Secondary (Metastatic) Lymph Node Cancer

In secondary or metastatic lymph node cancer, cancer cells from a malignant tumor of a  distant organ travel to the lymph nodes via the lymphatic or blood vessels and lodge within the lymph nodes, where they continue to proliferate. These cells, when examined under a microscope, are seen to resemble the cancer cells of the organ from where they originated.

Signs and Symptoms of Secondary Lymph Node Cancer

  • Enlarged lymph nodes which may feel firm or hard to the touch. They are usually painless, fixed and may be matted together.
  • Lymph nodes in the chest or abdomen may not be felt by the examining fingers but may produce pressure symptoms such as pain, backache or breathing difficulty.
  • Signs and symptoms of the primary cancer may be present but sometimes detection of an enlarged lymph node may be the first sign of cancer. For example – an enlarged left supraclavicular lymph node is often the first sign of stomach cancer.
  • Nonspecific symptoms such as weight loss, lack of appetite, fatigue and night sweats.

Diagnosis of Metastatic Lymph Node Cancer

Diagnosis may be as a result of routine examination or investigations conducted due to the presence of the signs and symptoms or due to a known case of cancer.

  1. Secondary lymph node cancer may be diagnosed by MRI or CT scan.
  2. Removal of the entire lymph node or a sample of the affected lymph node with subsequent micrsoscopic examination is the best method for diagnosis. This may be conducted by :
  • Excision biopsy – removing the lymph node(s) under anesthesia.
  • Sentinel node biopsy may be done to determine the possibility of spread of cancer away from the primary site. The sentinel node is the first lymph node which is affected when cancer spreads from the primary tumor. This procedure is done prior to surgery so that if this node is found to be cancerous it will necessitate the removal of this and other lymph nodes during surgery. If the sentinel node is not involved then further lymph node removal will not be necessary. This procedure is frequently used to determine melanoma and breast cancer spread. It may also be useful in evaluating cancer of the cervix, vulva, endometrium, as well as thyroid and prostate cancer.
  • Fine needle aspiration biopsy may be done by taking a sample from the affected lymph node by means of a needle attached to a syringe.

Importance of lymph node involvement lies in the fact that it may indicate spread of cancer from the primary site, not only to the nearby lymph nodes, but to other parts of the body.

Treatment of Metastatic Lymph Node Cancer

Treatment of secondary lymph node cancer depends upon various factors, especially the type and extent of the primary cancer as well as the age and general health of the patient.

Surgery, chemotherapy, radiation therapy, biological therapy, hormonal therapy or cryosurgery may be considered and a combination therapy, involving multiple treatment options, may at times be advisable.

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