For years, the treatment of early-stage prostate cancers that haven't spread beyond the organ has often included the removal of nearby lymph nodes in the pelvis. It's done as a precaution and as a means of "staging" the disease. Now, a major expert review on the topic suggests that, in many cases, men in this situation may be better off keeping their .
Doing so may help them avoid harmful side effects, such as disabling lymphedema. But even more importantly, leaving the pelvic nodes intact might also boost the success of newer immune-based cancer drugs, the experts suspect. The bottom line: "It is perhaps time to rethink whether lymph nodes are truly foes or friends in the oncologic management of prostate cancer," said senior study author Dr.
Ash Tewari, chair of urology at Icahn Mount Sinai in New York City. He and the review's co-authors believe that a closer look at the issue is overdue. "An in-depth assessment of indiscriminate lymph node removal during surgery, which has not been definitively shown to have therapeutic benefits, is prudent," he said.
"Our paper opens the door to potentially new strategies in the treatment of prostate cancer, focusing on harnessing the power of the rather than removing lymph nodes indiscriminately." Their review was published recently in the journal . As Tewari's team explained, early-stage localized are often treated with surgical removal of the prostate, as well as an average of six of the nearby lymph nodes.
One study found that, betwee.