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Lymph node surgery

What are lymph nodes?

Lymph nodes or lymph glands are tiny kidney-shaped water pumps that act as immune filters in our body. Their role is to drain any excess fluid and help our body fight infection and disease. Lymph nodes sit in clusters along the big blood vessels and are found throughout our body. 

Gynaecological cancers like cervical, endometrial, and ovarian cancer can involve lymph nodes on either side of the pelvis and along the aorta, our biggest blood vessel.

Why are lymph nodes important in cancer treatment?

Lymph nodes have the important job of filtering out infection and disease, so they’re the first place where cancer cells can spread to from the organ affected by cancer. These cancer cells are not always visible on a scan until they’ve grown to a substantial size.

What is lymph node dissection?

A lymph node dissection or lymphadenectomy is a surgical procedure to remove lymph nodes, and plays an important role in cancer treatment. 

It’s necessary to remove the lymph nodes and have them checked under the microscope for any signs of cancer. It’s possible for cancer cells to have spread to the lymph nodes, even when the scans do not suggest any lymph node involvement. 

What is sentinel lymph node detection?

Sentinel lymph node detection is a relatively recent development in the treatment of gynaecological cancers. 

Sentinel lymph node

The sentinel lymph node is the first lymph node that receives and drains fluid from a tumour, so it’s the first lymph node to which the cancer can spread. If the sentinel lymph node doesn’t have cancer cells, it’s unlikely that the rest of the nodes in the cluster will have cancer cells. 

Endometrial cancer

It’s normal procedure to offer sentinel lymph node detection to women who are undergoing surgery for endometrial cancer.

Cervical cancer

For cervical cancer treatment, sentinel lymph node detection is currently only offered to a select group of women in the early stages of cancer. 

If the sentinel lymph node isn’t identified during the surgery, a full lymph node dissection may be recommended. 

Does having lymph node surgery mean the cancer has already spread?

No, it doesn’t mean the cancer has spread. 

Lymph node surgery is carried out to check if there’s any early spread of the cancer that cannot be picked up by the best scans in the world.

Why do you need to check the lymph nodes?

To maximise the benefit of cancer treatment, it’s essential to detect any spread of cancer cells to the lymph nodes.

It’s important to find out if the lymph nodes have any cancer cells, as this will determine the need for any additional treatment like radiotherapy and/or chemotherapy. 

What is leg lymphoedema?

Leg lymphoedema is a swelling in the legs as a result of a build-up of fluid in the body’s soft tissues. It can be treated if detected at an early stage but can become permanent if it goes unnoticed and untreated. 

Anyone can develop lymphoedema, but lymph node surgery for gynaecological cancer is a risk factor in developing leg lymphoedema.

How is lymphoedema managed?

If you’re undergoing lymph node surgery, you’ll be referred to a physiotherapist or lymphoedema specialist for advice on prevention and management of lymphoedema.

What if I prefer not to have lymph node surgery?

The prospect of having cancer surgery can be extremely daunting. The discussions surrounding different treatment options can be complex, even intimidating.

We’d like to reassure you that Dr Vivek Arora will take the time to gain an in-depth understanding of your medical history to give you expert advice on the appropriateness of lymph node surgery. We encourage you to discuss your concerns openly and freely, and to ask as many questions as possible for complete peace of mind. 

Dr Vivek Arora will create an individualised treatment plan, taking into account your medical history and personal concerns. His ultimate priority is to recommend the best treatment approach while working with you to create a treatment plan that’s mutually acceptable without compromising your medical care. 

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