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Resection of the thymus cancer is the most successful approach of management. Resectability, type of tumour and spread are most important considerations in deciding management options. Thymic carcinomas are more aggressive than thymomas, and therefore  tend to spread rapidly and need more intensive and aggressive therapy.

Resectable Cancer

Surgery provides the best chance of long-term survival for patients with resectable cancers (almost all stage I and II thymus cancers, most stage III cancers, and limited percentages of stage IV cancers). Surgery entails removing the whole thymus and maybe pieces of surrounding organs or blood vessels if involved. As long as the tumour has been completely eliminated, early stage thymomas (such as stage I and II) normally do not require further care following surgery. In certain cases, where there is fear that any tumour (visible or nonvisible/microscopic) has been left behind, radiation treatment can be considered. Radiation therapy may be used following surgery in patients with more advanced stage thymomas (such as stages III and IV) even though all of the tumour has been eliminated. Radiation treatment is usually provided after surgery if the tumour cannot be entirely removed. Chemotherapy (chemo) can also be applied, depending on the amount of cancer left behind. It is also tried in cases the tumour has spread from beyond the chest to far away organs.

Thymic carcinoma is more likely to come back following surgery when compared to thymoma. If the tumour has been removed entirely, patients with stage I tumours do not require further treatment. Patients are usually administered with radiation following surgery if the tumour is more advanced. The radiation and chemo are more commonly used in thymic carcinoma as compared to thymoma.

Unresectable Cancer

Unresectable tumours are those which cannot be removed with surgery alone. This stage of tumours usually are cancers that are too close to critical systems (such as nerves and blood vessels) or have spread too far to be entirely eliminated (which includes many stage III and most stage IV cancers). It also includes persons who are too frail for surgery. In certain cases, clinicians may first consider giving chemo to try to make the tumour resectable. Surgery is performed if it shrinks enough. It is then accompanied by more chemo or radiation therapy treatment. For certain unresectable tumours, surgery can be the first treatment to attempt to eliminate as much of the tumour as possible. This is known as debulking surgery. Thereafter the tumour area is irradiated with/without chemotherapy.  The hope is that debulking makes the other therapies function well and will help patients to survive longer, even though the cancer is not completely cured. Studies in this combined multi-modality approach have had mixed outcomes.

Chemo and radiation therapy are the primary  choices for people who can’t get surgery, either because the disease has advanced too much or because they’re too ill from other critical medical conditions. Since unresectable cancers can be difficult to treat,  it is advisable to get in touch with thoracic surgeon in Delhi /nearby town possible to participate in a clinical trial with a newer type of therapies /medicines under an experienced thoracic surgeon.

Recurrent Thymus Cancer

Post-surgery or chemotherapy/radiotherapy if the cancer comes back it is considered recurrent. Recurrence may be local (in or around the same location where it began) or remote (spread to organs such as the lungs, liver, or bone). Thymomas return more frequently locally, whereas thymic carcinomas recur not only locally and but also in surrounding lymph nodes, spread to the liver, lungs, and bones as well. The treatment of thymus cancer that has recurred (returned) after initial therapy depends on upon the mode of treatment already done and duration from the initial treatment. Surgery can be an alternative if the recurrence is not too widespread, which may provide the best hope for long-term survival. But the treatment methods are limited to radiation therapy and/or chemotherapy in most cases.

Due to the difficult and intricate treatment of these types of thymus problem, it is advisable to consult a thoracic surgeon in Delhi /nearby place possible. This will not only remove your doubts but also remove any dilemma in taking decisions.