Sentinel lymph node removal query

My mum has been diagnosed with endometrial cancer and has been told she will need a full hysterectomy. They believe the cancer has not spread, but said would like to do a pelvic sentinel lymph nodes biopsy and if they can't find the sentinel lymph nodes then they would remove multiple other lymph nodes, to see if any signs the cancer has spread. My mum is relatively fit and healthy, but is also nearly 78 years old and extremely nervous about the operation, for obvious reasons, as well as previously struggling to recover after general anaesthetic in previous operations. 

She is very concerned regarding the lymph nodes biopsy removal, as it can cause problems with swollen legs etc, with lymphodema. She has a history of falls and had a knee and both hips replaced previously. 

She has been thinking over her options, since she found out what the surgery involves. She would like to know if she just opted for sentinel lymph node removal, would this likely cause lymphodema, or is it more likely to occur if they can't find it, and they take out more lymph nodes? 

She feels quality of life is better than quantity, if she ends up with swollen legs and issues where she won't feel herself or be able to walk as well or be able to dress up on occasion. 

But would go ahead with sentinel lymph node removal, if it was less likely to cause lymphodema. 

Is there any information you can provide, to be help her decide/,inform her and any statistics around it. 

Many thanks in advance

  • Dear SW29, and thank you for posting,

    I am sorry to learn of your mum's situation this must be a difficult time. I can understand she is concerned about the risk of lymphoedema.

    The doctors look at the lymph nodes as this helps them to stage the cancer and tells the doctors what the risk of the cancer returning is and whether further treatment after surgery is needed to reduce this risk.

    The sentinel lymph node is the first lymph node to which cancer cells are most likely to spread from the site where the cancer started (primary). A negative sentinel lymph node biopsy (SLNB) result suggests that cancer has not yet spread to nearby lymph nodes or other organs. This means extensive lymph node surgery is avoided, reducing the potential complications of having many lymph nodes removed.

    Although there is still a risk of lymphoedema, it is less than having many lymph nodes removed. The risk of lymphoedema increases with the number of lymph nodes that are removed. I have not been able to find any helpful statistics, but I wondered if your mother had a nurse specialist (CNS) who she could speak to who knows her situation.

    One question your mum could ask is what might happen if she decides not to have further lymph nodes removed if the SNLB cannot be done, and, how will she be monitored?

    I hope this helps a little. You or your mum may find it helpful to talk things through with one of our nurses on the helpline. The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5 pm, Monday to Friday.

    Jemma

  • Thanks for your quick reply. 

    That is somewhat helpful