Think Again: Positive Lymph Nodes and RP

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/11/2010 6:45 PM (GMT -6)   
I posted this on Ralphs thread, but thought it was worth its own thread.

From the InfoLink:

prostatecancerinfolink.net/2010/02/10/surgery-for-lymph-node-positive-prostate-cancer-a-second-look/

Mayo Clinic and the Munich Cancer Registry seem to agree that surgery is a good option for lymphatic invasion prostate cancer. This data is showing once more that RP and advanced cases is a great option. Mayo Clinic has argued this for years and was a pioneer in continuing RP even after discovering positive nodes prior to removing prostates. As you may already know, many surgeons will test nodes prior to performing the RP, and if found positive, they stop the procedure without completing the RP. The data in these studies have shown that is not a best practice. But rather, removing as many regional nodes as possible and completing the RP has shown excellent results.

However, it is worth noting that adjuvant radiation can also improve bFRS in these cases. You should bring this study to your doctor and ask his input on it.

Good news for the guys who had the nodes removed... Maybe not so good news for those told it would not help if they were. Of course, Snuffy Myers had a lymphadectomy in 1999 after his diagnosis with stage 4 N+ prostate cancer. Could help explain why he is still cancer free in 2010. (aside from that being an excellent oncologist himself)...

Tony
Prostate Cancer Forum Co-Moderator


BillSD
Regular Member


Date Joined Sep 2008
Total Posts : 143
   Posted 2/11/2010 7:13 PM (GMT -6)   

Tony,

Thanks for sharing. When the doctor told me how many lymph nodes he took out of me, I thought "How many do I have left?" Thought he took too many. But now, I realize it was a good thing, even if mine were officialy "non-cancerous". Just because the pathologist cannot see a few cells does not mean they were not lurking.

Keep posting research like this. I am alway interested in that aspect of our battle.

Bill in San Diego


Age 61 (59 @ Dx) PSA 4.4

Biopsy 5/15/08 Gleason (3+3=6)

Bone scan and pelvic CT: clear

HT - 2 mo Casodex, 3 mo Trelstar

RRP Surgery 9/15/08

Post-OP Gleason 3+4=7, Stage pT2c pN0 MX

SV, perineural margin, 18 lymph nodes, bladder neck: all carcinoma free

Perineural invasion & Distal Margin: Carcinoma present

IMRT adjuvant radiation (35 Treatments) Ended 1/27/09

PSA Tests: (10/08) (3/09) (7/09) (1/10): all <0.1


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/12/2010 1:01 AM (GMT -6)   
I find these study results to be stunning. A more than 100% improvement in overall survival at year ten.

I once asked a surgeon why the number of lymph nodes removed varied from patient to patient. His answer was, "they usually remove as many as the find along the way". The number of nodes they will encounter varies from patient to patient. This leads me to ask, well them, should they not search for more? My understanding is that MRI and CT can define many lymph nodes, would it not be a good move to find them prior to RP?

Regardless, these results I had heard about from Mayo, but the discrepancy is wider than I first believed.

Tony
Prostate Cancer Forum Co-Moderator

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