Extended Lymph Node Dissection and Prostate Cancer

Extended lymph node dissection

An extended pelvic lymph node dissection is a treatment for high-risk prostate cancer patients; a radical prostatectomy will also be done simultaneously. Prostate cancer typically spreads to the lymph nodes first, due to their close proximity to large pelvic blood vessels. Lymph nodes are small, spherical parts of the immune system which are found throughout the human body.

Micro metastases and high risk prostate cancer

Many high-risk, prostate-confined cancer patients have a PSA score of ten or higher, which indicates the possibility of undetectable micro metastases wherever cancer has been found to spread. There’s a probability that high-risk prostate cancer patients with a PSA score of twenty or higher, have micro metastases within their pelvic lymph nodes.

Extended lymph node dissection
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The extended pelvic lymph node dissection procedure

The extended pelvic lymph node dissection procedure removes lymph nodes from the pelvic blood vessels, as necessary; these are then analysed. The prostate is also surgically removed (radical prostatectomy) during this open surgical procedure; optimum results are best realised when higher levels of lymph node removal are achieved.

Advantages and disadvantages

Reassuringly, success can be measured using post-op PSA, histology and margins; additionally, hormone treatment that’s usually given over three years (alongside radiotherapy) may also prove unnecessary. Pelvic lymph nodes can be damaged and erectile dysfunction incurred; this is typical of any hormone treatment or non-nerve sparing radical prostatectomy procedure.

Second stage treatments (including hormone therapy and radiotherapy) are still viable options for patients, following their treatment and prostatectomy procedures; there’s also a significantly higher risk of experiencing side effects whenever radiotherapy precedes surgery. Some still prefer the accuracy and quick turnaround of surgery.

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