What are lymph nodes and why are they important. How can you effectively check your own lymph nodes. What should you do if you notice changes in your lymph nodes. How does the lymphatic system work in relation to skin cancer. Why is regular lymph node examination crucial for skin cancer patients.

The Lymphatic System: An Essential Component of Your Body’s Defense

The lymphatic system plays a crucial role in our body’s immune defense and waste removal processes. It consists of a network of vessels and tissues that work together to filter harmful substances and maintain our health. Let’s delve deeper into this fascinating system and understand its significance.

What is the lymphatic system?

The lymphatic system is a complex network of vessels, tissues, and organs that helps rid the body of toxins, waste, and other unwanted materials. It’s an essential part of the immune system, helping to defend against infections and diseases.

Key components of the lymphatic system

• Lymph: A clear, colorless fluid containing proteins and waste materials
• Lymphatic vessels: A network of thin tubes that transport lymph throughout the body
• Lymph nodes: Small, bean-shaped structures that filter lymph and trap harmful substances
• Lymphatic organs: Including the spleen, thymus, and tonsils

How does the lymphatic system function?

The lymphatic system works like a complex drainage system. It collects excess fluid from tissues, filters it through lymph nodes, and eventually returns it to the bloodstream. This process helps remove waste products, dead cells, and potentially harmful substances from our body.

Lymph Nodes: The Body’s Natural Filtration System

Lymph nodes are small, oval-shaped structures found throughout the lymphatic system. They act as filters, trapping and destroying harmful substances before the lymph is returned to the bloodstream. Understanding the role and location of lymph nodes is crucial, especially for those diagnosed with skin cancer.

Where are lymph nodes located?

Lymph nodes are distributed throughout the body, but they are most concentrated in certain areas:

• Head and neck
• Armpits (axillary region)
• Groin (inguinal region)
• Chest
• Abdomen

Why are lymph nodes important in skin cancer?

For individuals diagnosed with skin cancer, lymph nodes play a critical role in monitoring the potential spread of cancer cells. Cancer cells can sometimes break away from the primary tumor and travel through the lymphatic system, potentially lodging in nearby lymph nodes. This is why regular examination of lymph nodes is an essential part of follow-up care for skin cancer patients.

The Importance of Self-Checking Lymph Nodes for Skin Cancer Patients

If you’ve been diagnosed with skin cancer, your healthcare provider will likely emphasize the importance of regular lymph node checks. While these examinations are performed during follow-up appointments, learning to self-check between visits can be valuable.

Why should skin cancer patients check their lymph nodes?

Regular self-examination of lymph nodes allows for early detection of any changes or enlargements. Early detection of potential cancer spread can lead to prompt intervention and improved outcomes. It’s important to note that not all enlarged lymph nodes indicate cancer spread; they can also be a sign of infection or other benign conditions.

How often should you check your lymph nodes?

Checking your lymph nodes once a month is generally sufficient. It’s advisable to perform this self-examination at the same time you check your skin for any changing moles. Avoid checking too frequently, as this may make it difficult to notice subtle changes over time.

Step-by-Step Guide to Checking Lymph Nodes in the Head and Neck

Examining the lymph nodes in your head and neck region is a straightforward process that can be done at home. Follow these steps for a thorough self-examination:

1. Use your fingertips to gently feel the lymph nodes in a circular motion.
2. Start with the nodes in front of your ear (1) and follow the numbered sequence shown in the diagram, ending just above the collarbone (10).
3. Always check your nodes in this specific order for consistency.
4. Examine both sides of your head and neck for comparison.
5. When checking the nodes in your neck (8), tilt your head towards the side you’re examining to relax the muscle.
6. For nodes above the collarbone (10), hunch your shoulders and bring your elbows forward to relax the skin.

Remember, an enlarged lymph node may feel like a small, pea-sized swelling, though it can sometimes be larger.

Techniques for Examining Armpit (Axillary) Lymph Nodes

The armpit region contains important lymph nodes that should be checked regularly, especially if you’ve had skin cancer on your upper body or arms. Here’s how to properly examine your axillary lymph nodes:

1. Remove clothing from your upper body for easy access to the armpits.
2. Sit in a comfortable position.
3. To check the left armpit, lift your left arm slightly.
4. Place the fingers of your right hand high into the left armpit, then lower your arm.
5. Feel the central area of the armpit.
6. Move your fingers firmly against the chest wall in the following pattern:
   • Along the front border of the armpit
   • Along the back border of the armpit
   • Along the inner border of the arm
7. Repeat the process for the right armpit using your left hand.

Proper Method for Checking Groin (Inguinal) Lymph Nodes

If you’ve had skin cancer on your lower body or legs, it’s crucial to know how to check the lymph nodes in your groin area. Follow these steps for a thorough examination:

1. Identify the two main areas of inguinal lymph nodes:
   • The horizontal chain just below the groin ligament
   • The vertical chain along the upper thigh
2. Using your fingertips, gently feel along the horizontal chain of nodes in the right groin, just below the ligament.
3. Next, examine the vertical chain along the upper thigh.
4. Repeat the process for the left groin.

Remember to use gentle pressure and circular motions when feeling for lymph nodes. If you’re unsure about what you’re feeling, consult your healthcare provider for guidance.

Interpreting Your Findings: When to Seek Medical Attention

After performing a self-examination of your lymph nodes, it’s important to know how to interpret your findings and when to seek medical attention. Here are some guidelines to help you understand what to look for and when to be concerned:

Normal lymph nodes

Typically, lymph nodes are not noticeable or palpable when they’re normal size. They may feel like small, soft, bean-shaped structures if you can feel them at all.

Potentially concerning signs

• Enlargement: A lymph node that feels significantly larger than others or larger than a pea
• Firmness: Nodes that feel hard or rubbery
• Lack of mobility: Nodes that seem fixed in place rather than slightly movable
• Pain or tenderness: While this can be a sign of infection, persistent pain should be evaluated
• Clustering: Multiple enlarged nodes in the same area

When to contact your healthcare provider

If you notice any of the following, it’s advisable to reach out to your doctor or specialist nurse:

• A new, enlarged lymph node that doesn’t go away within a week
• Persistent swelling or pain in a lymph node
• Any of the concerning signs mentioned above, especially if they persist
• Any changes that worry you, even if they don’t fit the above criteria

Remember, many causes of lymph node enlargement are benign, such as infections. However, for skin cancer patients, it’s crucial to have any persistent changes evaluated promptly.

The Role of Professional Lymph Node Examinations in Skin Cancer Follow-up Care

While self-examination of lymph nodes is valuable, it doesn’t replace professional medical evaluations. Regular follow-up appointments with your healthcare provider are an essential part of skin cancer care. Let’s explore the importance of these professional examinations and what they entail.

Why are professional lymph node examinations important?

Professional examinations by trained healthcare providers offer several benefits:

• Expertise: Healthcare professionals have extensive training in detecting subtle changes in lymph nodes
• Consistency: Regular check-ups allow for comparison over time
• Comprehensive evaluation: Your provider can assess other aspects of your health simultaneously
• Immediate action: If abnormalities are detected, further tests can be ordered promptly

What happens during a professional lymph node examination?

During your follow-up appointments, your doctor or specialist nurse will:

1. Ask about any symptoms or changes you’ve noticed
2. Perform a thorough physical examination of relevant lymph node areas
3. Assess the size, consistency, and mobility of your lymph nodes
4. Compare findings to previous examinations
5. Discuss any concerns and answer your questions

How often should you have professional examinations?

The frequency of follow-up appointments depends on several factors, including:

• The type and stage of skin cancer you had
• Your overall health and risk factors
• The time elapsed since your initial treatment

Your healthcare provider will recommend an appropriate follow-up schedule based on your individual circumstances.

Maintaining Overall Lymphatic Health: Beyond Self-Examinations

While regular self-examinations and professional check-ups are crucial for monitoring your lymph nodes, there are additional steps you can take to support your overall lymphatic health. A well-functioning lymphatic system contributes to your body’s ability to fight infections and potentially reduce the risk of cancer spread.

Lifestyle habits for lymphatic health

Consider incorporating these practices into your daily routine:

• Stay hydrated: Adequate water intake helps maintain lymph fluid flow
• Exercise regularly: Physical activity promotes lymph circulation
• Maintain a healthy diet: Nutrient-rich foods support immune function
• Practice deep breathing: This can help stimulate lymph flow
• Consider dry brushing: Gentle skin brushing may help stimulate lymphatic drainage
• Manage stress: Chronic stress can negatively impact your immune system

The role of lymphatic massage

Lymphatic drainage massage is a specialized technique that may help improve lymph flow. While it’s best performed by a trained therapist, you can learn some simple self-massage techniques. However, always consult your healthcare provider before starting any new health practices, especially if you have a history of skin cancer.

Staying informed and proactive

Educate yourself about your specific type of skin cancer and its potential impact on the lymphatic system. Stay up-to-date with the latest research and treatment options. Don’t hesitate to discuss any new information or concerns with your healthcare team.

By combining regular self-examinations, professional check-ups, and overall lymphatic health practices, you’re taking important steps in managing your health after a skin cancer diagnosis. Remember, early detection and prompt medical attention are key to achieving the best possible outcomes.

How to check your Lymph Nodes

Introduction

You have been diagnosed with a skin cancer that on occasions can spread into the lymphatic system. That is why, as part of your examination, your nodes are examined by your doctor or specialist nurse at your follow-up appointments. The lymph nodes examined depend on the location of your skin cancer, eg: if your skin cancer was on your leg then the lymph nodes in your inguinal area (groin) will be felt or if on your face then the nodes in your head and neck would be examined. The aim is to detect any enlargement of the lymph nodes and undertake investigations at an early stage. Some people express a wish to check their own lymph nodes between clinic appointments. This is why you have been given this information. Your doctor or nurse will show you how and which lymph nodes to check. 

The Lymphatic System

This system consists of lymphatic vessels and tissue. Lymph is a fluid that contains proteins and waste materials, which is collected from around the cells in the body, eventually draining into larger vessels.   

Lymphatic vessels

One way of describing this is to imagine a river that starts as a small stream, which then weaves its way between the cells and small blood vessels of the body’s connective tissue.  On its journey more tissue and waste material is collected. The fluid (lymph) that accumulates firstly drains into larger lymph vessels, then into ducts in the neck, before emptying into the blood stream. 

Lymphatic tissue

Lymph nodes are small oval clumps of lymphatic tissue found at intervals along the vessels. They are grouped like “beads on a string” both deep in the body and near the surface (see previous diagram). These lymph nodes filter out harmful organisms and cells from the lymphatic fluid before it is returned to the blood stream. Lymph nodes can only be felt in the areas listed: 

• head and neck 
• arms 
• axilla (armpits) 
• inguinal area (groin)
• back of knees 

Usually lymph nodes are not enlarged and thus not able to be felt, but if you have previously had an infection (such as tonsillitis) you may have noticed and felt lymph nodes becoming enlarged, painful and tender.  Lymph nodes can also become enlarged due to cancer cells lodging in them. Checking your lymph nodes once a month is sufficient and this can be done at the same time as you check your skin for any changing moles. Checking them more often may result indifficulty noticing any change. 

Do not panic if you feel a lymph node as it may well be due to an infection, but if it has not gone away in a week contact your doctor or specialist nurse. 

How to Check Lymph Nodes in the Head and Neck

• With your fingertips, in a gentle circular motion feel the lymph nodes shown. 
• Start with the nodes in front of the ear (1) then follow in order finishing just above the collar bone (10)
• Always check your nodes in this order. 
• Check both sides for comparison. If you have an enlarged lymph node it may feel like a swelling the size of a pea, sometimes they can be larger. 

When feeling the nodes in your neck (marked 8): 

• Tilt your head towards the side you are examining, this helps to relax the muscle.  
• Now press your fingers under the muscle. 

When checking the lymph nodes above the collar bone: 

• Hunch your shoulders and bring your elbows forward to relax the skin. 
• Now feel above the collar bone (marked 10).

How to Check Lymph Nodes in the Armpit

Diagram how to check the lymph nodes in your armpitRemove all clothing down to the waist to get easy access to the armpits. 

• Sit in a comfortable position.
• Check each armpit in turn.

To check the left side, lift your arm slightly then place the fingers of your right hand high into the armpit and then lower your arm.

• Feel in the central area of the armpit.

Now move your fingers firmly against the chest wall as follows: 

• Along the front border of the armpit. 
• Along the back border of the armpit. 
• Feel along the inner border of the arm. 
• Now check the other armpit.

How to Check Lymph Nodes in the Groin

Diagram of the lymph nodes in the groinThere are two areas to look for inguinal (groin) nodes:

• Feel the horizontal chain of nodes in the right groin just below the ligament (see above diagram).
• Feel the vertical chain along the upper thigh (see above diagram).
• Check the lymph nodes in the other groin.

Conclusion 

The purpose of this information is to help you understand why you have your nodes checked at your follow-up appointments. It explains which lymph nodes you need to check and how to undertake this procedure yourself. The aim is to ensure that if in the unlikely case there is spread of your skin cancer to the lymph nodes, it is detected and reported to your doctor or nurse straight away rather than waiting until your next clinic appointment.

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where they are located, what functions they perform, in what diseases they increase

Inflammation and enlargement of the lymph nodes usually cause discomfort and pain. As a rule, this indicates that an inflammatory process is underway in the body.

What are lymph nodes

Lymph nodes are the most important organs that perform a barrier-filtration function ¹ . Their main function is the biological filter of lymph – a colorless liquid that washes all the tissues and cells of the body. It consists of plasma and formed elements. Interestingly, lymph plasma has an almost similar chemical structure to blood plasma, but contains fewer proteins ² .

Useful information about lymph nodes

Where are the lymph nodes

Lymph nodes are found almost everywhere. They are arranged in such a way as to become an obstacle in the way of various “garbage”: toxins, viruses, bacteria, parasites, fungi, cancer cells.

Most lymph nodes are located deep under the skin and even near internal organs where they cannot be felt. But some lymph nodes – under the jaw, in the armpits, in the groin – can be palpated even in a healthy, non-inflamed state.

Photo: Shutterstock

Functions of the lymph nodes

As mentioned earlier, the main function of the lymph nodes is barrier-protective function. In these organs of the lymphatic system, protective cells of the body are formed, such as lymphocytes, antibodies, phagocytes. Lymph nodes protect against the penetration of infections, and also prevent the reproduction of malignant tumor cells and play a role in the immune response to substances foreign to the body.

The lymph nodes also perform the following functions:

• hematopoietic – after the lymph nodes, lymph enriched with lymphocytes enters the blood;
• drainage – promote the outflow of excess fluid;
• depositing (reserve) – a lymph node is a temporary storage of lymphocytes and lymph. The latter lingers in the lymph node in order to ensure the unloading of the bloodstream in “emergency” situations, for example, during venous congestion;
• metabolic – lymph nodes are involved in the metabolism of fats, proteins, carbohydrates and other substances.

Causes of swollen lymph nodes

Lymph nodes have their own diseases, and most often their inflammation is a reaction to some other disease or condition. Completely different reasons can lead to an increase in lymph nodes (lymphadenopathy). Consider the most common of them.

Local infections

Infection is one of the most common causes of swollen lymph nodes.

— For example, it can be acute respiratory diseases, leading to an increase in regional lymph nodes associated with the area in which inflammation occurs, says general practitioner Oksana Khamitseva.

As a rule, the focus of the disease is located near enlarged lymph nodes. So, with infections of the upper respiratory tract, the lymph nodes in the neck become inflamed, with a sexual infection – in the groin.

Generalized viral and bacterial infections

If only one category of lymph nodes is affected, then they speak of local inflammation. If the nodes that are not adjacent to each other increase, then we are talking about a generalized inflammation of the lymph nodes.

This widespread inflammation can be caused by infections – bacterial, viral, fungal, which affect the entire body. It can be tuberculosis, some infectious skin diseases, rubella, chickenpox, cytomegalovirus, mononucleosis, HIV and others.

Autoimmune diseases

Autoimmune connective tissue diseases such as arthritis and systemic lupus erythematosus can also cause swollen lymph nodes. In such diseases, the body begins to attack its own cells. Due to the increasing load on the lymph nodes, their inflammation occurs.

Tumor processes

Swollen lymph nodes can also signal tumor processes in the body. As we wrote above, lymph nodes prevent the reproduction of cancer cells, but in some cases, tumor cells can get stuck in them and multiply. Tumor processes can lead to the development of leukemia, lymphogranulomatosis, lymphoma.

Hypersensitivity of the body

Allergic reactions can also provoke inflammation of the lymph nodes. In addition, their increase may be associated with hypersensitivity to certain drugs.

How lymph nodes are treated

The treatment of lymphadenopathy is varied and always depends on its cause. An increase in lymph nodes is a signal of inflammation, so you need to look for its source.

Most often, inflammation of the lymph nodes occurs as a secondary process, that is, a reaction to another disease:

• if this is associated with acute respiratory infections, then it is necessary to treat the respiratory tract infection itself, be it a bacterium or a virus;
• if it is associated with a generalized infection (mononucleosis, HIV), then long-term specific therapy is selected here;
• cat-scratch disease (felinosis) is treated with special antibiotics;
• Sepsis is stopped only in the hospital by intravenous administration of various drugs, including antibiotics, and ionic solutions.
• autoimmune diseases (systemic lupus erythematosus, Kawasaki disease, etc.) are treated by a rheumatologist, prescribing hormones or cytostatics in long courses under constant supervision.

Lymphadenopathy can also be caused by cancer. Conventionally, they can be divided into 3 sections:

1. leukemia, when the primary malignant focus is in the bone marrow;
2. lymphomas, when the foci are located directly in the lymph nodes;
3. metastases, when the focus is located in the internal organ, and cancer cells affect the lymph nodes in the path of lymph outflow.

— In the case of leukemia, a bone marrow transplant is possible. With lymphoma, it is useless to do this, you can only use various options for radiation, chemotherapy, genetic engineering methods. And if lymphadenopathy is caused by metastases, then, as a rule, the tumor of the corresponding organ is removed, entering healthy tissues and capturing the “package” of affected lymph nodes, says our expert Oksana Khamitseva.

How to maintain the health of the lymphatic system at home

According to physician Oksana Khamitseva, the health of the lymphatic system primarily depends on two components: good lymphatic drainage and normal functioning of the immune system. This is not difficult to achieve:

• regular physical activity;
• avoid tight, constricting clothing;
• smoking and alcohol cessation;
• courses of multivitamins 2 times a year;
• food high in protein and fiber in the diet;
• adequate fluid intake.

Popular questions and answers

General practitioner Oksana Khamitseva answers popular questions about lymph nodes.

Which lymph node is responsible for what?

– Each internal organ is supplied with lymph nodes, arteries and veins. If we talk about those lymph nodes that we can feel:

• Submandibular: increase with rhinitis, pharyngitis, tonsillitis, inflammation of the teeth and gums.
• Cervical: inflamed with acute respiratory infections, conjunctivitis, otitis media.
• Parotid: react to otitis media, acute respiratory infections.
• Occipital: increased with head and neck infections, acute tonsillitis, infectious mononucleosis.
• Axillary: may also be associated with mononucleosis, mastitis, breast cancer, HIV, cat scratch disease.
• Elbows: felinosis, HIV.
• Inguinal: mumps, generalized infections, inflammation of the urogenital organs.

What to do if the lymph nodes are inflamed?

– If you have lymphadenitis, you need to see a doctor, because you do not know what it can be connected with. If you notice an increase in lymph nodes in the head and neck, there are signs of acute respiratory infections (runny nose, sore throat, cough, fever), then you can independently start taking vitamins, antiviral drugs, NSAIDs, symptomatic treatments for colds.

If you notice an increase in lymph nodes, which is objectively not related to the infectious process, then doing something without a doctor’s recommendation can be dangerous. Even taking vitamins, if the process is autoimmune, will spur the immune system to even more aggressive inflammation.

Why is inflammation of the lymph nodes dangerous?

— Complications of lymphadenitis include:

• transfer of infection to nearby tissues: bones, subcutaneous fat, skin;
• blockage by blood clots of veins adjacent to inflamed lymph nodes;
• violation of lymphatic drainage, edema, “elephantiasis” of the limbs.

What can not be done with enlarged lymph nodes?

– If you notice an increase in lymph nodes, then it is strongly not recommended to ignore it, heat or apply ice, make lotions without the permission of a doctor. Also, do not smear with anti-inflammatory ointments (you will reduce one lymph node and decide that you are cured, and if it is an oncology?), squeeze and massage the lymph node.

The patient does not know in which direction the lymph flows from this or that lymph node, and if you make the wrong movements, stagnation can be provoked.

Which doctor treats lymph nodes?

— All roads lead to a therapist. After examination and examination, a specialist can identify what lymphadenitis is associated with, treat acute respiratory infections or refer to an ENT doctor, an infectious disease specialist if an infectious process is detected. If an autoimmune disease is detected, your doctor is a rheumatologist, and in case of suspicion of leukemia or lymphoma, an oncologist.

Sources:

1. Semioshko N.V. Lymph nodes adjacent to the celiac trunk // BBC 28.706 Ya431 V 38. – 2014. – P. 111. http://sno.grsmu.by/conference/mk47.pdf#page=111
2. Pogrelchuk O.E., Danko E.S. Blood and lymph. Hematopoiesis // In the world of scientific discoveries. – 2018. – S. 219-221. https://www.elibrary.ru/download/elibrary_36443065_39723184.pdf
3. Dvoretsky L.I. Differential diagnosis in lymphadenopathy // Handbook of a polyclinic doctor. – 2005. – no. 2. – S. 3-10. https://www.elibrary.ru/item.asp?id=18967212

Anatomy of the lymphatic system–Lymphosurgery Center

The lymphatic system – is an important part of the human cardiovascular system and complements it.

Unlike the circulatory system, the lymphatic system does not have its own pump and is open. The lymph circulating in it moves slowly and under little pressure. Lymph is a fluid that is constantly formed by drainage of interstitial fluid into the lymphatic capillaries.

The structure of the lymphatic system includes:

• Lymphatic capillaries
• Lymphatic vessels
• Lymph nodes
• Lymphatic trunks and ducts

From the capillaries, lymph enters the lymphatic vessels, and then into the ducts and trunks: from the left to the thoracic duct (the largest duct), the left jugular and left subclavian trunks; on the right into the right lymphatic duct, right jugular and right subclavian trunks. The ducts and trunks flow into the large veins of the neck, and then into the superior vena cava. In this way, lymph is transferred from the interstitial spaces back into the blood.

Lymph vessels pass through the lymph nodes. They are combined into several groups and are located along the vessels. Many afferent vessels carry lymph to the node, and it flows out from there only through one or two efferent vessels. Lymph nodes are small formations of a round, oval, bean-shaped, less often ribbon-shaped form up to 2 cm long. Here, lymph is filtered, foreign matter is separated and destroyed, and lymphocytes are produced here to fight infection. Lymph nodes that perform a barrier and immune role.

The main functions of the lymphatic system:

• Transport function – carrying lymph, metabolic products from tissues to the venous bed.

• Drainage function – the return of proteins, water, salts, toxins and metabolites from tissues to the blood. Removal of fluid, pus, effusion from the wound, cavities.