Lymph nodes are small, bean-shaped glands that filter the body’s immune system. Numbering around 600, they are connected by lymphatic vessels. Their surgical removal is sometimes necessary for diagnostic or therapeutic reasons, often in cancer management.
The Role of Lymph Nodes in the Body
The lymphatic system, which includes lymph nodes, is a network of organs, vessels, and tissues that circulates a clear fluid called lymph throughout the body. Lymph nodes filter this fluid, trapping harmful substances such as bacteria, viruses, and abnormal cells. These nodes house specialized immune cells, known as lymphocytes, which identify and destroy foreign invaders or damaged cells, including cancer cells.
When the body encounters an infection or disease, immune cells within the lymph nodes multiply, causing the nodes to swell. This swelling indicates the immune system is actively working to combat a threat. Their filtering and immune-response capabilities make lymph nodes a direct indicator of disease spread.
Medical Reasons for Lymph Node Removal
Lymph node removal, or lymphadenectomy, is most commonly performed for cancer. This surgical procedure offers both diagnostic information and a treatment pathway. Examining removed lymph nodes helps determine if cancer cells have spread beyond the primary tumor.
A primary reason for removal is cancer staging and diagnosis. Many cancers, including breast cancer, melanoma, head and neck cancers, colorectal cancer, thyroid cancer, and lung cancer, tend to spread to nearby lymph nodes early. Analyzing these nodes helps determine the extent of cancer spread, which guides subsequent treatment decisions. If cancer cells are found in the lymph nodes, it indicates a higher likelihood that the cancer has spread to other parts of the body.
Lymph node removal also serves as a direct treatment for cancer. If lymph nodes contain cancer cells, removing them can help prevent further disease spread. Cancer cells can use lymphatic vessels as a pathway to travel to distant sites, and removing affected nodes can disrupt this process. While cancer is the most frequent reason, nodes may also be removed for diagnosing lymphatic disorders like lymphoma, or rarely, for severe infections leading to abscesses.
Common Lymph Node Removal Procedures
Surgical approaches for lymph node removal vary. A common procedure is a sentinel lymph node biopsy (SLNB). This technique identifies the “sentinel” node, the first node where cancer cells are most likely to spread from a primary tumor. To locate these nodes, a surgeon injects a dye or radioactive substance near the tumor site. The dye or tracer travels to the sentinel nodes, which are then removed for examination.
If sentinel nodes are free of cancer cells, it suggests the cancer has likely not spread further, potentially avoiding more extensive surgery. If cancer cells are present, a more extensive lymphadenectomy or lymph node dissection may be performed. This involves removing a larger group of lymph nodes in a specific area. Common dissection sites include axillary (armpit) nodes for breast cancer or melanoma, inguinal (groin) nodes for penile or vulvar cancers, cervical (neck) nodes for head and neck or thyroid cancers, and pelvic nodes for bladder, rectal, or prostate cancers.
Life After Lymph Node Removal
After lymph node removal, lymphedema is a primary concern. This swelling results from lymph fluid buildup in tissues, occurring because surgery disrupts the lymphatic system’s normal drainage. Swelling commonly affects the arm or leg on the side of removal, but it can also impact the breast, chest, or torso.
Symptoms include fullness, heaviness, tightness, or aching in the affected area. The skin might also feel tight or appear puffy, and clothing or jewelry may fit differently. While there is no cure, lymphedema can be managed through various strategies. These include physical therapy, which often involves manual lymphatic drainage to stimulate fluid movement. Compression garments, such as sleeves or bandages, are used to apply pressure and reduce swelling. Regular exercise, maintaining a healthy weight, and elevating the affected limb can help manage symptoms and promote fluid drainage. Ongoing medical follow-up and patient education are important for monitoring and addressing complications.