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Below, week by week, is what OnCo's record of Thymoma (WHO types A, AB, B1, B2 and B3) says about the first two months: the order is typical, the timing is yours to ask about. Thymoma is the slower-growing kind of thymic epithelial tumour, an indolent cancer of the thymus gland behind the breastbone that often announces itself through the autoimmune disease myasthenia gravis. Complete surgical removal cures most patients, radiotherapy is added when the tumour has grown through its capsule, and chemotherapy is used to shrink large tumours or control spread in the chest. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Contrast CT of the chest, acetylcholine receptor antibodies and neurology review; no biopsy of a resectable encapsulated mass; MRI to separate thymoma from cysts and hyperplasia.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Complete thymectomy with the tumour, by sternotomy or minimally invasive or robotic approaches for smaller tumours; en bloc resection of involved pericardium, lung or vessels for stage III.
Postoperative radiotherapy for stage III or incomplete resection; considered for stage II B2 to B3 tumours; observation for completely resected stage I and II type A to B1.
Induction chemotherapy with cisplatin, doxorubicin and cyclophosphamide (CAP) or a platinum doublet, then surgery or radiotherapy according to response.
Repeat resection of pleural recurrences where feasible; chemotherapy rechallenge; octreotide with prednisone for octreotide-scan-positive tumours; everolimus, sunitinib or lenvatinib; PD-1 antibodies avoided or given only in trials because of severe immune toxicity.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.