Chemotherapy for thymus cancer

Chemotherapy uses drugs to destroy cancer cells. These drugs target rapidly dividing cells throughout the whole body. This means that chemotherapy kills cancer cells but it can also damage healthy cells.

With most types of chemotherapy, the drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic therapy.

Chemotherapy is given for different reasons. You may have chemotherapy 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 the cancer can't be removed with surgery (is inoperable)
• treat thymus cancer that has come back
• relieve pain and control other symptoms of advanced thymus cancer (called palliative chemotherapy)

Chemotherapy and radiation therapy may be given during the same time period to treat thymus cancer. This is called chemoradiation. Some chemotherapy drugs can help make radiation work better by making cancer cells more sensitive to radiation. Combining chemotherapy and radiation therapy can be more effective than either treatment on its own.

A chemotherapy combination that includes cisplatin 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:

• CAP – cisplatin, doxorubicin and cyclophosphamide
• cisplatin and etoposide
• CAP with prednisone
• carboplatin and paclitaxel
• ADOC – cisplatin, doxorubicin, vincristine and cyclophosphamide
• VIP – etoposide, ifosfamide and cisplatin
• gemcitabine, capecitabine and paclitaxel

If thymus cancer doesn’t respond to drugs used in earlier treatments or if it comes back, the following drugs may be used:

• etoposide
• fluorouracil (also called 5-fluorouracil or 5-FU)
• pemetrexed

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

The following drugs may be given with chemotherapy.

Prednisone is a corticosteroid drug that may be given with the chemotherapy combination. It is given to reduce swelling and lower the body’s immune response (reaction to foreign substances). It is taken as a pill once a day.

Mesna may be given at the same time as ifosfamide or cyclophosphamide. It’s a supportive drug used to protect the bladder from damage and lower the risk of urinary tract problems caused by these chemotherapy drugs. Mesna is given by intravenous (IV).

Octreotide (Sandostatin) is a type of drug called a somatostain analogue. These drugs lower the amount of hormones made and released by cancer cells in the thymus. Octreotide is used to slow and control the growth of advanced or metastatic thymus cancer. It’s 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 of chemotherapy will depend mainly on the drug, the dose, how it’s given, and your overall health. Tell your healthcare team if you have side effects that you think are from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Common side effects of chemotherapy drugs for thymus cancer include:

• low blood cell counts
• nausea and vomiting
• sore mouth and throat
• loss of appetite
• hair loss
• nerve damage
• diarrhea
• constipation
• bladder problems
• skin problems
• weight gain
• headache
• changes to blood sugar levels
• gallbladder problems, including gallstones

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

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