What is secondary cancer in the lymph nodes?

About the lymph nodes

The lymphatic system helps protect us from infection and disease. It also drains lymph fluid from the tissues of the body, before returning it to the blood.

The lymphatic system is made up of fine tubes called lymphatic vessels. They connect to groups of lymph nodes throughout the body.

Lymph nodes (sometimes called lymph glands) are small and bean-shaped. They filter bacteria (germs) and disease from the lymph fluid. When you have an infection, lymph nodes often swell as they fight the infection.

The diagram shows the network of lymph nodes throughout the body

About secondary cancer in the lymph nodes

Secondary cancer in the lymph nodes is when cancer cells have spread to the lymph nodes from a cancer that started somewhere else in the body.

Cancer that starts in one part of the body (primary cancer) can spread to other parts of the body. It does this through the bloodstream or the lymphatic system.

Primary cancer of the lymph nodes is called lymphoma. This is when cancer starts in the lymph nodes. This information is not about cancer that starts in the lymph nodes.

Cancer in nearby lymph nodes

Sometimes cancer is found in lymph nodes that are near to where the cancer started. For example, breast cancer cells may travel to lymph nodes in the armpit (axilla) or above the collar bone (clavicle).

If a surgeon removes a primary cancer, they often remove some of the nearby lymph nodes. The lymph nodes are examined to see if there are any cancer cells in them.

The risk of the cancer coming back may be higher if the nearby lymph nodes contain cancer cells. Your doctors may suggest you have more treatment after surgery to reduce the risk.

Cancer in lymph nodes that are further away is called secondary cancer. Cancer found in nearby lymph nodes is usually treated differently to cancer in lymph nodes that are further away from the primary cancer.

Secondary cancer in distant lymph nodes

Cancer cells can break away from the primary cancer and travel through the lymphatic system to lymph nodes further away from where the cancer started. These are known as distant lymph nodes. If cancer cells settle in the distant lymph nodes, it is known as secondary or metastatic cancer.

When the cancer cells in the distant lymph nodes are examined under a microscope, they look like cells from the primary cancer. For example, when a lung cancer has spread to distant lymph nodes, the cancer cells look like lung cancer cells.

The aim of treatment in this situation is usually to destroy as many cancer cells as possible. This can help control the cancer.

Symptoms of secondary cancer in the lymph nodes

The most common symptom of cancer in the lymph nodes is that 1 or more lymph nodes become swollen or feel hard. But if there are only a small number of cancer cells in the lymph nodes, you may not notice any changes.

If the swollen lymph nodes are deep inside the chest or tummy, the lymph nodes cannot be seen or felt. Often there are no symptoms. But sometimes swollen lymph nodes may press on nearby organs or structures. This can cause symptoms. For example, lymph nodes pressing on the lungs may cause breathlessness.

If lymph nodes press on the blood vessels, they can slow the flow of blood through the vessels. This can cause the area to become swollen and can sometimes lead to a blood clot forming.

Symptoms of a blood clot include:

  • pain, redness or swelling in a leg or arm
  • breathlessness
  • chest pain.

If you have any of these symptoms, contact a doctor straight away.

Sometimes cancer in the lymph nodes can block the flow of lymph fluid in that part of the body. If this happens in the arm or groin, it may cause a build-up of fluid that can cause swelling in the arm or leg. This condition is called lymphoedema.

Some people may also notice general symptoms of cancer, such as:

  • loss of appetite
  • weight loss
  • tiredness.

Always see your doctor straight away if you have symptoms. It is important to remember that lymph nodes can be swollen for other reasons, such as infections. But if you are worried, talk to your doctor or nurse.

Sometimes during a routine scan, a lymph node or a group of lymph nodes may look bigger than they should. This may be a sign that there is a secondary cancer in the lymph nodes.

Diagnosing secondary cancer in the lymph nodes

Secondary cancer in the lymph nodes may be diagnosed at the same time as the primary cancer. It may also be found during routine tests and scans after treatment.

If a lymph node close to the surface of the skin is affected, your doctor may be able to see it or feel it. If an affected lymph node is deep inside the chest, tummy or pelvis, only a scan can find it.

If you have had cancer before, you may only need a scan to make a diagnosis of secondary cancer in the lymph nodes. This may be:

  • A CT scan

    A CT scan takes a series of x-rays, which build up a 3D picture of the inside of the body.

  • An MRI scan

    An MRI scan uses magnetism to build up a detailed picture of the inside of your body.

  • An ultrasound scan

    An ultrasound scan uses sound waves to build up a picture of internal organs.

  • A PET-CT scan

    A PET-CT scan is a combination of a CT scan and a PET scan. PET-CT scans give more detailed information about the part of the body being scanned. 

Some people may have a sample of cells taken from the lymph node. This is called a biopsy. This test checks for cancer cells, but it is not always needed.

Your doctor or nurse will tell you what tests you will have and how long you are likely to wait for the results.

Treatment of secondary cancer in the lymph nodes

The treatment for secondary cancer in the lymph nodes depends on your situation. Your doctor will look at the type of primary cancer and your general health.

Treatments aim to destroy as many of the cancer cells as possible. You may have a combination of treatments, which can be more effective. Treatment may include:

Supportive or palliative care is treatment used to manage symptoms caused by cancer. Your cancer doctor or GP can refer you to doctors and nurses who specialise in symptom control.

Your feelings

Finding out your cancer has spread or come back may be even more upsetting than hearing for the first time that you have cancer. You may have many different feelings, including:

  • anxiety
  • uncertainty
  • fear
  • anger.

These are all normal reactions.

Everyone has their own way of coping with difficult situations. Some people find it helpful to talk to family or friends. Others prefer to seek help from people outside their situation. Some people prefer to keep their feelings to themselves. There is no right or wrong way to cope, but help is available if you need it.

We have more information about coping with advanced cancer that you may find helpful.

Macmillan is also here to support you. If you would like to talk, you can:

Reviewed: 30 April 2019
Reviewed: 30/04/2019
Next review: 30 April 2022
Next review: 30/04/2022

This content is currently being reviewed. New information will be coming soon.