“Doctor, I am having this swelling in the neck for 10 days. Is it cancer? Can you please cure these nodes?” Quite often I will have to alley the fears and calm to patient that there is nothing much to worry. However, a thorough evaluation is often needed. 

As a cancer surgeon I very often get patients with swollen lymph nodes coming to my clinic to enquire whether it is cancer! The fear is genuine. However, most often lymph node enlargement is due to causes other than cancer like infections. However, it is a symptom that should not be ignored.

What are lymph nodes?

Lymph nodes are glands that are located throughout the body, but visible and felt only when they are enlarged or swollen. The lymph system is an important part of the immune system, the body’s defense system against diseases. The lymph nodes filter lymph or body fluid as it flows through them, trapping bacteria, viruses, and other foreign substances, which are then destroyed by special white blood cells called lymphocytes.

Lymph nodes often swell in one location when a problem such as an injury, infection, or tumor develops in or near the lymph node. Which lymph nodes are swollen can help identify the problem. Common sites for swollen lymph nodes include the neck, groin, and underarms.

What are the common causes of lymph node enlargement?

It is important to remember that most of the enlarged lymph nodes are due to infection. These could be acute infection like viral flu or chronic diseases like tuberculosis (TB). Infected nodes are usually painful. However,  TB is an exemption for that.

Any cancers that spread in the body can cause the lymph nodes to swell and become hard. When cancer from one area spreads to the lymph nodes, the survival rate decreases.

Lymphoma, which is a cancer of the lymph nodes themselves, also causes the lymph nodes to swell. Lymph nodes that are swollen but not painful can be signs of a serious problem, such as cancer.

Quite often I get patients worried about enlarged nodes in armpit or neck. Mostly these are painful nodes due to mild infection. Most commonly the armpit nodes are due to hair removal over the arms and armpit, which leads to very minor infection. Some medications and allergic reactions to medications can cause the lymph nodes to swell. Anti-seizure and antimalarial drugs can also cause lymph nodes to swell. Sexually transmitted infections, such as syphilis or gonorrhea, can cause the lymph nodes in the groin area to swell.

What should I do when I feel enlarged lymph nodes?

Most of the enlarged lymph nodes are not cancers. However, it is advisable to see a doctor when you find enlarged nodes that do not go away in 2 weeks, but no need to panic. Nodes that are rapidly increasing in size over weeks are a warning sign.

Swollen lymph node glands may become smaller on their own without any treatment. In some cases, the doctor may wish to monitor them without treatment. In the case of infections, you may be prescribed antibiotics or antiviral medications to eliminate the condition causing the swollen lymph nodes. Your doctor might also give you medications to combat pain and inflammation. Your doctors may advise you tests like ultrasound scan and biopsy (if needed).

Doctor, can you make these nodes go away?

Lymph nodes enlarge in size as their work increases, that is filtering the body fluids. When there is an infection or injury, they need to filter the more to clear those. The nodes are not the problem, they are the solution. So, there is no point in getting rid of them. We remove them in cancer surgery as they filter cancer cells and store them. Removing them will give better chance of cure.

If you have swollen lymph nodes and no other symptoms, consult your doctor. Your doctor will discuss which treatment option is best for you.