Question About New Neck Lymph Node After Radiation/Chemo in 9/2023

Swoosh13

Hi Russ and All,

Only because I tend to be a little more pragmatic and intuitive instead of initially panicking, here I am again. My husband was diagnosed with Stage 1 base of tongue cancer (HPV+) in July 2023 (so a little over a year ago). He had 7 weeks of radiation to his left base of tongue and left 2 affected lymph nodes (but also received a bit lesser radiation to the right side of his neck, even though scans showed no metasteses to that side (so they radiated both sides). He also had 7 weekly doses of Cisplatin during that time, all of which he tolerated fairly well (other than losing about 30 pounds and has probably regained 15-20). He is actually at a much healthier weight now for his diabetes. Treatment was 9/6 to 10/27/23 (7 weeks as I said).

Anyways, today he had a routine dental visit (his second since his post-treatment PET in February 2024). Note also that his PET 2/24 showed NED, and he also had a camera/scope in late May 2024 by one of his tumor board doctors that also showed NED. The hygienist at the dentist today saw a swollen lymph node on the opposite side of his neck from the original tumor (so on his right side). She was concerned enough (about the size she thought) that he should get it checked by his cancer doctor(s). Unlike the first left side swollen lymph node which he noticed himself (which brought us to his cancer journey), he did not see, notice or feel this right sided one.

Tomorrow we are going for labs and seeing the Physician Assistant to his Oncologist for a check-up about this. I talked to his Oncologist nurse this afternoon and she made things happen. We also very much like and trust this PA.

So here's a question. Russ I've seen you write these TONS of times. Never assume you have cancer until they say it's cancer (or a recurrence). The question: Can 7 weeks of daily radiation to your head/neck cause reactive lymph nodes like this to swell going forward in your life?

I tend to think it's a possibility as I said, they radiated both sides of his head/neck last year, and saw nothing when his tumor board doctor scoped him in late May. He also saw his Radiologist in mid-August (he sees 3 of his tumor board doctors who will rotate the first year post-treatment every 3 months). Radiologist did not scope him in August, but his PA and he both did the whole speculum into his mouth/throat and again saw nothing. But of course we did not know anything about this "swollen lymph node" until the hygienist mentioned it today.

I personally have reactive lymph nodes (even had my left side one biopsied in 2019 and it was benign) so anytime I have the slightest virus it swells right up. Although my husband has not (thankfully) been sick like that.

Other than this, he is doing very well. Slight dry mouth (particularly at night), but not bad. Taste is maybe at 70% (but some things are still coming back more lately, particularly he loves tomotoes, spices anything he can season). Nothing tastes bad anymore, although he said sweets sometimes he can taste the first couple of bites like normal and then the taste goes away.

He has regained his strength and back to work 3 days/week (he's 68 so he does not need to work but loves it).

Anyways, would like to know your thoughts (or anyone else with this experience).

Swoosh13

goffrey

I had chemo radiation as well with weekly Cisplatin and also had lymph nodes on one side that were cancerous but had both sides radiated with the non cancerous side to a lesser degree. I do not think you get reactive lymph nodes post radiation that far out. It could be he has a virus brewing or some sort of infection enlarging his lymph node.

wbcgaruss

Hello, Swoosh, I don't know that I would get overly alarmed about one lymph node being swelled but I wouldn't ignore it either.

Your husband is not that long out of treatment and as far as I am concerned when they give you radiation they are sure they are hitting the cancer and dosing to get rid of it. So I doubt he is having any cancer recurrences.

But since the hygienist noticed it I would count that as a stay alert warning because they are trained to spot this kind of stuff when it gets to a certain size and warn the patient.

But please keep in mind anything is possible and anytime something is a little bit off for a H&N cancer person I urge them to see their doctor and play it safe.

I know once we have had H&N cancer, or probably any cancer for that matter any sore spot or bump, or unusual feeling we want to think of cancer especially when we are in the first years post-treatment, I know every issue brings cancer to mind till you get years out and get a little more relaxed.

So I don't know if you have had your appointment yet but they will probably tell you to keep an eye on it and watch for more swelling or see if it resolves itself.

I would recommend you ask them to have a CT Scan with dye and see if they feel it would be wise to do that.

I know recurrence of H&N cancer is a high risk going to the lungs and maybe the lymph nodes would be a possibility.

That is why my ENT has me get a chest CT Scan every year and because I have had cancer more than once I also get one of the H&N area.

And check with your ENT, as I think many ENTs recommend at least a chest X-ray once a year for H&N patients.

I think I am saying too much here and am not trying to alarm you I just want you to do what's necessary to make sure this is not cancer.

A swollen node in a person previously treated for H&N cancer should not be ignored and followed through till you are sure there is nothing serious going on.

All I am saying is if you have an issue like this keep an eye on it and don't be shy about calling your ENT and going in for an appointment to make sure it is nothing to worry about. And they may get you to get a CT Scan, I know the ENTs that I have had so far, and neither one has been hesitant to send me for a CT Scan if there was an issue they sent me for one. Make sure and ask "should my husband have a CT scan with contrast"?

So get this resolved to your satisfaction to make sure there are no issues and remember if for some reason cancer shows up again you want to be on top of it and get it while it is as small as possible.

Here is a link about swollen Lymph nodes to check out…

https://www.mayoclinic.org/diseases-conditions/swollen-lymph-nodes/symptoms-causes/syc-20353902

Best of Luck

Wishing You The Best

Take Care, God Bless

Russ

Swoosh13

Russ & Goffrey,

Thank you both!

We see his Oncologist’s PA tomorrow afternoon for labs and for him to check it. I’ll definitely ask for a CT with contrast if he’s at all suspicious. We have good insurance and if they put an order in it’ll be mostly covered. The first time around last year he had an ultrasound first which was then quickly followed by the CT. Yeah it’s scary. We just had our first mini-vacation this past weekend and I know my husband enjoyed it so much.
I’ll keep you posted after we know more tomorrow.
Swoosh13

SuzJ

I just went thru this, I was totally terrified.

My lymph nodes on the other side are swollen BUT after a CT and fnb, they are benign. YES!

Your lymph nodes are a form of defense against any gems, get a cold? Pop, up go the lymph nodes, allergies, you name it.

But one thing anyone here can tell you, when you know, you know. I was scared, but once the fnb was done, I looked at them, and said, 'it isn't cancer' I just knew.

What you don't get told, is that once you've had treatment on a side of your neck, the lymph on the other side get to work harder. Thank you radiation!

Swoosh13

https://csn.cancer.org/discussion/comment/1718002#Comment_1718002

Hi SuzJ,

Really appreciate your response and so glad they found everything to be benign!
We’re seeing my husband’s Oncologist PA this afternoon and he also ordered labs, so we’ll know more later today.
Will keep you all posted!

Swoosh13

Swoosh13

Hi Russ & All Again,

So good news so far, we saw my husband’s Oncology PA this afternoon and he said he was 99% sure this is a normal feeling “structure” on my husband’s neck. For several reasons … it did not feel suspicious, also because my husband has some residual lymphedema swelling under his chin from his radiation, it tends to pull the sides of his cheek/neck down so his submandibular glands appear more prominent. Also because he lost 30 pounds and maybe gained 15-20 back after treatment, because his face is thinner both sides of his neck show their structure more. He said he suspected pre-cancer that this area of concern (from his hygienist) was probably always a part of his neck. All my husband’s labs were normal (and he checked a ton of stuff). For extra security he will put in an order to get a non-urgent ultrasound of both sides of his neck to be done in the next 1-2 weeks. I asked about a CT and he thought we didn’t need that right now (also US is less expensive) plus again he was 99% sure this is nothing to worry about. So breathing a sigh of relief tonight and super glad his cancer team are so responsive and available.
Swoosh13

wbcgaruss

Thank you for the update, it sounds like he is well taken care of, so glad that they feel everything is normal for the situation.

Wishing You The Best

Take Care, God Bless

Russ

Swoosh13

Hi Russ and All,

Update: So my husband had his follow-up ultrasound of both sides of his neck this afternoon. We had the best news … “no suspicious cervical lymphadenopathy.” They compared it to his post-treatment PET of 2/24 and his very first ultrasound (pre-treatment) of 6/23.
Also thyroid normal and all lymph nodes Levels I-V (lateral compartment) and lymph nodes Level VI (central compartment) normal.
First got his results on-line through his My Chart acct but his Oncologist PA also wrote to say “Great News!”

Next regular 3 mo appt in mid-November. Glad they did the US even though his PA didn’t expect to see anything.

Swoosh13

wbcgaruss

So, Swoosh, I take that report as no cancer seen in his follow-up.

Ye-HaH things are lookin up.

Everythings comin up roses on the forum tonight.

tbret just got his NavDX test back and he scored "0" on it which means no cancer.

Hurray, everyone! I am so glad to see good news on here. It shows the other side of this cancer battle: Victory over this evil disease. It is what we fight for, and we have some winners today.

Take Care, God Bless

Russ

Celebration time….