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how large is large on lymph nodes?

Posts: 20
Joined: Sep 2009

in trying to decide whether to start treatment (rituxin) after being diagnosed with follicular lymphoma Stage IV...how do you know how large enlarged means? several nodes, mainly in abdomen are 2.4cm or 2.9 cm... when the growth is measured it is shown in mm as nodes
increase from 9mm to 19 mm in some areas. It seems grow is grow so again what defines "minimal"
additionally there is a mass on the aorta at bifurcation that is 1" by 1.5"..whatever cm's that comes out to be, easier for me to remember inches...

I've read on net nodes are between 1-2 cm depending our your size. Being female and only 5'2 I would think the nodes would be smaller in women than in men.

also read from one lady in a trial treatment that her node shrank to 1.4 which was still considered too large to be considered in remission.

any ideas? thanks

Posts: 12
Joined: Sep 2009

Great question but probably hard to answer online.

For many people, 2.9 cm lymph nodes in the abdomen aren't particularly big. Exactly where they are and if there is likely to be any impending danger is usually more important than the absolute size. I'll admit that 8 or 10 cm usually has my attention, but even that is a matter of opinion.

As to how big our lymph nodes are, they are approximately the same size no matter how tall or how heavy you are.

I also think about how quickly they are growing. The slower growing the better in my opinion.

Although it is sad to even point this out, it is probably worth mentioning that your oncologist stands to make a good profit from giving patients rituxan (at least this is true in the U.S.). Also, there is some concern of taking rituxan when its not needed that it may not work as well when it is needed. But that concern to hasn't been well studied or proven either. Obviously, on the average it is easier and more lucrative to give someone rituxan than to explain why waiting until later may be better. On the other hand, your oncologist may really think now is better than waiting. That's why its important to have an open and honest discussion and try to understand why they are or aren't suggesting treatment.

Depending on where you live, you may wish to have a visit with someone who specializes in lymphoma at a major university cancer center. There are many different opinions about the best way to treat follicular lymphoma and many new clinical trials as well.


Posts: 20
Joined: Sep 2009

Thanks John.

actually the oncologist seems in the opposite direction in that he said he would leave it up to me on starting the Rituxan; he seems thrilled with the "slow growth" and says he considers the nodes small. Because of the extreme fatigue I am experiencing I felt the symptoms were worsening..he said we could start Rituxan but wasn't sure they would help my symptoms. He drew blood for thyroid testing.

I guess the fact they are growing at all bothers me, and knowing there is the tumor on the aorta at birfucation, even though it is small, it is still not supposed to be there. You hear all the advantages of catching cancer early, but then you catch this early and you do nothing? hard to wrap your mind around that...the largest were in the mesentery areas.

so I am still praying God will send me the answer via burning bush before consultation next Monday.


Posts: 148
Joined: Sep 2009

Normally Lymph Nodes are well...just there and you can't even feel the darn things. So my rule of thumb is..if you can feel a node, it's too darn large and you should tell your Dr about it. They tend to swell and un-swell with nearly every little bacteria or virus that comes along in our every day lives, and they're just doing whatever it is that Lymph Nodes do, so I wouldn't get too alarmed unless they become very painful and obvious.

merrywinner's picture
Posts: 627
Joined: Aug 2009

That was a great response Dennis. My MD also made sure I understood that even with cancer in a lymph node it is still a functioning lymph node and will behave like one enlarging during illness or infection or even during treatment as an inflammatory response.

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