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Lymph node research expands mesothelioma diagnosis, treatment

New research shows that doctors may be able to examine a specific type of lymph node to provide a reliable sign of the spread of pleural mesothelioma. This method could potentially be used to more accurately diagnose the spread and treatment of the disease, doctors say.

Joseph Friedberg, a thoracic surgeon at the University of Maryland School of Medicine and the director of the Mesothelioma and Thoracic Oncology Treatment and Research Center, recently shared his findings at the Society of Thoracic Surgeons annual meeting.

Which lymph nodes need to be examined?

Lymph nodes are the harbingers of the spread of cancer. When cancer is found, doctors will examine lymph nodes to see if the cancer has spread or is in danger of spreading. The results will determine whether surgery is appropriate along with other treatment such as chemotherapy.

Doctors have previously focused on the mediastinal lymph nodes, which lie in the front of the chest behind the sternum, to determine the extent of the cancer. Doctors rarely examined the posterior intercostal lymph nodes – those along the spine – for mesothelioma cancer cells.

Friedberg found that the posterior intercostal lymph nodes showed the spread of mesothelioma tumor cells in half the patients examined, and were the only ones to show the spread of mesothelioma in 11 percent of cases.

His research showed that involvement of the posterior intercostal lymph node showed 2.5-times greater risk of cancer progression and 2.3-times greater risk of death.

More information for the patient

Armed with this more complete battery of information, doctors can make more informed decisions about surgery and other forms of treatment.

Unfortunately, there currently is no way to examine posterior intercostal lymph nodes without an operation. Friedberg called for more research.

Although there is no cure for mesothelioma, Friedberg says he wants to make the disease more manageable. Decisions made regarding the spread of the disease may help spare surgery on the lungs and increase both the quality and length of life for the patient.

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