Lymph Node Concerns: Anxiety, Symptoms, and Next Steps

Lymph node issues?

Hello Doctor,
Before I explain my situation, I want to mention that I tend to become overly anxious and worried due to health issues.
Two months ago, after reading about skin cancer online, I had two moles removed.
During that time, I was very concerned and noticed a weight loss.
The second mole was removed from the right side of my buttock, and after the procedure, I experienced inflammation and pain.
A week later, I came across information about lymph nodes online and began self-examining, only to find a lump in my left groin that is about 1 cm, soft, and movable.
Just when I thought my mood was starting to improve, I fell back into a state of extreme worry and anxiety.
A week ago, I consulted with a family medicine doctor and a hematologist at a veterans' hospital, and they both advised me to monitor the situation for any changes in size or fever.
It has been almost two weeks, but I have been very anxious during this time.
My weight has dropped from 66 kg before the mole removals to 63 kg, and now I weigh 61 kg.
I am unsure if this weight loss is due to excessive anxiety.
Current situation:
1.
After discovering the groin lymph node, I started checking other areas and found another small lymph node next to the original one.
I can also feel a small lymph node in my right groin, none exceeding 1 cm.
2.
I checked my neck and found 3 to 4 lymph nodes, all under 1 cm, which are also soft and movable.
3.
Recently, I have been experiencing night sweats; shortly after falling asleep, I notice that my body and bedding become wet.
I wake up once or twice, but then it stops.
These symptoms have made me increasingly worried about malignant lymph nodes.
However, since the lymph nodes I can feel are movable and soft, I am uncertain whether I should see a doctor again or continue to observe.
Given the night sweats and weight loss, I feel that my excessive anxiety and stress may be causing autonomic nervous system dysregulation, which could lead to decreased immunity and lymphadenopathy, even though the lymph nodes are not larger than 1 cm.
Could you please clarify whether lymph nodes that do not exceed 1 cm are generally considered normal? I have been observing daily without any significant changes, but could the absence of enlargement still cause night sweats and weight loss? Or is it more likely that these symptoms are due to anxiety and stress-induced autonomic nervous system dysregulation? I would greatly appreciate your insights.
Thank you, Doctor.
I kindly ask for your advice; I am currently an intern at National Taiwan University Hospital, and the appointments there are fully booked.

Dàxuéshēng, 20~29 year old female. Ask Date: 2015/07/28

Dr. Chen Sirong reply Oncology

Hello, university student / 20 / biomedical engineering junior!
1.
I understand that you are very worried.

2.
As you mentioned, excessive anxiety, high stress, and tension can lead to autonomic nervous system dysregulation, which can result in symptoms like night sweats and weight loss.

3.
You also know that lymph nodes that are less than 1 cm are considered soft and mobile, and most of them are benign.

4.
The appointment slots at National Taiwan University are fully booked, but you can go to the site at 4 AM to queue for walk-in numbers.

5.
Given your constitution, it is normal for these to appear, and regular follow-ups, such as seeing a doctor every three to six months, are advisable.
If there are no significant changes in between, allow yourself to relax and enjoy life! You can't worry like this for a lifetime!
Thank you for your letter,
Dr.
Chen Si-Rong

Reply Date: 2015/07/28

More Info

It sounds like you are experiencing a significant amount of anxiety related to your health, particularly concerning the lymph nodes you have discovered. This is a common issue for many individuals, especially those who are prone to anxiety or have had previous health concerns. Let's break down your situation and address your questions.

Understanding Lymph Nodes and Anxiety
Lymph nodes are small, bean-shaped structures that are part of the lymphatic system, which plays a crucial role in the immune response. It is normal to have lymph nodes that can be felt, especially in areas like the groin, neck, and armpits. Lymph nodes can swell for various reasons, including infections, inflammation, or other medical conditions. In your case, the fact that the lymph nodes you are feeling are soft, movable, and less than one centimeter in size is generally a reassuring sign.
However, your anxiety about these findings is understandable, especially given your recent experiences with skin cancer concerns and the subsequent removal of moles. Anxiety can indeed manifest physically, leading to symptoms such as weight loss, night sweats, and increased sensitivity to bodily sensations. The weight loss you have experienced (from 66 kg to 61 kg) could be attributed to your heightened anxiety and stress levels, which can affect appetite and overall well-being.

Addressing Your Concerns
1. Lymph Node Size and Characteristics: Generally, lymph nodes that are less than one centimeter in size, soft, and movable are considered normal. However, any changes in size, consistency, or the development of new symptoms (such as fever or persistent pain) should prompt a reevaluation by a healthcare professional.

2. Night Sweats and Weight Loss: Night sweats can be caused by various factors, including anxiety, hormonal changes, or infections. Given your anxiety, it is plausible that your stress levels are contributing to these symptoms. It is essential to monitor these symptoms and discuss them with a healthcare provider if they persist or worsen.

3. Next Steps: Since you have already consulted with doctors who have advised you to observe the lymph nodes, it may be beneficial to continue doing so while also addressing your anxiety. If you notice any changes in the lymph nodes or if your symptoms (like night sweats and weight loss) continue, it would be wise to seek further evaluation.

4. Managing Anxiety: Consider incorporating stress-reduction techniques into your daily routine. Practices such as mindfulness, meditation, or cognitive-behavioral therapy (CBT) can be effective in managing anxiety. Keeping a journal to track your thoughts and feelings may also help you identify triggers and patterns in your anxiety.

5. When to Seek Help: If your anxiety becomes overwhelming or if you find it challenging to manage your symptoms, it may be beneficial to speak with a mental health professional. They can provide support and strategies tailored to your needs.

Conclusion
In summary, while your concerns about the lymph nodes are valid, the characteristics you described are generally not alarming. However, your anxiety is likely exacerbating your physical symptoms. Focus on managing your stress and anxiety, and continue to monitor your health. If you have any new symptoms or changes, don't hesitate to reach out to a healthcare professional for further evaluation. Remember, taking care of your mental health is just as important as addressing your physical health.

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