New lymphnode removal surgery less risky, more effective against cancer

This year, one and a half million people will be diagnosed with cancer. The goal is to catch the disease before it spreads, increasing survival.

Doctors have developed a new kind of surgery that could help some patients stop the cancer in its tracks, with less risk of another trip to the hospital.

Seventeen-year-old swimmer Grant Grussing thought the small lesion on his leg was nothing, but tests showed it was melanoma and it spread to his lymph nodes. Grant needed surgery.

"If you are able to remove the lymph nodes well, completely, you have the opportunity to stop cancer in its tracks,” says Dr. Virai Master, assistant professor of Urology at Emory University School of Medicine.

Traditionally, removing lymph nodes from the thigh and groin area meant an eight-to-ten-inch incision and a 50% risk of complications.

"The enormity of the risk of the procedure is based in the fact that it's a large incision in an area that's prone to infection,” says Dr. Keith Delman, assistant professor of surgery at Emory University School of Medicine.

Dr. Delman helped develop a new approach. Instead of one big incision, he makes three half-inch incisions in the thigh. He fills the leg with air then goes under the skin to remove the lymph nodes, staying clear of vital structures.

"There's no one else in the world who has done this approach for melanoma,” says Dr. Master.

Grant jumped back into competitive swimming less than a month after surgery, and so far, tests show he's cancer-free.

"I'm good to go, 100 percent,” says Grant.

Now, with his dad cheering him on, he's full speed ahead toward a healthier future.

The new lymph node surgery was modified at Emory University, where doctors have performed more than 40 of the procedures.

So far, the procedure has shown a significant reduction in complications like
Infection and leg swelling compared to the standard procedure.



BACKGROUND: Cancer occurs when abnormal cells form and grow within the body. In some cases, these abnormal cells form solid tissue and become tumors. When the cells originate in blood cells, it is known as leukemia or lymphoma. These cells can spread, or metastasize, to different parts of the body. Cells from solid tumors most often spread to the lungs, bones, liver and brain. Cancer that originates in blood cells is typically not localized and can travel throughout the entire body. Cancer that has metastasized can be found by x-rays or other tests. In some cases, the metastatic disease can cause symptoms which lead to the discovery of the cancer.

LYMPH NODES: In some cases, cancer can spread to the lymph nodes. The lymph nodes are part of the immune system and are distributed throughout the body, linked by lymphatic vessels. The lymph nodes attempt to filter out foreign substances or particles in the body. The lymph nodes are able to indicate infection by becoming enlarged or enflamed. These infections can be small, like a sore-throat, or life threatening, like cancer. When cancer is detected, the lymph nodes can be biopsied in order to determine cancer staging.

LYMH NODE REMOVAL SURGERY: When cancer spreads to the lymph nodes, the cancer can become much more aggressive and life-threatening. Currently, removing the lymph nodes involves an eight to ten inch incision and carries a 50 percent chance of infection following the surgery. Doctors are now looking at less invasive ways to surgically remove cancer-infected lymph nodes in order to stop the spread of cancer. The procedure, inguino-femoral lymphadenectomy, would be a complete removal of the lymph nodes through small incisions near the groin. Currently, 37 minimally invasive lymph node removal surgeries have been performed successfully. Clinical trials to compare the less invasive results to the results of open surgery are now beginning.

Vince Dollard
Public Relations
Emory Winship Cancer Institute
Atlanta, GA
(404) 778-4580

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