Dynamic sentinel lymph node biopsy with a new probe 

07/04/2016 00:00 
Penile cancer patients need to undergo lymph node biopsies to detect whether the cancer has spread into the lymphatic system. But with the donation of a new sentinel node probe to UCLH, patients can be biopsied in a much less invasive manner.

The probe was donated by the Asian Foundation for Help after one of its trustees, Ketan Mehta, was successfully treated at UCLH by consultant urological surgeon Asif Muneer.
“Cancer can spread from the primary site into the lymphatic system. Typically, to check for spread to the lymphatic system, many lymph nodes are excised and sent to pathology for assessment, usually through quite invasive surgery,” Jamshed Bomanji, the head of the nuclear medicine department, said.
“An alternative is to assess the node most at risk from spread (the sentinel node), and excise that using a more targeted and less invasive surgical technique.

“We can do this by injecting a small amount of radioactive material close to the primary cancer site and watch the spread of the tracer into the lymphatic system.
“We take an image of this radioactivity in the lymph nodes to try to narrow down the area for surgical excision, and then on the same day in theatre, use the sentinel node probe to localise this radioactive sentinel node when the patient is on the surgical table.
“This single (or small number) node can then be sent to histopathology to check for cancerous cells,” Dr Bomanji said.
“If the sentinel node biopsy results are negative then it means patients avoid having to undergo extensive surgery to remove all of the lymph nodes,” Mr Muneer said.

“Although the technique has been used in breast surgery and melanoma for a number of years, it has gradually been adopted for penile cancer patients who have non-palpable lymph nodes. It avoids unnecessary major surgery in 80% of patients if the sentinel lymph node is clear of tumour.
“We have been lucky that the Asian Foundation agreed to help the penile cancer team obtain a new gamma probe for this group of patients. We are indebted to them for their kind donation.”

Penile cancer affects between 400 and 500 men in the UK each year. It is most common in men over the age of 50, although younger men are also at risk. You can read Martin’s story here.

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