Cancer cells that break away from a tumor can travel throughout the body via structures in the lymphatic system called lymph nodes. Removing and analyzing lymph nodes in a lab determines whether cancer has spread. However, lymph node removal (the procedure is called dissection) can lead to problems, explained Dr. Paula Lee, MD, a specialist in gynecologic cancers at Duke. The biggest concern is lymphedema.
“It’s a huge quality of life issue,” Lee said. “It’s a permanent condition that doesn’t go away with treatment. Women come in and say, ‘I don’t want a full lymph node dissection.” That’s because once lymph nodes are removed to stage a gynecologic cancer, they can no longer act as conduits for lymph fluid. The fluid can build up and cause painful swelling in the legs that can lead to infection and illness.