Lymph node cancer, secondary

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.

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.

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.

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.

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:

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.

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:

• anxiety
• uncertainty
• fear
• anger.

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.

We have more information about:

• cancer and your emotions
• coping with advanced cancer.

Macmillan is also here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line for free on 0808 808 00 00.
• Chat to our specialists online
• Visit our secondary lymph nodes cancer forum to talk with people who have been affected by secondary cancer in the lymph nodes – you can also share your experience, and ask an expert your questions.

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
• use short sentences
• use illustrations to explain text
• structure the information clearly
• make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.