Lymph nodes, normally tiny and hard to find, get much larger with infection, inflammation or cancer. You sometimes feel your lymph nodes with your fingers or even see them. Such happens when you have strep throat and lymph nodes under your jaw on the side of your neck swell. But sometimes only a few cancer cells exist in a lymph node, making the node seem normal. Your doctor must remove your lymph node or part of it, in these cases to check for cancer.
Your surgeon may remove lymph nodes from the region of your body where primary cancer is surgically removed. Taking one lymph node out to check for cancer is a biopsy. Taking many lymph nodes out is a lymph node dissection or sampling.
Cancer being found in your lymph nodes indicates your cancer may return after surgery. This helps your physician decide whether you need chemo, radiation or other treatments after your cancer tumor has been removed.
Doctors sometimes take samples of your lymph nodes using needles, such as on enlarged nodes. This needle biopsy takes samples of tissue for examination by a pathologist under a microscope. The pathologist notifies your doctor if cancer cells are found in the sample.
Doctors sometimes use imaging studies or scans to find enlarged nodes in your body. When these studies find enlarged nodes near a cancer site, doctors assume the nodes also contain cancer.
The pathologist sometimes must use special tests to find cancer cells when there are few in the nodes. If there are very few cancer cells in your node, your treatment may stay the same as before.
If your doctor finds a lot of cancer in your lymph node, that mass is easily seen. An extracapsular extension exists when the cancer grows out of the node’s external capsule.
Having a lot of cancer found in your nodes often means the cancer is quickly growing and more likely will spread to other locations in your body. When lymph nodes nearest your primary cancer site are the only place that cancer is found to have spread, you may undergo surgery for removal of the primary cancer and those lymph nodes. That may clear the cancer from your body.
Cancer spreading to distant nodes in your body usually require extra chemo or radiation treatment.
Your cancer treatment plan develops based upon your cancer type and its stage. Doctors sometimes assign a stage to your cancer based upon the TNM system, meaning the Tumor-Nodes- Metastasis system. If there is no cancer in your lymph nodes near your cancer, your N gains a 0 value. If your nodes near the cancer or in distant areas of the body show cancer, the N gains a value of 1, 2 or 3. The number depends on how seriously your nodes are affected, the amount of cancer found, enlargement and location.
A low TNM cancer score provides a positive survival outlook. A cancer found very early that has not spread may receive a score of T1, N0, M0. This indicates a small tumor with no node involvement and no metastases.
Lymph nodes removed during cancer surgery leave that area of your body without proper lymph draining ability. This causes a backup of lymph fluid and a condition called lymphedema. For many cancer survivors, lymphedema affects them for the rest of their lives. Removing more lymph nodes makes this more likely to happen.