Neck : Lymphnodes with Cancer
- Lymph nodes in neck – Sometimes cancer cells are found in the lymph nodes of the neck when there is no evidence of cancer in other parts of the body. When this happens, the cancer is called secondaries with unknown (occult) primary.
Most common symptoms:
- Swelling in the neck (mostly painless)
HOW DO WE DIAGNOSE?
To find the cause of symptoms, a surgical oncologist evaluates a person’s medical history, performs a physical examination, and orders diagnostic tests. The examination and tests conducted may vary depending on the symptoms.
- Physical examination may include visual inspection of the oral and nasal cavities, neck, throat, and tongue using a small mirror and/or lights. The surgical oncologist may also feel for lumps in the neck, lips, gums, and cheeks. Doctor may examine chest, abdomen and do per vaginal and per rectal examination to find site of primary.
- An Ultrasound-guided Fine Needle aspiration Cytology test or a TRUCUT biopsy is usually used to confirm the diagnosis. It may also help in search of possible primary.
- A biopsy of lymph node may be needed under GA to make a diagnosis. A biopsy is the only sure way to tell whether a person has cancer and type of cancer. It could be squamous cell carcinoma, adenocarcinoma, lymphoma. Special tests like Immunohistochemistry, molecular tests and NGS may be done to find site of primary.
- Laboratory tests examine samples of blood, urine, tumor markers.
- X-rays and US of suspected areas.
- CT scan/or MRI of local area may be useful.
- PET scan is useful in locating primary as well as in finding any other focus of cancer.
TUMOR BOARD/ MULTISPECIALTY CLINIC EVALUATION
Each and every Head & Neck cancer patient is evaluated by a special team of Surgical Oncologists (Head & Neck unit), Medical Oncologists, Radiation Oncologists, Onco-pathologists and Imaging Specialists. Depending on the age, general condition, type of pathology and stage of the disease, a custom made treatment plan is charted out for each and every patient as per International Treatment Guidelines. (NCCN – National Comprehensive Cancer Network).
- MND, RND, and extended neck dissections
DO’s after Surgery
- All medicines as prescribed in the discharge note along with medicines for chronic diseases like diabetes, hypertension, thyroid-related, and asthma should be continued as earlier.
- Shoulder exercises as and when advised.
- Care of the drain and output charting as advised.
- Care of the wound as advised.
DON’Ts after Surgery
- Avoid addictions
- Avoid hot fomentations for pain relief
When to reach the treating team?
- As per appointment.
- If the swelling around the neck wound increases suddenly or within few hours.
- Fresh bleeding from the neck wound. Minimal blood-stained discharge from neck wound during cleaning may need attention
- If there’s difficulty in breathing or swallowing, fever.
MBBS, MS, M.Ch.
Dr. A.K. Dewan Head & Neck Surgical Oncology
MS(Surgery), MRCS(Edinburg), M.Ch. Surgical Oncology
Dr. Mudit Agarwal Head & Neck Surgical Oncology
Dr. Vikas Arora Head & Neck Surgical Oncology
MBBS, DLO, DNB (ENT)
Dr. Ghanshyam Mandal Head & Neck Surgical Oncology
MBBS, MS, FHNS
Dr. Vishal Yadav Head & Neck Surgical Oncology