Chemotherapy for thymus cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is sometimes used to treat thymus cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is sometimes given at the same time as radiation therapy to treat thymus cancer. This is called chemoradiation.

Chemotherapy is given for different reasons. You may have chemotherapy or chemoradiation to:

• shrink a tumour before other treatments such as surgery or radiation therapy (called induction chemotherapy)
• destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (recur) (called adjuvant chemotherapy)
• control the growth of cancer cells in the body when surgery can’t be done (is inoperable)
• treat thymus cancer that has come back
• relieve pain and control other symptoms of advanced thymus cancer (called palliative chemotherapy)

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the blood to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the thymus.

A chemotherapy combination that includes cisplatin (Platinol AQ) is usually used for thymus cancer. It can be given alone or at the same time as radiation therapy. The most common chemotherapy drug combinations used to treat thymus cancer are:

• PAC – cisplatin, doxorubicin (Adriamycin) and cyclophosphamide (Procytox)
• ADOC – cisplatin, doxorubicin, vincristine (Oncovin) and cyclophosphamide
• VIP – etoposide (Vepesid, VP-16), ifosfamide (Ifex) and cisplatin
• cisplatin and etoposide
• paclitaxel (Taxol) and carboplatin (Paraplatin, Paraplatin AQ)

Chemotherapy for thymus cancer is most often given through a needle into a vein (intravenously). It is usually given for a few days every 3 weeks. How long chemotherapy treatment is used depends on the type of drug combination. It is usually given for several months.

Prednisone is a corticosteroid drug that may be given with the chemotherapy combination. It is taken as a pill once a day.

Mesna (Uromitexan) is given at the same time as certain chemotherapy drugs, such as ifosfamide. It is a supportive drug used to protect the bladder from damage and lower the risk of urinary tract problems caused by the chemotherapy. Mesna is given through a needle into a vein.

Octreotide (Sandostatin) is a drug called a somatostatin analogue. It works by lowering the amount of hormones made and released by certain tumours to slow down and control the growth of cancer. It may be used for recurrent thymoma that is advanced or metastatic, especially when surgery can’t be done. Octreotide is given once a month as an injection into the muscle or under the skin. It may be combined with a corticosteroid drug like prednisone.

Side effects can happen with any type of treatment for thymus cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the types of drugs, the dose, how it’s given and your overall health. Side effects that may happen from chemotherapy drugs used for thymus cancer are:

• nausea and vomiting
• sore mouth and throat
• loss of appetite
• hair loss
• low blood cell counts (bone marrow suppression), which can cause increased infections, fatigue and easy bruising and bleeding
• peripheral nerve damage (peripheral neuropathy), which can cause pain, burning and tingling in the hands and feet

Octreotide may cause these side effects:

• gallbladder problems, including gallstones
• diarrhea
• fatty stool (steatorrhea)
• pain in the abdomen
• nausea and vomiting
• high or low blood sugar (glucose) levels

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy or other drugs you are taking. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.