Thymus Cancer: Surgery
Surgery is commonly used to treat thymus tumors. One of the first things your healthcare
providers will do is figure out if all of the tumor can be removed.
Different kinds of surgery may be done. Which type you have depends on how big the
tumor is, whether the cancer has spread, and how close the tumor is to key tissues
(like nerves and blood vessels). It also depends on your overall health and other
factors.
When might surgery be used for thymus tumors?
Surgery is the main treatment for thymus tumors, if it can be done. The goal is to
remove the tumor and often all of the thymus. In some cases, you may need surgery
for a diagnosis.
Your healthcare provider may recommend surgery even if they don’t think all of the
tumor can be removed. Here, the goal is to take out as much of the tumor as possible
(called debulking). This might help other treatments, like radiation and chemotherapy,
work better. Not all healthcare providers agree with this, though.
Types of surgery for thymus tumors
Thymectomy
The main type of surgery for thymus tumors is called a thymectomy. This is when the tumor and the rest of the thymus gland is removed. If the cancer
has reached nearby structures, such as blood vessels, the lining of your lung (pleura),
lining around your heart (pericardium), or a lung, these are also taken out.
This type of surgery is often done through a cut made in skin on the front of your
chest and then a cut through the middle of your breastbone (sternum). This is called
a median sternotomy.
Less often, the surgery might be done through several small cuts (incisions). A long,
thin, lighted video camera (called a laparoscope) is put in one of the cuts to see
inside your chest. Then special long, thin surgical tools are put in through the other
cuts to do the surgery. This approach should be done only by surgeons at centers that
have a lot of experience with this technique.
Possible risks, complications, and side effects of surgery
All surgery has risks. Some of the risks of any major surgery include:
Risks from surgery for a thymus tumor
Along with the risks above, thymus tumor surgery can sometimes cause other problems.
These can include:
Getting ready for your surgery
Before you go for surgery, you’ll meet with your surgeon to talk about the procedure.
At this time, you can ask any questions and discuss any concerns you may have. This
is also a good time to review the side effects of the surgery and to talk about its
risks. You might ask if the surgery will leave scars and what those scars will look
like. You might also want to ask how you'll feel after surgery and when you can expect
to return to your normal activities. After you’ve discussed all the details with your
surgeon, you'll sign a consent form that says the surgeon can do the surgery.
On the day of your surgery, you may be asked to arrive at the hospital admission area
a couple of hours before your surgery is supposed to start. There, you'll complete
the needed paperwork and then go to a pre-op (pre-operative or before surgery) area.
You’ll undress and put on a hospital gown. Your healthcare team will meet you there.
They'll ask you about your medical history, the medicines you take, and any allergies
you have. They’ll also talk about the surgical procedure. Try not to get frustrated
by the repetition. These questions are repeated to help prevent mistakes.
While you’re in the pre-op area, an anesthesiologist or a nurse anesthetist will evaluate
you. They will explain the anesthesia you'll be given during surgery. The purpose
of the anesthesia is to put you into a deep sleep so you won't feel any pain during
the surgery. Be sure to answer all the questions well and honestly. This helps prevent
complications. Also ask any questions you have about your anesthesia. You’ll have
to sign a form that states that you understand the risks involved.
Your surgeon will also see you in the pre-op area. Ask any last-minute questions you
have. This can help put your mind at ease.
What to expect during surgery
When it’s time for your surgery, you’ll be taken into the operating room. There will
be many people there, including the anesthesiologist, surgeon, and nurses. Everyone
will have on a surgical gown and a face mask.
Once you’re in the room, medical staff will move you onto the operating table. Your
anesthesiologist or nurse will put an intravenous line (IV) into your arm. This requires
just a small skin prick. (Sometimes the IV may be started in the pre-op area instead.)
Someone might put special stockings on your legs to help prevent blood clots. Electrocardiogram
(ECG) wires with small, sticky pads on the end will be attached to your chest to monitor
your heart. A blood pressure cuff will be wrapped around your arm. When all the preparation
is done, a mask might be put over your nose and mouth. You’ll be given the anesthesia
and will fall asleep.
During surgery, a catheter may be placed through your urethra and into your bladder.
This is a soft, hollow tube used to drain urine into a bag. You’ll also have a breathing
tube put in your windpipe. A breathing machine (ventilator) will control your breathing
during surgery. Also, a nasogastric (NG) tube may be put in your nose. This tube goes
into your stomach to drain its contents.
What's removed during surgery and where the incisions (cuts) are made depend on the
type of surgery you have.
After surgery, medical staff will move you to the recovery room. There, they'll monitor
you for a few hours. When you wake up, don't be alarmed by the number of tubes and
wires attached to you. These are normal post-op (post-operative or after surgery)
monitors. When you’re fully awake in the recovery room, your family or other support
people will be able to see you for a short time. Once you’re awake and stable, you'll
be moved to a regular hospital room.
What to expect after surgery
When you first wake up, you might have some pain. Your healthcare provider will give
you pain relievers as needed to help you feel more comfortable. The pain medicines
will also help you get up and walk soon after your surgery. This is important for
your recovery.
You’ll likely stay in the hospital for a few days. It will take time to get back to
eating normally and having regular bowel movements. You may still have the catheter
in your bladder to drain urine. It allows your healthcare providers to measure your
urine output. This helps to keep track of your fluids and make sure you're drinking
enough liquids. It’s usually taken out before you go home.
When you're up and about, feeling better, and your pain is controlled, you'll be able
to go home. You can slowly return to most normal activities once you leave the hospital.
But don't lift heavy things for several weeks. You'll be taught how to care for your
incision, when to use your pain medicines, what problems to watch for, and when to
call your healthcare provider. Always follow the instructions you get from your healthcare
team.
After surgery, you may feel weak or tired for a while. The amount of time it takes
to heal from an operation is different for each person. But you may not feel like
yourself for many months. Your healthcare provider will give you instructions about
whether and when you can get your incisions wet. You likely won't be able to drive
for a while, as directed by your healthcare providers.
Talk to your healthcare team
If you have any questions about your surgery, talk to your healthcare team. They can
help you know what to expect before, during, and after surgery.
Ask your healthcare provider what signs of problems you should watch for and when
to call. Know how to get help after office hours and on weekends and holidays.