Lymph Node Mapping
Incredibly, at just 12 years of age, Ryan Harper is no stranger to skin cancer. "They took off all the moles on my head, and they tested them for skin cancer." says Ryan who will undergo lymph node mapping to determine the extent of spread of his skin cancer.
In order to determine exactly where the cancer is and if the cancer has spread, doctors at Children's Healthcare of Atlanta will perform sentinel lymph node mapping, a procedure that's been done in adults but is new for kids.
Darren is Ryan's dad. "They're going to inject a dye into the spot on his head and it's going to drain into the neck into his lymph nodes. If any of those lymph nodes take on the dye, they're going to take those out." says Darren. Sentinel lymph node mapping has been used in adults over the last 10 years for a variety of cancers, namely breast and melanoma. Its primary goal is to determine if a cancer has spread. By determining whether or not the cancer has spread to that first or sentinel lymph node, doctors can decide whether or not to use more aggressive treatments like interferon drug therapy or chemotherapy. "You can avoid doing what may be a potentially morbid procedure, where one ends up taking out a large number of lymph nodes." explains Dr. Kenneth Gow of Children's Healthcare of Atlanta.
A radioactive and blue dye is injected into the tissue at the site of the tumor. The dye travels through the lymphatic system to the first lymph node in the area. "Both the nuclear dye as well as the blue dye determine which node is your sentinel lymph node and by specifically taking that lymph node out you can determine whether that patient has cancer that has spread." explains Dr. Gow. According to Dr. Gow, because it is the first lymph node in that drainage area, if it is found to be free of cancer, then the rest of the lymph nodes should also be cancer-free. On the other hand, if the sentinel lymph node does contain cancer cells, then there is a high probability that the other lymph nodes are similarly affected and should be removed. Through lymph node mapping doctors determined that Ryan's cancer had spread. Ryan had a follow-up operation taking out all of the lymph nodes in his neck. Thanks to lymph node mapping he is now cancer free and on medication to ensure he remains that way.
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