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Lymph Nodes why take them out!

Posted by jeff Marchi @jeffmarc, Sep 24 12:31pm

An interesting article I read discussed the removal of lymph nodes during cancer surgery, and the negative aspects of doing it.

"Lymph nodes aren't just passive waiting rooms for immune cells, they actively train and educate T cells, and send them off to do their job," said Professor Axel Kallies, PhD, Laboratory Head at the Doherty Institute and the corresponding author on both studies. "Our research suggests that removing lymph nodes during cancer surgery, a common practice to prevent tumor spread, may inadvertently reduce the effectiveness of treatments, such as checkpoint blockade and CAR T cell therapies. Preserving lymph nodes could strengthen immune responses and increase the effectiveness of immunotherapy."

But what are lymph nodes, and what do they do?
Lymph nodes are small, bean-shaped organs scattered throughout the body that act as checkpoints of the immune system. They filter lymph fluid, which drains from tissues, trapping and destroying germs, cancer cells, and other harmful material. Inside, lymph nodes are packed with immune cells like T cells, B cells, and dendritic cells that communicate, train, and multiply in response to threats.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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heavyphil | @heavyphil | Sep 25 7:42am

Surfer & Jeff, whether they are organs, organelles, organ-like or part of an organ system they still function the same way.
All the various definitions found online don’t change the fact that cancerous nodes need to be eliminated surgically or with radiation.
The real question, originally asked by Jeff - whether multiple nodes should be removed as a matter of course - is an interesting one.
My surgeon only removed ONE node on each side and I cursed him for doing so. Was he that confident that he got it all or was he just sloppy? Negligent? In a hurry to make tee time?
Or did he know the importance of the nodes in dealing with unseen rogue cells which may have gotten out?? I’ll never know…
Phil

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rensselaer234 | @rensselaer234 | Sep 26 6:42am
In reply to @jeffmarc "@surftohealth88 I see what you are saying but all searches say organ. https://en.wikipedia.org/wiki/Lymph_node If you do..." + (show)
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@surftohealth88
I see what you are saying but all searches say organ.
https://en.wikipedia.org/wiki/Lymph_node
If you do a search “are lymph nodes organs” there are many references saying they are. Maybe the whole lymphatic system are considered an organ and that is why they are called that.

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@jeffmarc
My interpretation is the lymphatic system is comprised of lymph nodes (organs), lymph fluid (tissue?), lymph vessels etc. (my 1960’s biology classes).
Interesting article Jeff, thanks.

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rlpostrp | @rlpostrp | Sep 26 11:04am

When discussing what was then my "pending" DaVinci Robotic-assisted Radical Prostatectomy, I asked my urologist if he planned on removing my lymph nodes as well? I knew that if the cancer spreads to the lymph nodes, your time is now limited. My urologist had two responses: 1) Statistical studies show that after many lymph nodes being removed, and an overwhelmingly vast percentage in the upper 90-percents showing no-invasion/no- pathology, standards of practice for prostatectomy now do NOT routinely remove the lymph nodes. He added that the prevailing and accepted protocol is to NOT remove lymph nodes, as is offered by the author of the above Mayo post. 2) He told me that with my Gleason score of 3+4=7 (with only 6-10% of cells "4" on the second pass examination), a PSA of 6.1 ng/ml, and most importantly, a PET Scan that showed 100% confinement of the cancer in my prostate, that he "didn't need to remove the lymph nodes." Had there been Gallium-68 radioactive tracer uptake outside the prostate, and perhaps specifically in the lymph nodes, he would have removed them, but that he and the general population just don't see it very often.
I was however reminded of the father of my sister's best friend. "After" he died of prostate cancer in his late '60's, his family and friends recalled how he was often complaining of lower back pain for a very long time. He thought he was just getting old and was "paying for" all of the misuse and strain on his back through his earlier years. He was finally diagnosed with prostate cancer, and was dead within a few months after, with massive pelvic area lymph node invasion, as well as elsewhere in his body. I don't recall what his Gleason score was, but it was likely a 5+4=9. Lesson learned for men over 40 to 50 and onward: If you have lower back pain - and really for no reason - and you haven't had a PSA in a while: Go to the doctor and get tested before it is too late.

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surftohealth88 | @surftohealth88 | Sep 26 1:04pm
In reply to @heavyphil "Surfer & Jeff, whether they are organs, organelles, organ-like or part of an organ system they..." + (show)
Profile picture for heavyphil @heavyphil

Surfer & Jeff, whether they are organs, organelles, organ-like or part of an organ system they still function the same way.
All the various definitions found online don’t change the fact that cancerous nodes need to be eliminated surgically or with radiation.
The real question, originally asked by Jeff - whether multiple nodes should be removed as a matter of course - is an interesting one.
My surgeon only removed ONE node on each side and I cursed him for doing so. Was he that confident that he got it all or was he just sloppy? Negligent? In a hurry to make tee time?
Or did he know the importance of the nodes in dealing with unseen rogue cells which may have gotten out?? I’ll never know…
Phil

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@heavyphil

Our surgeon was in a hurry lol - I know that for a fact. My husband asked him to sample some since one was faintly glowing on a PSAM scan, but nodes were not removed for examination. Explanation was "they all looked normal size when he was operating".
Most days I feel like I exist in some parallel universe with no logic or that the Universe is making some very bad jokes with me and my husband.

Oh well....

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heavyphil | @heavyphil | Sep 26 3:49pm
In reply to @surftohealth88 "@heavyphil Our surgeon was in a hurry lol - I know that for a fact. My..." + (show)
Profile picture for surftohealth88 @surftohealth88

@heavyphil

Our surgeon was in a hurry lol - I know that for a fact. My husband asked him to sample some since one was faintly glowing on a PSAM scan, but nodes were not removed for examination. Explanation was "they all looked normal size when he was operating".
Most days I feel like I exist in some parallel universe with no logic or that the Universe is making some very bad jokes with me and my husband.

Oh well....

Jump to this post

@surftohealth88 So in the age of advanced PET scans, AI enabled genetic testing and daVinci robots we now access lymph glands in high risk patients as if they were nectarines in the produce aisle??
I mean, I understand that the surgeon has seen plenty of glands in his day - especially the swollen reactive ones FULL of inflammation and PCa cells…but how about the ones with just a few - or a small cluster the size of a poppy seed? Surely he can’t see those…
Know exactly how you feel, which is why on most days I don’t leave my house!!!
Phil

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Profile picture for xahnegrey40
xahnegrey40 | @xahnegrey40 | Sep 28 8:54am
In reply to @rlpostrp "When discussing what was then my "pending" DaVinci Robotic-assisted Radical Prostatectomy, I asked my urologist if..." + (show)
Profile picture for rlpostrp @rlpostrp

When discussing what was then my "pending" DaVinci Robotic-assisted Radical Prostatectomy, I asked my urologist if he planned on removing my lymph nodes as well? I knew that if the cancer spreads to the lymph nodes, your time is now limited. My urologist had two responses: 1) Statistical studies show that after many lymph nodes being removed, and an overwhelmingly vast percentage in the upper 90-percents showing no-invasion/no- pathology, standards of practice for prostatectomy now do NOT routinely remove the lymph nodes. He added that the prevailing and accepted protocol is to NOT remove lymph nodes, as is offered by the author of the above Mayo post. 2) He told me that with my Gleason score of 3+4=7 (with only 6-10% of cells "4" on the second pass examination), a PSA of 6.1 ng/ml, and most importantly, a PET Scan that showed 100% confinement of the cancer in my prostate, that he "didn't need to remove the lymph nodes." Had there been Gallium-68 radioactive tracer uptake outside the prostate, and perhaps specifically in the lymph nodes, he would have removed them, but that he and the general population just don't see it very often.
I was however reminded of the father of my sister's best friend. "After" he died of prostate cancer in his late '60's, his family and friends recalled how he was often complaining of lower back pain for a very long time. He thought he was just getting old and was "paying for" all of the misuse and strain on his back through his earlier years. He was finally diagnosed with prostate cancer, and was dead within a few months after, with massive pelvic area lymph node invasion, as well as elsewhere in his body. I don't recall what his Gleason score was, but it was likely a 5+4=9. Lesson learned for men over 40 to 50 and onward: If you have lower back pain - and really for no reason - and you haven't had a PSA in a while: Go to the doctor and get tested before it is too late.

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@rlpostrp so you said in your post that lymph node invasion gives one'limited time'..and yet later said that men over 40 with lower back pain go to doc and get tested.

Many men died from prostate cancer back in the day. One treatment option was castration which is not reverseable...( done even now in rare cases I believe)...

however, just to clarify, according to my research discussions with docs, even metastic prostate cancer ( to bones) can be treated with ADT and radiation ( including lymph nodes-the fewer the better) plus spot radiation ..the PET scans now can see very early cancer growth, pin point it and in many cases, early ADT/radiation can and does suppress the disease for many years...

Of course people still die from prostate cancer ( OJ SImpson, Wm Hurt, Dennis Hopper, Timothy leary ) but many die because they ignore symptoms or refuse treatment...lots of great advancements in last 15 yrs !

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