Lymph node cancer, secondary
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About the lymph nodes
The lymphatic system helps protect us from infection and disease. It is made up of fine tubes called lymphatic vessels. These vessels connect to groups of small lymph nodes throughout the body.
The lymphatic system drains lymph fluid from the body’s tissues before returning it to the blood.
The lymphatic system
Lymph nodes are sometimes called lymph glands. They filter bacteria (germs) and disease from the lymph fluid. When you have an infection, some lymph nodes may swell as they fight the infection.
About secondary cancer in the lymph nodes
The place where a cancer starts in the body is called a primary cancer. Sometimes, cancer cells spread to other parts of the body through the bloodstream or the lymphatic system.
Secondary cancer in the lymph nodes happens when cancer cells spread to the lymph nodes from cancer that started somewhere else in the body.
This may be lymph nodes near to where the cancer started. Or it may be lymph nodes further away in a different part of the body.
Primary cancer of the lymph nodes is when cancer starts in the lymph nodes. This is called lymphoma.
Secondary cancer in nearby lymph nodes
Sometimes, cancer is found in lymph nodes near to where the cancer started. For example, breast cancer cells may travel to lymph nodes in the armpit (axilla) or above the collar bone (clavicle).
If a surgeon removes a primary cancer, they often also remove some of the nearby lymph nodes. The lymph nodes are examined under a microscope to see if there are any cancer cells in them.
The risk of the cancer coming back may be higher if the nearby lymph nodes contain cancer cells. Your doctor may suggest you have more treatment after surgery to reduce this risk.
Secondary cancer in nearby lymph nodes is often treated differently to secondary cancer in distant lymph nodes – these are lymph nodes further away from the primary cancer.
Secondary cancer in distant lymph nodes
Cancer cells can travel through the lymphatic system to lymph nodes further away from where the cancer started. These are called distant lymph nodes. If cancer cells have spread to distant lymph nodes, it is called secondary or metastatic cancer.
Sometimes, cancer cells can be in distant lymph nodes even when no cancer cells are found in nearby lymph nodes. But this is less common.
Under a microscope, cancer cells in the distant lymph nodes look like cells from the primary cancer. For example, when lung cancer spreads to distant lymph nodes, the cancer cells look like lung cancer cells.
The aim of treatment in this situation is usually to destroy as many cancer cells as possible. This can help control the cancer.
The most common symptom of cancer in the lymph nodes is that 1 or more lymph nodes become swollen or feel hard. But if there are only a few cancer cells in the lymph nodes, you may not notice any changes.
If the swollen lymph nodes are deep inside the chest or tummy (abdomen), you will not be able to see or feel them. But they may be visible on a CT scan.
Often there are no symptoms of cancer. But sometimes swollen lymph nodes press on nearby organs or tissue. This can cause symptoms. For example, lymph nodes pressing on the lungs may cause breathlessness.
If lymph nodes press on the blood vessels, they can slow the flow of blood. This can cause the area to become swollen. It can sometimes lead to a blood clot forming. Symptoms of a blood clot include pain and redness or swelling in a leg or arm.
If you have any of these symptoms, contact your doctor straight away.
Sometimes, cancer in the lymph nodes can block the flow of lymph fluid in that part of the body. If this happens in the arm or groin, a build-up of fluid can cause swelling in the arm or leg. This is called lymphoedema.
Some people may also notice general symptoms of cancer, such as:
- loss of appetite
- weight loss
Always contact your doctor straight away if you have symptoms. It is important to remember that lymph nodes can be swollen for other reasons, such as infections. But if you are worried, talk to your doctor or nurse.
Secondary cancer in the lymph nodes may be diagnosed at the same time as the primary cancer. It may also be found during routine tests and scans after treatment.
If a lymph node close to the surface of the skin is affected, your doctor may be able to see it or feel it. If the lymph node is deep inside the chest, tummy or pelvis, only a scan can find it.
If you have had cancer before, you may only need a scan to diagnose secondary cancer in the lymph nodes. This may be one or more of the following:
A CT scan
An MRI scan
An ultrasound scan
A PET-CT scan
Some people may have a sample of cells taken from the lymph node. This is called a biopsy. This test checks for cancer cells.
You may have a biopsy if it has been a long time since you were first diagnosed with cancer.
Your cancer doctor or nurse will tell you what tests you will have and when you might get the results.
Treatment for secondary cancer in the lymph nodes depends on your situation. Your cancer doctor will look at the type of primary cancer and your general health.
Treatments aim to destroy as many of the cancer cells as possible. You may have a combination of treatments, which can be more effective. Treatment may include:
Supportive or palliative care is also used to manage symptoms caused by cancer.
Many people think this type of care is only given to people at the end of life. Supportive and palliative care is more common in people with advanced cancer. But you may also have it if your symptoms are more difficult to control.
Your cancer doctor or GP can refer you to doctors and nurses who specialise in symptom control.
Finding out that the cancer has spread or come back may be even more upsetting than hearing for the first time that you have cancer. You may have many different feelings, including:
These are all normal reactions.
Everyone has their own way of coping with difficult situations. Some people find it helpful to talk to family or friends. Others would rather get help from people outside their situation. Some people prefer to keep their feelings to themselves. There is no right or wrong way to cope, but help is available if you need it.
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Below is a sample of the sources used in our secondary cancer in the lymph nodes information. If you would like more information about the sources we use, please contact us at email@example.com
Mercadante AA, Tadi P. Histology, Lymph Nodes. 2022 May 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. PMID: 32644479.
BMJ Best Practice Online Assessment of lymphadenopathy. Updated Jan 2023.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.
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