New study finds no need for radical melanoma surgery
Medical research goes on all the time. But once in a blue moon, a study comes along that deserves the title of “game-changer.”
And that’s exactly what experts are calling a new study on melanoma led by Dr. Mark Faries, head of surgical oncology at The Angeles Clinic and Research Institute.
Hopefully, Dr. Faries will transform the way melanoma patients are treated… and save them from a devastating surgical procedure that won’t extend their lives one iota.
Having skin cancer is always scary, but for those diagnosed with the deadliest kind — a melanoma — things can get complicated very quickly.
If a melanoma is “thin,” it’s usually just removed under local anesthesia. However, if cancer cells are found in the normal tissue around the melanoma (a.k.a. the “margin”), the doc will most likely go back to take more out, which is still no big deal (other than giving you a bigger wound/scar than originally planned).
But when a doctor believes that the cancer has spread even farther, into the adjacent lymph nodes, everything becomes a lot more serious.
In that case, the typical practice is to first remove one lymph node located in the region of the tumor, called the sentinel. If cancer cells are found there, a more radical surgical procedure called “complete lymph node dissection” becomes the “standard of care” — often without a second to lose.
And this is where Dr. Faries’s new study should command center stage.
That surgery involves taking out all of the lymph nodes in the region of the melanoma. And no matter how much your doctor may try reassure you or downplay the situation, it’s a very big deal.
Besides the very real risks of a surgical infection and nerve damage, around 25 to 30 percent of patients who undergo this extreme lymph node removal will suffer from painful side effects such as lymphedema, when the arm or leg swells with fluid. According to experts, that risk can jump to 60 percent for seniors and those who are overweight.
As key players in our immune system, lymph nodes filter fluid to trap bacteria and viruses. When they’re removed, fluid that’s got nowhere to go can build up elsewhere, which can harden your skin, cause infection, and make moving those swollen extremities pretty uncomfortable.
The game-changer in this new research is that if the “sentinel” node shows signs of cancer, there’s no need to rush into that extreme complete dissection surgery.
To come to that conclusion, Dr. Faries and his team examined 10 years of records on close to 2,000 melanoma patients from all over the world with cancer found in the sample lymph node surgery.
Only half received the extensive operation to remove all of the surrounding nodes, while the rest simply had that one sentinel node removed. No drastic surgery to heal from. No nerve damage or lymphedema risk.
This new research found that there were no life-extending benefits for the patients who had that radical surgery.
Cancer docs have been so amazed by these findings that some have described them as “practice-changing,” “definitive,” and “unequivocal.”
But this isn’t the first time that lymph node surgery has been called into question. Three years ago, a study out of the UK went so far as to say that even having that sentinel lymph node biopsied was totally unnecessary, because it provided “no survival advantage” to patients.
Of his findings at the time, Dr. J. Meirion Thomas, a surgical oncologist at the Imperial College in London, said that “sentinel node biopsy in melanoma benefits doctors and hospitals but not patients,” who can be “considerably harmed” by the procedure.
So, if you have been diagnosed with melanoma, it’s of utmost importance that you discuss these new findings with your doctor before you agree to undergo lymph node surgery.
Actually, it’s so vital that even if your surgeon brushes this research aside, you should absolutely consider getting a second — or even third — opinion.
“Is full lymph node removal needed for melanoma?” Alan Mozes, June 8, 2017, HealthDay, webmd.com
