Probably the first thought that will come to mind when told that the cancer you have been diagnosed with has spread to the lymph nodes is I am doomed.
Is that the case? There is every reason to think that because our body has a network of lymph vessels and lymph nodes.
Carrying a clear watery fluid called lymph, the main purpose of this network is to collect fluid, debris and other things that are in the body's tissues.
The lymphatic system, a part of the body's immune system, routes lymph fluid throughout the body through nodes.
Lymph nodes, working as filters, contain immune cells that attack and destroy germs in the lymph fluid.
The nodes filter fluid and debris that were picked up by the lymphatic network leading to it.
For example fluid from the head, scalp and face flows down through the nodes in the neck.
Slowly making its way around the body the fluid makes it way back to the chest.
There the filtered fluid is dumped back into the bloodstream.
There are two ways cancer can appear in the lymph nodes.
It may start in the node, lymphoma, caused by the abnormal growth of the white blood cells filled in the node.
Or it has spread there from somewhere else, a secondary cancer or metastasis.
Cancer cells break away from the tumor, the primary site, and travel through the lymph system or bloodstream.
When in the lymphatic system, the cancer cell may enter a lymph node and either die or be destroyed before the cancer begins to grow.
Usually the cancer cells will affect the lymph nodes that are near the cancer's primary site.
For instance, thyroid cancer will affect the lymph nodes in the neck near the thyroid gland.
If the cancer cell gets lodged in the node, to survive it has to overcome the natural defenses of the body and acquire its own blood supply.
As the tumor grows, it causes the lymph node to become inflamed and larger.
When a large nodule is found, the doctor may do a fine needle biopsy.
With the use of a very fine needle, tissue is extracted from the node and looked at under a microscope by a pathologist.
If there is cancer in the nodule, the cells will look like the cells of the primary cancer.
Therefore when thyroid cancer cells break away from the thyroid gland and spread to the lymph nodes, the cells in the node will look like thyroid cancer cells.
During surgery for a primary cancer, the surgeon will remove one or more lymph nodes from the area.
These will be sent to a pathologist for biopsy.
The information from this biopsy will determine the risk of the cancer returning, and whether more treatment will be needed after surgery.
What does it mean if the cancer has spread to the lymph nodes? That will all depend on the pathology report.
If there are very few cancer cells found in the node, the normal treatment for the primary cancer may all that be required.
Unfortunately, if there is lots of cancer cells found in the nodules, this may mean that the cancer is more aggressive, along with the possibility of it having spread elsewhere in the body.
The treatment protocol when cancer has spread to the lymph nodes will depend on how much it has spread.
If the cancer is only in the local nodes of the primary cancer, surgery may be all the is needed.
When the cancer has spread to nodes further away from the primary tumor, there will probably be a need of extra treatment with chemotherapy or radiation.
If cancer cells has spread to the lymph nodes, it does not mean the cancer cannot be controlled.
In the case of thyroid cancer, once the thyroid has been removed, patients will have a whole body radioactive scan.
If this scan shows suspicious lymph nodes, a fine needle biopsy may be done to determine if there is thyroid cancer cells there or not.
In some cases, surgery may be performed to remove these suspicious nodules, a radical neck dissection.