Sentinel lymph nodes

Dr Elizabeth Baird (Remuera Dermatology) and Professor Rod Dunbar (University of Auckland) discuss sentinel lymph nodes and their role in melanoma treatment. A sentinel lymph node is the first lymph node or nodes, a cancer spreads to from the primary tumour.

Transcript

Dr Elizabeth Baird
Sentinel lymph node biopsy is a very common procedure that we perform for thick melanomas when we are concerned that they may have spread. The problem is working out which lymph node that piece of skin is draining to. And in all our textbooks it says that, if you have a melanoma on the left arm, the lymph node that you will need to biopsy is in the left armpit. However, many studies have shown that that is not the case, and sometimes quite paradoxically, a lymph node on the right side might be the sentinel lymph node biopsy.

Professor Rod Dunbar
So in melanoma, it’s important to find out which lymph nodes would be the first ones that the melanoma cells would go to. At the Sydney Melanoma Unit, they have the most experience in the world in this – they have done over 5,000 cases. There is something very special that Hayley has been able to do in her project and that is to make a map across the three-dimensional surface of the human body to look at which lymph nodes are the first lymph nodes the melanoma cells would go to if they left the skin.

Dr Elizabeth Baird
A technique that helps us work out the sentinel lymph node – i.e. the lymph node that that melanoma is draining to – is useful. This study helps us in that regard. A negative sentinel lymph node is great news for the patient and very, very reassuring. Unfortunately, in New Zealand at present, we don't have lots of really great treatments for advanced melanoma. As always, medical science is advancing, and there are many exciting new treatments coming through for melanoma, but currently, unfortunately in New Zealand, more then 250 people a year die of this disease.

Acknowledgements:
Dr Elizabeth Baird
Professor Rod Dunbar
TVNZ TELEVISION ARCHIVES
Dr Roger Uren