Sometimes in leukemia or lymphoma, the disease is in an 'active' state and is producing lots of dysfunctional white blood cells. However, at times the disease can also 'slow down' and some of the cells can die. This can mean that the swollen lymph nodes can fluctuate in size, growing and shrinking over time.
Often, people with follicular lymphoma complain that their lymph nodes have been swollen for a long time; the size may increase and decrease several times before they seek medical attention.
A reactive node tends to enlarge fairly quickly and then starts to shrink after the inciting infection goes away. On the other hand, a cancerous lymph node almost never shrinks without treatment of the cancer. So even if a swollen node doesn't totally go away, if it shrinks considerably that's a reassuring sign.
The swelling associated with follicular lymphoma often occurs in the neck, underarms, or groin. It is often painless and may remain over time, or the lymph nodes may shrink and then swell again.
The survival rate often falls once cancer reaches the lymph nodes. According to the American Cancer Society , the survival rate for colon cancer is 91% if a person receives a diagnosis in the early stages. However, if cancer spreads to the lymph nodes, it drops to 72%.
The overall 5-year relative survival rate for people with NHL is 74%. But it's important to keep in mind that survival rates can vary widely for different types and stages of lymphoma.
Enlarged lymph nodes are usually firm, mobile and non-tender, and may fluctuate in size, with spontaneous regression well documented. Rapid growth of nodes is unusual. The response to therapy is generally good, but relapse is common.
Size: Lymph nodes are made to change in size because they're doing a job. They grow larger as the number of cells caught inside of them increases and shrink back down to normal as that number drops. But the normal size of an average lymph node is under 1.5 centimeters, or about ¾ of an inch or smaller.
Sometimes lymph nodes remain swollen long after an infection has disappeared. As long as the lymph node does not change or become hard, this is not typically a sign of a problem. If a person notices that a lymph nodes changes, hardens, or grows very large, they should see a doctor.
The lumps are caused by lymphoma cells building up in your lymph nodes, which makes the lymph nodes swell. The swollen lymph nodes are usually painless. They might stay swollen or they might shrink a little and then come back from time-to-time. Most people have no other symptoms.
This means that the cell dies when it attempts to divide. So, if a cell does not divide, then it does not die, but just sits there. At the same time, if a cell doesn't divide, it also cannot grow and spread. For tumors that divide slowly, the mass may shrink over a long, extended period after radiation stops.
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 few cancer cells in the lymph nodes, you may not notice any changes. If the swollen lymph nodes are deep inside the chest or tummy (abdomen), you will not be able to see or feel them.
Those near the body's surface often get big enough to feel with your fingers, and some can even be seen. But if there are only a few cancer cells in a lymph node, it may look and feel normal.
Lymph nodes measuring more than 1 cm in the short axis diameter are considered malignant. However, the size threshold does vary with anatomic site and underlying tumour type; e.g. in rectal cancer, lymph nodes larger than 5 mm are regarded as pathological.
Typical malignant cervical lymph nodes are larger in size, rounded in shape (S/L > 0.5), have loss of the echogenic hilum, appear homogenously hypoechoic, demonstrate peripheral or mixed vascularity, and demonstrate high vascular resistance.
In Hodgkin disease, the lymph nodes are usually larger than those that occur with common infections, and they do no shrink when treated with standard medications like antibiotics.
What to Expect: After the infection is gone, the nodes slowly return to normal size. This may take 2 to 4 weeks. However, they won't ever completely go away.
Painful lymph nodes are generally a sign that your body is fighting an infection. The soreness usually goes away in a couple of days without treatment. The lymph node may not return to its normal size for several weeks.
A CT scan might show which lymph nodes are enlarged and may be affected by non-Hodgkin lymphoma (NHL). A CT scan is a test that uses x-rays and a computer to create detailed pictures of the inside of your body. It takes pictures from different angles. The computer puts them together to make a 3 dimensional (3D) image.
The cervical lymph node status is a very important consideration in the assessment of squamous cell carcinoma. Ultrasound is a noninvasive and inexpensive technique that can be used to differentiate between the benign and metastatic nodes.
Treatment for cancer in the lymph nodes
Other treatment options for cancer in the lymph nodes may include chemotherapy, radiation therapy, a stem cell transplant, immunotherapy or targeted therapy. There's a higher risk for cancer to come back following surgery when a cancer has spread to lymph nodes.
Low-Grade Lymphoma
These grow so slowly that patients can live for many years mostly without symptoms, although some may experience pain from an enlarged lymph gland. After five to 10 years, low-grade disorders begin to progress rapidly to become aggressive or high-grade and produce more severe symptoms.
With lymphoma, the lymph nodes often grow slowly and may be there for months or years before they're noticed. But sometimes they grow very quickly. Usually, the swollen nodes don't hurt. But some people say their lumps ache or are painful.