Should You Be Concerned About Swollen Lymph Nodes in Your Neck?

You have about 600 pea- to bean-sized lymph nodes all over your body, from your legs to your jaw. And most of the time, swollen lymph nodes in your neck are harmless — a sign that your body is fighting off some type of virus, like a cold or the flu.

But occasionally, those lumps can signal something more serious.

It’s uncommon for swollen lymph nodes to be an early sign of cancer. But it can happen. Internal medicine physician Daniel Sullivan, MD, explains.

What causes cancerous swollen lymph nodes?

When the lymph nodes in your neck swell, it’s called cervical lymphadenopathy. It’s usually a sign that your body is doing its best to fight off something like a cold, sore throat or ear infection.

But in some cases, swelling can also be a sign of cancerous cells in the lymph nodes — whether because cancer has started there or traveled there from another part of your body.

“Lymph nodes are the body’s sophisticated sewer system,” Dr. Sullivan illustrates. “They get rid of things our body doesn’t want, like bacteria, viruses and other things that enter our system.”

Usually, treating the infection that’s causing those lymph nodes to swell will help shrink them back down to size. But if cancer is the cause of the swelling, treatment isn’t as straightforward.

Cancers related to swollen lymph nodes

Swollen lymph nodes in the neck may be associated with several types of cancer, such as:

• Leukemia: This blood cancer is characterized by fast-growing abnormal blood cells. It can cause cancer cells to build up in the lymph nodes and cause swelling.
• Lymphoma: This group of blood cancers starts in the lymphatic system. The most common symptom is having swollen — but painless — lymph nodes.
• Melanoma: “Skin cancers that start on the face or scalp can spread beyond the skin and cause lymph nodes to swell,” Dr. Sullivan says.
• Squamous cell carcinoma: This type of skin cancer can form in the mucous membranes that line your mouth. It may cause nearby lymph nodes to swell.
• Oral cancers: Other cancers that affect the mouth and cheek area can also lead to swelling in the lymph nodes of your neck.
• Thyroid cancers: Most thyroid cancers actually don’t cause any symptoms. But when they do, swollen lymph nodes are a possibility.

“Swollen lymph nodes can also be a sign of metastatic cancers,” Dr. Sullivan says. “When cancer cells break off from the original tumor, they enter the bloodstream or lymphatic system and spread to other parts of your body.”

What do swollen, cancerous lymph nodes look and feel like?

You can’t tell the difference between run-of-the-mill swollen lymph nodes and cancerous lymph nodes on your own. Only a healthcare provider can say for certain. But there are some clues to watch for.

• Pain: When you’re battling a cold, swollen lymph nodes often feel tender or painful to the touch. But swollen lymph nodes associated with cancer typically don’t hurt.
• Size: When your body is fighting an infection, your lymph nodes may feel puffy or enlarged. But if they grow to 1.5 centimeters or more, that could be a sign that something else is going on. (That’s slightly smaller than a dime, for reference.)
• Growth: Once you’ve successfully battled an infection, swollen lymph nodes should return to their usual size — not continue to grow, as is sometimes the case when the swelling is due to cancer.
• Texture: Lymph nodes are typically soft and a little bit squishy. Lymphoma can make them feel a bit rubbery, while metastatic cancers can make them feel hard and firm.
• Movement: Healthy lymph nodes move under your fingers when you press lightly. Lymph nodes affected by lymphoma may, too. But metastatic cancers can cause them to feel like they’re stuck in place.

If cancer is the cause of your swollen lymph nodes, you may also experience other symptoms. Doctors call these “B symptoms,” and they’re most commonly associated with leukemia and lymphoma. They include:

• Unexplained weight loss
• A fever above 103 degrees Fahrenheit (39.44 degrees Celsius) for more than two days
• Drenching night sweats

When to see a doctor

Most of the time, swollen lymph nodes are a fleeting concern. As soon as your body clears the infection it’s fighting, your lymph nodes return to their usual size.

But talk to a healthcare provider if you have swollen lymph nodes that aren’t accompanied by other cold or flu-like symptoms, but:

• Are 1 centimeter or larger in diameter (about the size of a wooden pencil eraser)
• Seem to be getting bigger
• Feel firm, hard or rubbery
• Aren’t tender or painful
• Are accompanied by symptoms like fever, weight loss and night sweats
• Persist for two weeks or longer

“If it’s been going on for more than two weeks and they continue to get larger, that’s a red flag for us to look into causes beyond common infections,” Dr. Sullivan states.

Your doctor will want to discuss factors like:

• Your age: Swollen lymph nodes are somewhat less likely to be a sign of cancer in younger people. And your general risk of cancer goes up as you get older.
• Lifestyle choices: Your provider will ask about any habits that could raise your risk of cancer, including smoking and excessive alcohol use.
• History of skin cancer: “If you had skin cancer that was treated, we’d consider the possibility that it traveled beyond the skin,” Dr. Sullivan notes.
• Human papillomavirus (HPV): People with this virus have a higher risk of developing cancers of the mouth or throat, including squamous cell cancer.

It can be nerve-racking and scary to experience a symptom that’s sometimes associated with cancer. It’s important to talk to a healthcare provider about your concerns so that they can help get to the bottom of it, whether it’s a simple infection or a sign of a more serious condition.

“Coming in and talking about your health history allows us to plan the best next steps in your care,” Dr. Sullivan encourages. “We can work to figure out a diagnosis and get started on the right treatment for you.”