Lymph Nodes: Concerns and Insights from a Cancer Patient

Q: Lymph Nodes: Concerns and Insights from a Cancer Patient

Patient： Xiao Ke / 37 years old / Male<br>1. <br>I brushed my teeth too hard and hit my lower gum, resulting in an ulcer the next day. <br>A： This allowed bacteria to enter, causing inflammation and resulting in swollen lymph nodes in the neck, which is quite reasonable.<br>2. <b

I was overwhelmed by lymph nodes?

Dr.
Chen, first of all, I want to thank you for saving me from panic and helplessness a few years ago on this platform.
Recently, those feelings have returned, and I have many questions I would like to ask you:
1.
A few weeks ago, I accidentally injured my lower gum while brushing my teeth too hard, and the next day, that area developed an ulcer.
It took over three weeks (around February 17) to heal.
I was initially very worried that it might be oral cancer because I read online that if an ulcer doesn't heal within two weeks, one should be cautious, and if it lasts more than three weeks, the chances of oral cancer are significant.
2.
Last Monday (February 12), I felt a lump in my left jaw that was warm and swollen.
I wasn't sure if it was a lymph node or some gland that was inflamed.
Then, on February 13, I felt a small lump just below my left neck, above the collarbone.
This lump doesn't hurt much, is about one centimeter, and feels movable.
Is this lump above the collarbone related to the swollen lump in my jaw from February 13? The jaw lump has noticeably shrunk and is no longer painful, but the neck lump seems to have stayed about the same size (I think I may have felt this neck lump before, but I'm not entirely sure).
3.
Because I was very worried, I visited an ENT specialist on February 20.
The doctor initially couldn't feel the lump, but after I pointed it out, he found it and said it was small.
He examined my head, neck, and nasopharynx and said there was nothing to worry about; it should be a normal deep cervical lymph node.
4.
I seem to have obsessive-compulsive disorder or panic disorder, and I keep touching the lump in my neck and searching online for information that scares me.
Yesterday, I found out that the lymph node above the left collarbone is called Virchow's node, which is associated with cancer metastasis, and usually indicates late-stage cancer.
This scared me so much that I started shaking and feeling cold.
Is this really the case?
5.
Additionally, the lymph node in my neck seems to change in firmness and size depending on my posture.
For example, when my hand is resting normally, I can't feel it, but when I raise my left hand to the right side, I can feel the soft, movable lump (less than one centimeter).
When I lift my left hand higher, the lump becomes less movable and feels firmer (about one centimeter).
Is this a normal phenomenon? (Is it due to muscle compression?)
6.
Finally, regarding the location of lymph nodes, as long as they are less than one centimeter, not painful, not associated with fever, and not increasing in size or number, can I just observe them? How long should I observe them before I can feel reassured? I've read online that it could be one or two weeks or even several months.
If it were cancer, would it grow quickly?
7.
I apologize for having so many questions; please help me once more.

Xiao Ke, 30~39 year old female. Ask Date: 2018/02/22

Dr. Chen Sirong reply Oncology

Patient: Xiao Ke / 37 years old / Male
1.
I brushed my teeth too hard and hit my lower gum, resulting in an ulcer the next day.
A: This allowed bacteria to enter, causing inflammation and resulting in swollen lymph nodes in the neck, which is quite reasonable.
2.
On February 20, I visited an ENT specialist who examined my head, neck, and nasopharynx.
He said there was nothing wrong and that it should be normal deep cervical lymph nodes.
A: So you should feel reassured!
3.1 I seem to have obsessive-compulsive disorder or panic disorder, and I keep touching the lymph node in my neck and searching online for information that scares me.
A: You are already aware that your behavior is causing you distress!
3.2 Yesterday, I found out that the lymph node above my left clavicle is called Virchow's node, which is associated with cancer metastasis and is usually indicative of late-stage cancer.
I got so scared that I kept feeling cold and trembling.
Is this really the case? A: Instead of scaring yourself with what you read, it’s better to trust your doctor’s advice and have regular follow-ups.
If there are any changes, see your original ENT specialist immediately.
If there are no changes, that’s good.
You can visit your ENT specialist again if you catch a cold, and have them check it then.
5.
I’d like to ask about the lymph node in my neck; it seems to change in firmness and size depending on my posture.
For example, when my hand is resting normally, I can’t feel it, but when I raise my left hand to the right side, I can feel that soft, movable node (less than one centimeter).
When I raise my left hand higher, that node doesn’t move much and feels firmer (about one centimeter).
Is this a normal phenomenon? (Is it muscle compression?) A: I do not recommend that you act as your own doctor and study these professional issues!
6.
Lastly, I’d like to ask, regardless of the location of the lymph nodes, as long as they are less than one centimeter, not painful, not associated with fever, and not increasing in size or number, can I just observe them? How long should I observe them before I can feel reassured? Some sources say one to two weeks, while others say several months.
If it were cancer, would it grow quickly? A: If there are any changes, see your original ENT specialist immediately.
If there are no changes, that’s good.
You can visit your ENT specialist again if you catch a cold, and have them check it then.

Happy New Year, Taoyuan Hospital, Chen Si-Rong.

Reply Date: 2018/02/22

More Info

Dear Patient,
Thank you for reaching out with your concerns. It's completely understandable to feel anxious about health issues, especially when it comes to lymph nodes and potential cancer. Let’s address your questions one by one.

1. Oral Ulcer from Brushing: It’s common for vigorous brushing to cause trauma to the gums, leading to ulcers. These typically heal within a couple of weeks. If an ulcer persists for more than three weeks, it’s wise to consult a healthcare professional, as persistent ulcers can sometimes indicate underlying issues, including oral cancer. However, in your case, since it healed after three weeks, it’s likely just a result of trauma.

2. Swollen Lymph Nodes: The swelling you felt under your jaw could indeed be related to the oral ulcer. Lymph nodes can become reactive and swell in response to infections or inflammation in nearby areas, such as the mouth. The node you felt near your collarbone (supraclavicular lymph node) may or may not be related to the swelling under your jaw. It’s important to monitor these nodes, especially if they change in size or become painful.

3. Doctor's Assessment: It’s reassuring that the ENT specialist found nothing concerning during your examination. Normal deep cervical lymph nodes can often be palpable and may vary in size and consistency. If the doctor felt it was small and not concerning, that’s a positive sign.

4. Virchow's Node: The term "Virchow's node" refers to a left supraclavicular lymph node that can be associated with abdominal malignancies. However, not all supraclavicular nodes are malignant. Your doctor’s reassurance is crucial here. It’s essential to avoid self-diagnosing based on internet searches, as this can lead to unnecessary anxiety.

5. Lymph Node Mobility and Consistency: It’s normal for lymph nodes to feel different based on your position or muscle tension. Nodes can be more palpable when you are relaxed, and they may feel firmer or less mobile when muscles are tense. This variability is common and not necessarily indicative of malignancy.

6. Monitoring Lymph Nodes: Generally, lymph nodes that are less than 1 cm, non-tender, and stable in size can be monitored. If they remain unchanged over a few weeks to months, it’s usually a good sign. However, if you notice any changes—such as an increase in size, tenderness, or the development of new nodes—it's important to follow up with your healthcare provider.

7. General Advice: It’s understandable to have many questions, especially when dealing with health concerns. The best approach is to maintain regular check-ups with your healthcare provider, who can guide you based on your specific situation. If anxiety persists, consider discussing it with a mental health professional, as managing stress and anxiety can significantly improve your overall well-being.

In summary, while it’s natural to worry about lymph nodes and potential malignancies, many factors influence their behavior. Regular monitoring and professional guidance are key. If you have further questions or if anything changes, don’t hesitate to reach out to your healthcare provider.

Take care, and I wish you the best in your health journey.

Sincerely,
Doctor Q&A Teams

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