose treatment abroad and you will for sure get the best results!
Author: Dr. Nadezhda Ivanisova