For Years, We Have Known that the Vast Majority of Cancers Spread Through the Lymphatic System and from There, Can Spread to Other Vital Organs.
In the early 1990s, Dr. Donald Morton described a technique to identify the first lymph nodes in that sequence of spread that changed the practice of surgical oncology. In the past, patients with intermediate-risk melanoma underwent complete removal of all regional lymph nodes, a procedure that has a moderate complication rate, like lymphedema, nerve injuries and wound complications. The procedure Dr. Morton and the John Wayne Cancer Institute pioneered uses dye and radiotracers to allow the surgeon to locate and then remove these key lymph nodes, termed sentinel lymph node(s). These can then be examined under a microscope to determine if there has been any spread of the tumor outside of the primary site.
Importantly, this information provides many benefits to the patient.
- It can potentially minimize the extent of the surgery needed
- It decreases the risk for long term complications that accompany a more extensive surgery
- It provides better staging and prognostic information to help guide treatment decisions
- It also has been shown to even improve the patients survival
The procedure is minimally invasive and is done on an outpatient basis. In some cases, the larger operation may still be needed, but four out of five patients can be spared. The sentinel node technique has become the international medical standard for melanoma surgery, and is being adapted to many other cancers .