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Head and Neck Cancer

Swollen Lymp Nodes in Neck

03/07/2008

Question:

Hi I`m a 21 year old male and I have a few swollen lymph nodes on both sides of my neck. I first discovered a swollen gland last July/August on the left side of my neck. I went to see a doctor who asked a bunch of questions and then preceeded to get blood work done on me, and wanted to run a cat scan as well. I wasn`t able to get the cat scan that day, but they did do the blood work. Everything came back normal on that.

I went to see another doctor who said she believed it was allergy related to the new building I was working in. I didn`t think anything more about it afterwards. Finally last month I went in for my physical and she decided she wanted to run a cat scan on it now just because it still was there, and she wanted to run some blood work as well but mostly for chlosterol levels, although I`m a skinny guy (125 lbs). The results came back on the blood as all my levels were normal.

Now my first question is, If i had leukeima or lymphoma would it show up in the blood even if they weren`t looking for it? Now the cat scan results came back as my swollen gland was over 2 cm in size, and that I had other swollen lymph nodes in my neck. They scheduled me for a general surgeon for the next day. I went to see him, and he said he couldn`t perform a biopsy on me, because the gland had gotten smaller, and wasn`t big enough to perform on it, and that he couldn`t even feel the other glands in my neck. He told me to come back in a month to look again. The original swollen gland has gotten larger and smaller over the months and is currently at its smallest state.

In the past week I`ve started to notice the other lymph nodes in my neck. They`re swollen, I wouldn`t say hard, they aren`t painful, and when I put my finger on one and push down it feels movable and goes side to side. The original swollen gland from 6 to 7 months ago on the left side of my neck has gotten pretty small but is still there.

I believe its a good sign that the gland can shrink because I don`t believe cancer can shrink on its own. However, I`m worried about those other glands in my neck that I can feel now, although they don`t feel that big. I would say there are two one each side of my neck.

If it was cancer would I be showing signs by now this does go back more than 6 months, and i eat fine, sleep well, and in general haven`t been sick.

I`m just really concerned, and don`t want to have cancer.

Worried Young Adult

Answer:

It is always worrisome to find a lump in the neck. No node larger than 2 cm that has been present for more than 2 weeks should be ignored. It is not uncommon especially in younger people to have enlarged nodes. They are most often reactive to some type of irritation or infection. They often will disappear on their own. It is only the persistent nodes that are getting larger over time that are of concern. There are also other factors to consider like the location, the shape and the consistency of the node. If the mass persists or you remain concerned I would suggest that you have a thorough head and neck examination. This is most often best performed by an otolaryngologist.

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Response by:

Cheryl  Koliha-Brandt, MSN, RN, CNS, CORLN Cheryl Koliha-Brandt, MSN, RN, CNS, CORLN
Clinical Nurse Specialist and Instructor of
Head and Neck Surgery and Oncology 
Frances Payne Bolton School of Nursing
Case Western Reserve University

Pierre  Lavertu, MD, FRCS(C), FACS Pierre Lavertu, MD, FRCS(C), FACS
Professor of Otolaryngology-Head and Neck Surgery
School of Medicine
Case Western Reserve University