i believe that the information below pertains to all kind of PC surgery. there should be no difference in that decision between
open radical surgery and robotic surgery. it appears from the research below that the decision to remove the lymph nodes is made by the surgeon depending on his findings and the cancer stage of the patient. i believe it is the practice of many surgeons to test the lymph nodes and tissue in the margins for cancer during the surgery to determine if any removal is necessary.
I THINK IT IS EXTREMELY IMPORTANT THAT THIS ISSUE BE DISCUSSED WITH THE SURGEON PRIOR TO SURGERY AS TO WHETHER OR NOT HE WILL REMOVE THE LYMPH NODES AND HOW HE MAKES THIS DECISION. HE SHOULD HAVE A PATHOLOGIST TEST A SAMPLING OF THE LYMPH NODES WHILE THE SURGERY IS IN PROGRESS. IF ANY ARE CANCEROUS, HE WILL HAVE TO MAKE A DECISION AS TO WHETHER THEY SHOULD ALL BE REMOVED.
I HOPE THAT SOME OF THE MEMBERS HERE CAN TELL YOU WHAT THEIR SURGEONS DID AND WHY. TAMU's post below confirms what I believed (i.e., that a responsible surgeon will not chance leaving the lymph nodes in). to leave them in poses a risk for cancer recurring down the road if in fact the lymph nodes contain any cancer. there is at least one recurrent case of cancer after surgery on this website whereby they have detected cancer in the lymph nodes. when this happens it is a very sad situation which hopefully can be resolved if caught in time enough.
******comment by Sloan-Kettering one of the top cancer centers in the U.S. http://www.mskcc.org/mskcc/html/62034.cfm
To treat prostate cancer, surgeons generally remove the prostate, as well as some tissue surrounding it, and usually remove a sample of the lymph nodes in nearby tissue to determine whether the cancer has spread beyond the prostate. In general, 75 percent of men treated with surgery will never have a recurrence of their cancer.
*****comment by malecare, a good PC website. http://www.malecare.com/prostate-cancer_65.htm
Prostate cancer surgery also known as a radical prostatectomy, is a surgical procedure whereby the prostate gland and attached seminal vesicles are removed. Lymph nodes near the prostate are usually removed at the same time.
*****comment by the american cancer society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Surgery_36.asp
Some surgeons remove lymph nodes from around the prostate at the time of surgery.. If any of the nodes contain cancer cells, which means the cancer has spread, they often will not continue with the surgery because it is unlikely that the cancer can be cured. Other surgeons only remove the prostate gland and may not remove lymph nodes. The decision depends on your PSA level and Gleason score. If either is high, they might remove the lymph nodes around the prostate.
*****comment by the prostate cancer research institute (which incidentally is an excellent website for PC research and education). http://www.prostate-cancer.org/education/localdis/brosman_RP2003.html
we have found that less than three percent of men in the low to moderate risk categories had metastases in their pelvic lymph nodes. Many urologists are no longer removing these lymph nodes.
The pelvic lymph nodes, small oval or round bodies located along vessels that filter lymphatic fluid, are usually the first site of any spread of the cancer beyond the prostate gland. Normally, these lymph nodes are also removed during the operation. Fortunately, you have many other lymph nodes, so your body will not miss these few.
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.
Post Edited (pcdave) : 2/14/2007 4:33:07 PM (GMT-7)