The lymph nodes are part of the body’s fluid drainage (lymphatic) system which helps its natural defences (immune system) to fight off infections. These nodes are all over your body, but the nodes that are affected by cervical cancer tend to be those in the pelvis. Although lymph nodes can be seen on scans, particularly MRI scans; it can be very difficult to tell whether or not they have been affected by a tumour based on a scan alone. This means it is sometimes necessary to remove the lymph nodes and examine them and see if they contain cancer. This is called a lymph node dissection or lymphadenectomy.
A lymphadenectomy is usually carried out as part of another surgery and can be quite a big operation. It is carried out under general anaesthetic (where you are asleep). The surgery involves removing all of the affected lymph nodes from the pelvis.
This surgery is usually carried out laparoscopically (using key hole surgery), which speeds up the recovery time.
Currently a new procedure called sentinel node detection is being looked at in clinical trials as a possible alternative to lymphadenectomy. In sentinel node detection just a few lymph nodes are removed. If you are eligible for such a trial your gynae-oncologist will explain this to you in detail.
Side effects/complications after lymphadenectomy/lymph node dissection
You will likely experience some discomfort or pain after your operation, which will be managed by your health care team with painkillers.
You may also experience some swelling in the area of one or both of your legs. This is caused by a build up of lymph fluid that cannot drain away normally because the glands have been removed. It is more likely to happen if you have had radiotherapy to the pelvic area as well as surgery. This swelling is called lymphoedema, your health care team will give you lots of advice on how to avoid and manage this swelling. This includes massage, exercise, and wearing a tight elastic sleeve or stocking. Your surgeon may also put a small drainage tube in place during your surgery to help reduce the build up of this fluid, which will be removed a few days later.
For more information on lymphoedema please visit our side effects of radiotherapy/brachytherapy information page.