the drainage area must be removed. This procedure depends upon an effective technique for identifying the sentinel lymph node. If the cancer has spread to the sentinel lymph nodes, the surgeon will then remove all lymph nodes in the region. If the sentinel lymph node is found to be cancer free; all other nodes of the same area are generally cancer-free. The accurate identification and biopsy of the sentinel lymph node (when pathologically negative) means that other nodes will not be removed. The retention of normal lymph nodes benefits the patient by preventing lymphatic fluid accumulation in the arm or other extremity.
Dr. Woltering's new method can be used with solid tumors from a number of cancers including melanoma, breast cancer, head and neck cancers, lung cancer, neuroendocrine cancers, squamous carcinoma and colorectal cancer. The current techniques for identifying the sentinel lymph node involve the use of a radioactive colloid compound, a vital dye, or both. When both a dye and a radiolabeled carrier are used, they have been injected separately. The radiolabeled carrier substance is injected either the afternoon prior to surgery or the morning of surgery while the patient is awake.
Dr. Woltering notes that "many patients consider the injection of the radiolabeled colloid carrier as painful as childbirth."
"This may be the most valuable part of our invention," says Woltering. "It prevents women from having a painful, scary procedure while they are awake and substitutes an equally effective injection performed while they are sedated or asleep."
The usual interval from radioactive injection until surgery is 2-4 hours and with the increasing demand for sentinel lymph node sampling, surgeons have been forced to deal with major delays in surgical schedules.
Next steps along the road to FDA approva
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