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A lymph node removal, also known as a “lymphadenectomy,” is usually done for two main reasons: to diagnose or rule out serious medical conditions like cancer, or to treat cancers that have spread through the lymphatic system. Lymphadenectomy is usually considered a fairly serious procedure, and is usually only performed in situations where a patient’s health may be seriously at risk. Most of the time it’s done as a part of cancer screening or treatment, though many different types of cancer could be the cause. In rarer events it’s done to screen for other conditions impacting the lymph nodes, particularly the human immunodeficiency virus (HIV). In most cases there are other, more efficient tests for this sort of condition, and lymphadenectomy is usually only recommended if no other less invasive option seems feasible.
A lymph node is a small, ball-shaped tissue mass that can be found throughout the body. Lymph nodes are an important part of the immune system in part because they trap foreign particles. They also help the body to fight off infections, and warn the body about those infections and any life-threatening diseases by becoming inflamed and swollen.
All of these nodes are a part of what is known as the larger lymphatic system, which courses through much of the body. It is filled with lymphatic fluid. Diseases sometimes use this fluid as a way of spreading from place to place inside a person’s system, and no condition is more notorious for this than cancer. Many different types of cancers use the lymph fluid to move and grow in new places, which is known medically as “metastasis.” Lymph node metastasis occurs when a localized cancer, such as breast or lung cancer, starts to spread to other parts of the body, This can prove fatal even if caught early.
When surgeons remove a person’s lymph nodes they usually study the tissues that have been removed with a particular focus on finding cells that indicate the presence of cancer; if cancer is already known, they’re often looking for evidence of metastasis. If neither is detected, they may look for secondary reasons for inflammation, like other diseases or conditions.
A doctor may perform a lymphadenectomy to test for cancer cells within the lymph node, which can help determine if the cancer has spread. Cells within the lymph system are not static but travel throughout the body, meaning that finding cancer in a lymph node means it is likely to be found elsewhere, too. Removal of the lymph nodes in such a case means the doctor can both determine whether the cancer has spread and remove part of the patient’s cancer in the process.
The particular node affected by lymph node removal surgery depends on the type of illness suspected. For example, treatment for pharynx cancer, which affects the throat, often involves the removal of lymph nodes in the throat. Depending on the size of the cancerous tumor, the removal procedure may involve a just few nodes near the tumor or a radical neck dissection in which all lymph nodes in the neck are removed.
While lymphadenectomy may help to diagnose cancer and can help the doctor determine the cancer’s growth or regression as treatment progresses, it also has another benefit. Removal of a lymph node or nodes near the original tumor can prevent the cancer's spread to other parts of the body. In some cases, the procedure has been to known to remove all signs of cancer from the patient’s body, curing the disease in the process.
Cancer-related treatments are the most common use of lymph node removal in most circumstances, but they are not the only time this sort of treatment is warranted. Swollen lymph nodes can be an indication of a variety of illnesses, especially autoimmune diseases such as arthritis and HIV. When the swelling fails to correct on its own and other symptoms don’t clearly indicate a particular illness, doctors can use lymph node removal to first rule out cancer and then help identify the true cause of the swelling. It’s usually rare for removal to be performed first, but it can be a later-line treatment if nothing else seems to be giving conclusive results.
I just read a recent article on breast cancer research that found that removing fewer lymph nodes in surgery could actually produce better results. In fact, they compared the benefits and risks of sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection (ALND) and found that ALND might do more harm than good. Do you think that ALND, which removes all 20-30 lymph nodes, is just playing it safe, or do you think it might actually cause more problems than it’s worth?