SWOLLEN LYMPH NODES: A CANCER RED FLAG

Lymph nodes are small, bean-shaped structures that filter substances within the body. Composed of cells that aid in infection defense, lymph nodes are part of the lymphatic tissue. There are numerous lymph nodes throughout the body, with commonly recognized locations being the armpits, neck, and groin.

Function of Lymph Nodes

Lymph nodes filter substances present in lymph fluid, a fluid that drains from the body’s cells and tissues. This fluid contains:

• Proteins
• Minerals
• Fats
• Nutrients
• White blood cells (specifically lymphocytes)
• Damaged cells
• Cancerous cells
• Bacteria or viruses (referred to as foreign invaders)

As lymph fluid travels through the lymph nodes, the tissue within the nodes filters and recycles the components of lymph fluid needed by the body. Specialized cells in the nodes target, destroy, and eliminate waste, especially foreign invaders, which helps the immune system keep the body healthy.

Interaction with Other Body Systems

Lymph nodes work in close coordination with:

• The immune system, which defends the body against harmful invaders such as bacteria and viruses, helping to prevent infections and diseases.
• The lymphatic system, a part of the immune system responsible for protecting the body from foreign invaders, maintaining fluid levels, absorbing nutrients and fats, and eliminating waste.

Lymph nodes act as a filter for the lymphatic fluid, clearing it of waste and harmful invaders while retaining the necessary components for health.

Anatomy of Lymph Nodes

Lymph nodes are distributed throughout the body and are often located where major blood vessels converge. Common locations include:

• Neck
• Armpits
• Chest
• Abdomen
• Groin
• Behind the ears

Structurally, lymph nodes resemble sprouting kidney beans, where the sprout-like parts are tubes that transport lymphatic fluid through the body. Blood vessels lead into each node, which has an outer layer that divides the inner parts into sections. Lymphatic fluid flows through these sections, where it is filtered before exiting through the lymphatic channels.

Swollen lymph nodes often indicate that the body is responding to an infection or illness. In most cases, they return to their normal size once the issue has been addressed.

Lymph nodes are small, round, bean-like glands scattered throughout the body. These glands can sometimes be felt as small bumps, especially when they swell due to conditions like lymphadenopathy. As part of the lymphatic system, lymph nodes, along with other organs like the spleen and tonsils, help defend the body against harmful pathogens.

Their primary function is to filter lymph fluid, which travels from the body’s cells to its tissues. This fluid contains nutrients, fats, minerals, proteins, and other substances. The lymph nodes work to clear out harmful elements in the fluid, such as bacteria and viruses, to maintain overall health.

Common Signs of Swollen Lymph Nodes

• Lymph nodes that are larger than usual, sometimes comparable to the size of a kidney bean or bigger.
• Pain or tenderness around the lymph nodes.

Swollen lymph nodes often appear alongside other symptoms related to the underlying illness:

• A runny nose, sore throat, or fever, which may point to an upper respiratory infection.
• Swelling in multiple lymph node areas in the body, often associated with infections or immune disorders such as rheumatoid arthritis.
• Hard, immovable lymph nodes that may grow quickly, a sign of certain cancers.

Causes of Swollen Lymph Nodes

Lymph nodes contain specialized immune cells called lymphocytes. These cells target bacteria, viruses, and other harmful substances. When the body fights off infections, it produces more immune cells, leading to the swelling of lymph nodes.

Swollen nodes can be triggered by several common and treatable conditions, such as:

• Viral infections like the common cold.
• Bacterial infections, such as ear infections, skin infections, or dental infections.
• Strep throat, measles, or mononucleosis (mono).

In some cases, swollen lymph nodes may be a symptom of more serious illnesses, including:

• Tuberculosis, which primarily affects the lungs.
• Lyme disease, a tick-borne infection.
• Immune system issues like lupus or rheumatoid arthritis.
• HIV/AIDS, which spreads through sexual contact or intravenous drug use.

Certain types of cancer may also cause lymph node swelling, such as:

• Lymphoma, a cancer affecting the lymphatic system.
• Leukemia, a cancer of the blood.

When Does Cancer Spread to the Lymph Nodes?

The speed at which cancer spreads to the lymph nodes can vary based on the type of cancer. Some cancers spread rapidly, while others progress more slowly.

Not all cancers impact the lymph nodes. For instance, research shows that osteosarcomas, a type of bone cancer, involve the lymph nodes in only 4–11% of cases.

Cancer Staging and Lymph Node Involvement

Cancer stages indicate how far the disease has spread from its original site. Different staging systems exist, such as:

• Stage 0 (carcinoma in situ): Abnormal cells are present but haven’t spread.
• Stages 1, 2, and 3: Cancer is present, with higher stages indicating larger and more widespread tumors.
• Stage 4: The cancer has metastasized to distant areas of the body.

Some cancers involve lymph nodes at stage 2, while others may reach stage 3 before lymph node involvement occurs.

TNM Staging System

Another common way to stage cancer is the TNM system, where:

• T refers to the size of the original tumor.
• N refers to the number of nearby lymph nodes that contain cancer.
• M refers to whether the cancer has metastasized (spread to distant areas).

Each letter is followed by a number that provides more details:

• X: Cancer in the nearby lymph nodes cannot be measured.
• 0: No cancer is present in nearby lymph nodes.
• 1, 2, or 3: These numbers indicate the location and number of lymph nodes with cancer. The higher the number, the more lymph nodes are involved.

Diagnosis

To determine the cause of swollen lymph nodes, doctors may take several steps:

• Medical history: Your doctor will inquire about when the swelling started and any other accompanying symptoms.
• Physical exam: They will check the size, texture, and warmth of the lymph nodes, which can give clues about the underlying condition.
• Blood tests: Blood tests, such as a complete blood count (CBC), can help detect infections or blood cancers.
• Imaging studies: A chest X-ray or CT scan may be performed to locate sources of infection or to detect tumors.

Biopsy: In some cases, a lymph node biopsy is necessary to confirm the diagnosis. A sample or the entire lymph node may be removed for analysis.

Treatment

Treatment for swollen lymph nodes depends on the underlying cause:

• Infections: Bacterial infections are typically treated with antibiotics, while viral infections generally resolve on their own. Specific treatments may be required for conditions like HIV.
• Immune disorders: If swollen lymph nodes are caused by conditions like lupus or rheumatoid arthritis, treatment will focus on managing the underlying disorder.
• Cancer: If cancer is the cause of the swelling, treatment may include surgery, radiation, or chemotherapy, depending on the type of cancer involved.

The approach to treating cancer that has spread to the lymph nodes depends on factors like the tumor’s size, location, and whether the cancer has metastasized to other parts of the body.

• Surgery may be an option for managing certain types of metastatic cancer affecting the lymph nodes. Other possible treatments include chemotherapy, radiation therapy, stem cell transplants, immunotherapy, or targeted therapy.
• If cancer has spread to the lymph nodes, there’s a higher chance of recurrence after surgery. In such cases, chemotherapy or radiation therapy might be recommended following the surgical procedure to lower the risk of cancer returning.

Note: When lymph nodes are surgically removed, typically due to the presence of cancer cells, it can help prevent the cancer from spreading. However, this procedure can also lead to some negative side effects.

After lymph nodes are excised, the drainage of lymph fluid from that area is disrupted. This disruption can result in a condition known as lymphedema, where lymph fluid accumulates in the lymph vessels. Lymphedema may cause swelling and discomfort in the affected region and can potentially become a chronic issue.

Data shows that approximately 89% of individuals diagnosed with Hodgkin lymphoma and around 74% of those diagnosed with non-Hodgkin lymphoma are alive five years after their diagnosis.

It is important to note that survival rates are general estimates based on the outcomes of groups of people with the same condition. These numbers cannot determine an individual’s life expectancy with lymphoma. If you have questions about your specific situation, it’s best to consult your healthcare provider for more personalized information.

Taking Care of Yourself with Lymphoma

If you’re living with lymphoma, developing a plan for managing your condition can be helpful. This plan can guide you through treatment and any necessary follow-up care. Here are some important points to consider when creating your plan:

• Learn how lymphoma treatment may impact your daily routine. This will help you determine if you’ll need assistance at home or during treatment sessions.
• Maintain a balanced diet that includes lean proteins, whole grains, and full-fat dairy products. Since treatment may affect your appetite, consulting a nutritionist can help you ensure you’re consuming enough food and fluids to stay strong during treatment.
• Make time for personal activities, such as journaling, listening to music, or spending time outdoors. These can provide relaxation and enjoyment during treatment.
• Managing stress is important. Practices such as meditation, relaxation techniques, or deep breathing exercises can help alleviate the anxiety that often accompanies cancer.
• Incorporating exercise into your routine can be beneficial. Studies show that physical activity can improve the quality of life by reducing fatigue and stress in people with lymphoma.
• Dealing with cancer can feel isolating at times, and it may be difficult to open up to family and friends. Speak with your healthcare provider about support services and programs that could offer additional assistance.

Is Lymphoma a Serious Cancer?

The seriousness of lymphoma depends on the specific type. For instance, non-Hodgkin lymphoma can increase the risk of life-threatening infections, other cancers, or heart disease. Statistics show that around 3 in 100,000 people worldwide die from some form of non-Hodgkin lymphoma.

Does Lymphoma Appear in Blood Tests?

While blood tests can reveal issues such as elevated white blood cell counts, which may indicate lymphoma, leukemia, or other blood cancers, they do not diagnose lymphoma directly. Lymphoma is typically diagnosed through biopsy and imaging test results.

Where Does Lymphoma Typically Begin?

Lymphoma can start in any area where lymphocytes, the white blood cells responsible for fighting infections, are found. These cells are present throughout your lymphatic system, including in the lymph nodes, spleen, bone marrow, and other areas of the body. The most common early symptom is swollen lymph nodes in places like the neck, chest, armpits, abdomen, or groin.

How Long Can You Have Lymphoma Without Knowing?

It’s possible to have lymphoma for years without recognizing any symptoms. In some cases, lymphoma is discovered through routine imaging tests that reveal signs of the disease.

Also Read: Lymphoma rash: When a blood cancer attacks the skin