Some cancers have been found to cause swelling of the lymph nodes — then, after it has started there, it’s likely to spread somewhere, medical experts said.
There are many causes for swollen lymph nodes, according to the Cancer Treatment Centers of America. Most commonly, lymph nodes become swollen because of an infection, such as a viral upper respiratory infection like the common cold.
“Sometimes,” said Dr. Alan Piper, who has treated patients at the cancer center.
“Lymph node swelling means something more sinister is happening. When an individual experiences pain or swelling of the lymph nodes it can raise alarms because it’s a common symptom of cancer that starts in the lymphatic system,” he said.
The case of Susan Wolfe-Tank provides a glimpse of the battle.
Already receiving treatment for breast cancer, the Wisconsin woman eventually was admitted to Georgetown University Hospital in the District.
She said her arm was too painfully swollen to lift anything heavy or even fit into her usual clothing.
“Right in this area, feel that — that is your lymph node,” Dr. David Song of MedStar Georgetown University Hospital in Washington told Wolfe-Tank during a recent checkup, according to U.S. News & World Report.
Song, Georgetown’s plastic surgery chief, had removed healthy lymph nodes from Wolfe-Tank’s back and side and implanted them in the affected arm.
As the new nodes took root, her arm was shrinking.
A delighted Song’s only caution: “Take care of them,” by wearing a compression sleeve as prescribed.
“This isn’t a cure. I will still have to be careful,” said Wolfe-Tank, 51, of Hurley, Wisconsin.
But, “I will be able to cross-country ski again, just live a normal life. Look at my arm, it’s incredible,” she said.
Lymphedema is a chronic swelling, often in an arm or leg that in severe cases can be disfiguring, impair mobility, cause disabling pain, harden the skin and lead to infection.
Lymph nodes work like biological pumps in a network that’s part of the immune system.
They drain watery fluid called lymph that, traveling through tiny channels, bring nutrients to cells and take away bacteria and waste material.
Lose or damage enough lymph nodes or channels in a particular area and that fluid builds up.
There’s no good count, but millions of Americans are estimated to have some degree of lymphedema, and while it can be hereditary or result from injury, many U.S. cases are a lasting side effect of treatment for a variety of cancers.
Consider breast cancer. While better surgical techniques in recent decades have lowered the risk, experts estimate that still about 6 percent of breast cancer survivors who undergo a “sentinel node biopsy” — removing a few nodes to check for spreading cancer — will develop lymphedema.
That risk jumps to about 20 percent for women like Wolfe-Tank who need additional lymph nodes removed because of more advanced cancer, U.S. News & World Report said.
Radiation causes further harm. Yet too often women aren’t warned about symptoms or checked for early signs, when lymphedema is more easily treated, said Dr. Sheldon Feldman of New York’s Montefiore Einstein Center for Cancer Care.
He co-authored physician guidelines issued this fall by the American Society of Breast Surgeons on prevention and treatment of breast cancer-related lymphedema.
Typical patients have “had that swelling for a while,” Feldman said. “Now the treatment is an uphill battle.”
The main treatment consists of wearing compression bandages and massage to bring down swelling. A lymphedema specialist initially prescribed a large pump that massaged Wolfe-Tank’s arm for an hour a night, temporarily relieving some of the pain.
“But if I used my arm, I was back to square one,” Wolfe-Tank said. “I didn’t fit into my coat anymore. I live in the snow capital of Wisconsin. I’m not supposed to shovel. We’ve got to fix this.”
Wolfe-Tank had struggled for four years when an oncologist recommended lymph node transfer.
The rationale: There are more lymph nodes in the body’s trunk than in the limbs — more avenues to drain off fluid — and thus it should be safe to move a few.
Hunting for a surgeon, Wolfe-Tank found Song, who transferred about five nodes along with supportive blood vessels and other tissue, hoping they’d grow new channels to drain fluid.
There are other options, including a technique called lymphovenous bypass reroutes lymph-carrying channels, going around damaged or missing nodes to drain into veins instead.
For more information, visit www.cancercenter.com, www.cancer.org, or a local specialist.
Information from U.S. News & World Report was included in this story.