3D illustration of a cross view of a lymphatic ganglion
The removal of lymph nodes during cancer surgery has saved numerous lives in various tumor types. However, recent studies are in question parts of this practice has long been established.
Imagine that the body’s immunity defenses are a city, and the lymph nodes the centers where police and firefighters gather to exchange information and prepare the fight against crime.
What happens if they are too removed from these centers? This is the new issue that is at the center of modern cancer surgery, explains Justin StebbingProfessor of Biomedical Sciences at Anglia Ruskin University, UK, in an article no.
When surgeons remove lymph nodes, they usually do so for two reasons: to determine if cancer has already spread and to prevent its propagation to other organs. For decades, this approach was considered the most effective treatment standard.
When one tumor escapes your place of originCancer cells tend to travel through lymphatic vessels and settle in the closest ganglia that function as biological filters. Detect tumor cells in these ganglia indicates that the disease may have more likely to return After treatment.
Removal of these ganglia allows doctors to accurately determine the development phase in which the disease is and, potentially, increasing hypotheses of eliminating all tumor cellsbesides giving indications to oncologists that cancer should be treated more aggressively.
But lymph nodes There are no mere points of passage: They play an active role in the body’s immune response, functioning as meeting places where immune system cells exchange information about cancer, emphasizes Stebbing.
Recent studies led investigators to rethink the importance of these centers in the activation of powerful and lasting immunity reactions.
One of these studies, conducted by researchers at the University of Melbourne, Australia, and recently Nature Immunologyshows that the lymph nodes help maintain a special type of immune celldesignated “Lymphocyte T CD8 Positive”, Capable of destroying cancer cells.
These cells are prepared and kept ready to act thanks to the environment within the lymph nodes.
Without these centers, the Immunity response of the body against cancerespecially during immunotherapy treatments, It can be weaker than you thought.
The investigation shows that the specific cells of the ganglia trigger a First outbreak of anticancer activity. However, this effect was only demonstrated in the laboratory, and not yet in humans.
The removal of lymph nodes It is not free from risks. Patients may suffer swelling (lymphodema), greater risk of infections in the affected limb and sometimes chronic pain or mobility difficulties.
There are also fears that when removing lymph nodes, thus reducing the immediate risk of cancer dissemination, if inadvertently can weaken immunity defenses on timeespecially at a time when modern treatments They are increasingly dependent on natural immunity of the patient himself.
Why do surgeons continue to remove lymph nodes?
In many types of solid tumors, the Risk of metastization remains high, and ganglia involvement is one of the best cancer recurrence indicators.
The removal of ganglia also provides essential information To choose the most effective treatments after surgery. In breast cancer, for example, doctors often resort to the “Biopsy of the Sentinel Ganglion”, removing only the first ganglion where the fluid drains from the tumor.
When analyzing this “Sentinel ganglion”, it is possible to check if the cancer spread, reducing the number of ganglia removed and decreasing the risk of side effects.
Investigators are better understand how they work lymph nodes in long -term diseases. The new study shows that ganglia are not simple passive filters; They are true training centerswhere special immunity cells grow, multiply and become effective combatants.
That is especially important during treatments that reinforce the immune system, such as Control Point Block Therapiescurrently used in various types of cancer.
These results suggest that removing lymphatic ganglia not only prevents cancer propagation, but also eliminates fundamental centers where the immune system watches the body and reactivates to combat the disease.
In the last decade, hospitals have adopted Soft surgeries and directed to lymph nodes. Instead of removing all ganglia from a region, the Objective is now to minimize the impactremoving only those that are most likely to contain tumor cells.
This approach Reduces complications for patients and can help preserve your immunity. Some patients with early -stage cancers may even avoid completely removal of ganglia, first resorting to image exams and biopsies to monitor any disseminations.
For those who fear the consequences of extensive removal of ganglia, promising therapies. Immunotherapy drugs, targeted treatments and even cancer vaccines are being developed to “re -educate” the immune system, even when some ganglia have been removed.
Still, there is increasing evidence that patients get better results When at least some of these centers are preservedmaintaining the body’s ability to assemble and support a defense against remaining cancer cells.
In the future, cancer surgery may become even more personalized. By mapping the activity inside lymph nodes – identifying which are essential for immune function and which are most likely to generate new tumors – doctors can adapt the surgery, ensuring each patient the maximum benefit with minimal damages.
These recent discoveries challenge surgeons and oncologists to carefully consider each decision: not only what is removed today, but also Immunity defenses that are for tomorrow.
