When the doctor tells you that you have cancer, and then says, "I have to remove some lymph nodes along with the tumor," it's normal to feel a little scared. "Why are they removing these nodes? What will happen with this? Is this a major operation ?" Many questions like these probably come to your mind. Don't be afraid. Today, we are talking about this surgery called Lymphadenectomy to answer those questions.
First of all, what is Lymphadenectomy?
Simply put, a lymphadenectomy is the surgical removal of one or more lymph nodes in your body. In our common language, this is also called a "lumpectomy."
Imagine that our body is like a big city. There is a network of roads (blood vessels) everywhere in this city. Also, there is a separate system to remove waste and ensure security in this city. That is what the lymphatic system in our body is like. This system has small security checkpoints. We call those checkpoints lymph nodes .
Their main job is to filter and clean the lymph that flows through the lymphatic system. That is, they capture and destroy germs, damaged cells, and especially cancer cells in this fluid. So they are a very important part of our body's immune system.
Then why remove these lymph nodes from someone with cancer?
The main reason for this is to know exactly whether the cancer has spread to other parts of the body. The main route through which this spread (metastasis) occurs is through the lymphatic system.
Imagine this. You have a tumor in one part of your body. It's like a small fire in one room of a house. Now we want to know if this fire has spread to other rooms. So what do we do? We go to the nearest rooms and see if the fire has spread there.
Similarly, doctors also check the lymph nodes near the tumor to see if cancer cells have spread there.
This surgery accomplishes several main goals:
- Determine the stage of the cancer: Doctors can determine the stage of the cancer based on whether or not there are cancer cells in the lymph nodes. This is very important for planning future treatment.
- As a treatment: If there are cancer cells in the lymph nodes, removing those nodes also removes those cancer cells from the body. This means that this is both a diagnosis and a treatment.
- Stop the cancer from spreading further: Removing lymph nodes that contain cancer cells stops the cancer from spreading further in the body.
- Prevent cancer from coming back: After removing the tumor, removing any cancer cells that may remain in the surrounding lymph nodes can reduce the risk of cancer coming back in the future.
What types of cancer most often require this surgery?
This surgery is recommended for several types of cancer that are more likely to spread through the lymphatic system. The main types of cancer that take a leading role are:
- Breast cancer
- Melanoma skin cancer
- Head and neck cancer
- Thyroid cancer
- Lung cancer
- Stomach cancer
- Colorectal cancer
- Testicular and ovarian cancer
- Bladder, rectal, and prostate cancer
What are the main types of lymphadenectomy surgery?
There are two ways to do this surgery. It's like the police asking whether to check only the suspicious area or to check the entire area.
| Type of surgery | Simply put... |
|---|---|
| Regional (Selective) Lymphadenectomy | This involves removing only a sample, that is, only a small amount, from the lymph node region closest to the cancerous tumor. |
| Radical (Complete/Total) Lymphadenectomy | This involves removing all the lymph nodes in the area. This is done if there is a suspicion that the cancer has spread far enough. |
Sometimes, doctors first do something called a Sentinel Node Biopsy . This means they find the "sentinel" lymph node, where cancer cells are likely to have spread from the tumor, and remove just that one for testing. If it doesn't contain cancer cells, they often decide not to remove the others. If it does, more nodes will need to be removed.
Where on the body do you remove moles this way?
This depends on where your cancer is located, as each type of cancer spreads through specific lymph node regions in the body.
| Name of the surgery | Where there are ants to be removed | Often associated cancers |
|---|---|---|
| Axillary Lymphadenectomy | Armpit area | Breast cancer, melanoma of the hand |
| Inguinal Lymphadenectomy | Groin area | Cancer of the penis and vulva |
| Cervical Lymphadenectomy | Neck area | Head, neck and thyroid cancer |
| Retroperitoneal Lymphadenectomy | Back of the abdomen (inside the stomach) | Testicular and ovarian cancer |
| Pelvic Lymphadenectomy | Pelvis | Bladder, rectal, prostate cancer |
| Mediastinal Lymphadenectomy | Middle part of the chest | Lung cancer, Lymphoma |
What happens before, during and after the surgery?
Before surgery
Before scheduling your surgery, your doctor will likely order tests such as scans to check the condition of your lymph nodes. They may also perform a needle biopsy, which involves removing a small piece of tissue for examination. If these tests show signs of cancer, a lymphadenectomy is performed.
During surgery
This surgery is usually done under general anesthesia. This means you won't feel anything, you'll be completely asleep. There are two ways the surgery can be done.
1. Open Surgery: In this, a single long incision is made at the relevant site and the lymph nodes are removed.
2. Laparoscopic Surgery: This involves making several small incisions, inserting a camera through one, and inserting instruments through other incisions. This method has a shorter healing time and smaller scars.
After surgery, the surgeon will place a small tube called a drain inside the incision and connect it to a tube. This is to prevent unnecessary fluid from accumulating at the surgical site. This drain will need to be left in place for several days or weeks.
After the surgery
If you had a minor keyhole surgery, you will be able to go home the same day. If you had an open surgery, you will need to stay in the hospital for one to three days. When you go home, you will be given detailed instructions on how to care for the wound and how to take your medications. You will need to see the doctor again to remove the drain, cut the stitches, and get the biopsy report.
What are the benefits, risks, and side effects of this surgery?
Like any surgery, this one has benefits as well as some risks and side effects.
| Benefits | Risks & Side Effects |
|---|---|
| You can know exactly whether the cancer has spread. | Wound infection. |
| Determining the stage of the cancer helps choose the best treatment. | Damage to surrounding nerves and blood vessels. |
| It removes cancer cells from the lymph nodes and stops them from spreading. | Numbness and stiffness around the incision. |
| Reduces the risk of cancer recurrence. | Fluid accumulation at the surgical site (Seroma). |
| Lymphedema: This is a side effect that you should be aware of. When a large number of lymph nodes are removed, the flow of lymph fluid can be disrupted, causing a permanent swelling of an organ, such as an arm or leg. This condition doesn't happen to everyone. But it's important to be aware of it. |
When you should call your doctor
If you experience any of these symptoms after your surgery, call your doctor immediately .
- If the wound is red, oozing pus, or has a fever (these are signs of infection).
- If there is unbearable pain, numbness, or stiffness.
- If an organ, such as an arm or leg, swells excessively.
- If certain movements are difficult to perform.
Lymphadenectomy is a very important step in the cancer treatment process. It provides valuable information about your condition and can help stop the cancer from spreading. As with all surgeries, there are risks, but the benefits are worth the risks. The most important thing is to talk to your doctor about it and ask any questions you may have.
Take-Home Message
- Lymphadenectomy is the surgical removal of lymph nodes (nodes) that may contain cancer cells.
- The main goal of this is to find out if the cancer has spread (diagnosis) and to remove the spread cells (treatment).
- The information obtained from this surgery is essential for determining the stage of your cancer and planning future treatment.
- Lymphedema, a condition in which the limbs swell, is one of the main side effects that can occur after surgery. However, this does not happen to everyone.
- During your recovery, be aware of any signs of infection, excessive swelling, or unbearable pain. If this occurs, notify your doctor immediately.
- Talk openly with your doctor about any fears or doubts you may have.
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