› Forums › General Melanoma Community › Choosing not to remove all lymph nodes in basin, anyone?
- This topic has 24 replies, 6 voices, and was last updated 10 years, 2 months ago by Michelem.
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- February 7, 2014 at 2:36 pm
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?
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- February 7, 2014 at 3:27 pm
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.
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- February 7, 2014 at 3:27 pm
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.
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- February 7, 2014 at 9:34 pm
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
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- February 7, 2014 at 9:34 pm
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
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- February 7, 2014 at 9:34 pm
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
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- February 9, 2014 at 6:09 pm
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
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- February 9, 2014 at 6:09 pm
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
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- February 9, 2014 at 6:09 pm
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
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- February 7, 2014 at 3:27 pm
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.
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- February 7, 2014 at 4:09 pm
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.
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- February 7, 2014 at 4:09 pm
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.
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- February 7, 2014 at 4:09 pm
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.
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- February 7, 2014 at 5:00 pm
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!
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- February 7, 2014 at 5:00 pm
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!
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- February 7, 2014 at 5:00 pm
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!
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- February 7, 2014 at 8:33 pm
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!
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- February 7, 2014 at 8:33 pm
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!
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- February 7, 2014 at 8:33 pm
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!
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- February 9, 2014 at 8:47 am
Check what this Oncologist says about CLND Saving most people.
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- February 9, 2014 at 8:47 am
Check what this Oncologist says about CLND Saving most people.
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- February 9, 2014 at 8:47 am
Check what this Oncologist says about CLND Saving most people.
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- February 9, 2014 at 8:47 am
Check what this Oncologist says about CLND Saving most people.
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- February 9, 2014 at 8:47 am
Check what this Oncologist says about CLND Saving most people.
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- February 9, 2014 at 8:47 am
Check what this Oncologist says about CLND Saving most people.
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