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Choosing not to remove all lymph nodes in basin, anyone?

Forums General Melanoma Community Choosing not to remove all lymph nodes in basin, anyone?

  • Post
    kab07011
    Participant

      Did anyone you know or on this board choose to leave lymph nodes intact when recommended they all be removed and checked for cancer(melanoma or other type)? Does removing them actually extend life expectancy? Does anyone wonder if they were left alone(even with small cancer cells), being part of our body's immune system they would eventually help fight off cancer? 

    Viewing 17 reply threads
    • Replies
        JerryfromFauq
        Participant

          Many Oncologist's have the same questions.  This is why there are trials being run to get a statistcal basis to see what the differences are in re-occurnce and stage advancement between partial removal of a lymph node basin and a complete Lymph Node Disection (CLND).  My personal belfve is that if there are sufficient "clear" lymph nodes removed, then having some left will tend to trap other unseen cells trying to follow the lymph channel and they might then become an other swollen lymph node or the body might be able to control the reduced volume, but that by traping them at a location nearer to the primary location,  they will likely take longer to travel the lymph path to its junction with the Blood system up above the heart, especially if coming from the lower portion of the body.

           

          JerryfromFauq
          Participant

            Many Oncologist's have the same questions.  This is why there are trials being run to get a statistcal basis to see what the differences are in re-occurnce and stage advancement between partial removal of a lymph node basin and a complete Lymph Node Disection (CLND).  My personal belfve is that if there are sufficient "clear" lymph nodes removed, then having some left will tend to trap other unseen cells trying to follow the lymph channel and they might then become an other swollen lymph node or the body might be able to control the reduced volume, but that by traping them at a location nearer to the primary location,  they will likely take longer to travel the lymph path to its junction with the Blood system up above the heart, especially if coming from the lower portion of the body.

             

              kpcollins31
              Participant
                Keep in mind I am not a doctor, but I agree with Jerry and believe the lymph nodes can act as filters that can catch melanoma cells. I would prefer to remove filters as needed as opposed to getting rid of all of them due to a few bad ones. There is still a clinical trial out there to help understand if there is benefit to CLND. So as with all treatment options, these are personal decisions.

                Kevin

                kpcollins31
                Participant
                  Keep in mind I am not a doctor, but I agree with Jerry and believe the lymph nodes can act as filters that can catch melanoma cells. I would prefer to remove filters as needed as opposed to getting rid of all of them due to a few bad ones. There is still a clinical trial out there to help understand if there is benefit to CLND. So as with all treatment options, these are personal decisions.

                  Kevin

                  kpcollins31
                  Participant
                    Keep in mind I am not a doctor, but I agree with Jerry and believe the lymph nodes can act as filters that can catch melanoma cells. I would prefer to remove filters as needed as opposed to getting rid of all of them due to a few bad ones. There is still a clinical trial out there to help understand if there is benefit to CLND. So as with all treatment options, these are personal decisions.

                    Kevin

                    Michelem
                    Participant

                      This is interesting. We didn't know this was an option. My husband had 15 lymph nodes removed from the groin area last October. In December, a second PET scan showed further lymph involvement, so more glands were removed. Our surgeon said he removed several that appeared healthy to be sure of getting everything – but when tested, the "healthy" glands also proved cancerous. If the latest PET shows no further progression, next step will be radiation. First ipi infusion is tomorrow.

                      And yes, lymphedema is proving to be a major problem. mm

                      Michelem
                      Participant

                        This is interesting. We didn't know this was an option. My husband had 15 lymph nodes removed from the groin area last October. In December, a second PET scan showed further lymph involvement, so more glands were removed. Our surgeon said he removed several that appeared healthy to be sure of getting everything – but when tested, the "healthy" glands also proved cancerous. If the latest PET shows no further progression, next step will be radiation. First ipi infusion is tomorrow.

                        And yes, lymphedema is proving to be a major problem. mm

                        Michelem
                        Participant

                          This is interesting. We didn't know this was an option. My husband had 15 lymph nodes removed from the groin area last October. In December, a second PET scan showed further lymph involvement, so more glands were removed. Our surgeon said he removed several that appeared healthy to be sure of getting everything – but when tested, the "healthy" glands also proved cancerous. If the latest PET shows no further progression, next step will be radiation. First ipi infusion is tomorrow.

                          And yes, lymphedema is proving to be a major problem. mm

                        JerryfromFauq
                        Participant

                          Many Oncologist's have the same questions.  This is why there are trials being run to get a statistcal basis to see what the differences are in re-occurnce and stage advancement between partial removal of a lymph node basin and a complete Lymph Node Disection (CLND).  My personal belfve is that if there are sufficient "clear" lymph nodes removed, then having some left will tend to trap other unseen cells trying to follow the lymph channel and they might then become an other swollen lymph node or the body might be able to control the reduced volume, but that by traping them at a location nearer to the primary location,  they will likely take longer to travel the lymph path to its junction with the Blood system up above the heart, especially if coming from the lower portion of the body.

                           

                          Colleen66
                          Participant

                            I had the partial node removal in the groin.  Aside from the Sentinal Node (had Mel) removed during the WLE, one more of the surface nodes had Mel but was encapsulated and very small number of cells. The Doctor had told me before the operation that she would only take the surface nodes unless a larger numbers of nodes looked to be involved. A total of 7 surface nodes, in the fat layer, were taken with the one being involved.  Although I still have lymphedema, it is quite manageable.  A little over 1 year our with 3 weeks HD Inf. and I'm stll good.  Not pronounced NED but nothing definitive showing up on scans.  

                            Colleen66
                            Participant

                              I had the partial node removal in the groin.  Aside from the Sentinal Node (had Mel) removed during the WLE, one more of the surface nodes had Mel but was encapsulated and very small number of cells. The Doctor had told me before the operation that she would only take the surface nodes unless a larger numbers of nodes looked to be involved. A total of 7 surface nodes, in the fat layer, were taken with the one being involved.  Although I still have lymphedema, it is quite manageable.  A little over 1 year our with 3 weeks HD Inf. and I'm stll good.  Not pronounced NED but nothing definitive showing up on scans.  

                              Colleen66
                              Participant

                                I had the partial node removal in the groin.  Aside from the Sentinal Node (had Mel) removed during the WLE, one more of the surface nodes had Mel but was encapsulated and very small number of cells. The Doctor had told me before the operation that she would only take the surface nodes unless a larger numbers of nodes looked to be involved. A total of 7 surface nodes, in the fat layer, were taken with the one being involved.  Although I still have lymphedema, it is quite manageable.  A little over 1 year our with 3 weeks HD Inf. and I'm stll good.  Not pronounced NED but nothing definitive showing up on scans.  

                                SABKLYN
                                Participant

                                  Good morning.  I had the same decision to make a year ago and decided to do the lymph node dissection(groin).  My surgeon at Sloan Kettering explained the option of joining the study to do ultra sound or have the surgery.  I was concerned about the lymphedema and other potential complications. What it came down to for me was just taking what I thought to be the most aggressive path.  But this is a very personal decision and comes down to which path gives you more peace of mind. I did get a post op infection which I think was more a function of the amount of time the post surgical drains were in but after a week of antibiotics I was fine.  I've had virtually no swelling.  I'm 55 and in reasonably good shape.  Good luck!

                                  SABKLYN
                                  Participant

                                    Good morning.  I had the same decision to make a year ago and decided to do the lymph node dissection(groin).  My surgeon at Sloan Kettering explained the option of joining the study to do ultra sound or have the surgery.  I was concerned about the lymphedema and other potential complications. What it came down to for me was just taking what I thought to be the most aggressive path.  But this is a very personal decision and comes down to which path gives you more peace of mind. I did get a post op infection which I think was more a function of the amount of time the post surgical drains were in but after a week of antibiotics I was fine.  I've had virtually no swelling.  I'm 55 and in reasonably good shape.  Good luck!

                                    SABKLYN
                                    Participant

                                      Good morning.  I had the same decision to make a year ago and decided to do the lymph node dissection(groin).  My surgeon at Sloan Kettering explained the option of joining the study to do ultra sound or have the surgery.  I was concerned about the lymphedema and other potential complications. What it came down to for me was just taking what I thought to be the most aggressive path.  But this is a very personal decision and comes down to which path gives you more peace of mind. I did get a post op infection which I think was more a function of the amount of time the post surgical drains were in but after a week of antibiotics I was fine.  I've had virtually no swelling.  I'm 55 and in reasonably good shape.  Good luck!

                                      heiditemple
                                      Participant

                                        I was faced with this as well.  During my sentinel node biopsy, 4 out of the 8 nodes they removed were positive for melanoma, which scared me.  When they did the surgery to remove the rest of the lymph nodes in my neck, none of them came back positive.  I have a pretty nasty scar on my neck from the surgeries, but I feel like it was the right call for me.  I hope you're able to come to a decision you're comfortable with!

                                        heiditemple
                                        Participant

                                          I was faced with this as well.  During my sentinel node biopsy, 4 out of the 8 nodes they removed were positive for melanoma, which scared me.  When they did the surgery to remove the rest of the lymph nodes in my neck, none of them came back positive.  I have a pretty nasty scar on my neck from the surgeries, but I feel like it was the right call for me.  I hope you're able to come to a decision you're comfortable with!

                                          heiditemple
                                          Participant

                                            I was faced with this as well.  During my sentinel node biopsy, 4 out of the 8 nodes they removed were positive for melanoma, which scared me.  When they did the surgery to remove the rest of the lymph nodes in my neck, none of them came back positive.  I have a pretty nasty scar on my neck from the surgeries, but I feel like it was the right call for me.  I hope you're able to come to a decision you're comfortable with!

                                            JerryfromFauq
                                            Participant

                                              Check what this Oncologist says about CLND Saving most people.

                                               

                                              JerryfromFauq
                                              Participant

                                                Check what this Oncologist says about CLND Saving most people.

                                                 

                                                JerryfromFauq
                                                Participant

                                                  Check what this Oncologist says about CLND Saving most people.

                                                   

                                                  JerryfromFauq
                                                  Participant

                                                    Check what this Oncologist says about CLND Saving most people.

                                                     

                                                    JerryfromFauq
                                                    Participant

                                                      Check what this Oncologist says about CLND Saving most people.

                                                       

                                                      JerryfromFauq
                                                      Participant

                                                        Check what this Oncologist says about CLND Saving most people.

                                                         

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