National guidelines recommend that doctors examine a minimum of twelve lymph nodes when staging colorectal cancer. However, a study published in the Journal of the National Cancer Institute found that out of more than 100,000 colorectal cancer patients, only 37% had received proper lymph node sampling.
The guidelines are in place because lymph node status is the strongest predictor of tumor recurrence and survival in patients whose cancer has not spread. If your doctor is doing less than expected in staging your colorectal cancer, it may be safe to assume that he/she will do less than expected in treating it.
What should you do?
Basically, ask. If you don't know if your doctor has done the right thing, ask. If you don't know if she/he is going to do the right thing, ask."Are you going to check for lymph node involvement?" If the answer is no, ask why. If the answer is yes, ask "How many lymph nodes are you going to examine?" If the answer is fewer than twelve, don't be afraid to ask why. Twelve is a guideline, not a law. Your doctor may have a reason for examining fewer. However, you're entitled to hear the explanation and to decide if it makes sense to you.
Source: Baxter, N. and Virnig, D. "Lymph Node Evaluation in Colorectal Cancer Patients: A Population-Based Study." 97.3 (Feb. 2005): 219-225. 25 Aug. 2006.
