Swollen Cervical Lymph Nodes in Neck: Does It Mean Cervical Cancer?

What are cervical lymph nodes?

Cervical lymph nodes are small, bean-shaped structures located in your neck. They're part of your body's immune system and work like natural filters, filtering lymphatic fluid and trapping harmful substances such as bacteria, viruses, and cancer cells. Think of them as your body's security checkpoints, monitoring for anything unusual that might affect your health.

What is cervical cancer?

Cervical cancer develops in the cervix, which is the lower part of the uterus (womb) that connects to the vagina. It's often caused by persistent infection with certain types of human papillomavirus (HPV). Regular screening through Pap smears can help detect cervical cancer early.

How are cervical lymph nodes related to cervical cancer?

Cervical cancer primarily spreads locally to the surrounding tissues. However, in more advanced stages of cervical cancer, cancer cells can travel through the lymphatic system, using it like a highway to travel to other parts of the body.

Thus, doctors pay close attention to the lymph nodes because:

• The involvement of lymph nodes helps doctors determine how far the cancer has spread

• This information is crucial for planning the most effective treatment

Types of cervical lymph nodes

Cervical lymph nodes can be divided into several groups, based on their location in the neck:

• Superficial cervical lymph nodes: 

  • Found just under the skin in the neck.

• Deep cervical lymph nodes: 

  • Located deeper in the neck, near the carotid artery and internal jugular vein.

How cervical cancer spreads through lymph nodes

• Pelvic lymph nodes

  • These are the first lymph nodes that may be affected

  • Located in the pelvic region, near the cervix

  • Often the earliest indication that cancer cells have begun to spread

• Para-aortic lymph nodes

  • These lymph nodes are found next to the aorta (near the heart)

  • These nodes may become affected if the cancer continues to progress

  • Involvement of these nodes indicates the cancer has spread beyond the pelvic area

• Distant lymph nodes

  • In advanced stages, cancer can reach lymph nodes far from the original site

  • This includes lymph nodes in the neck (cervical lymph nodes) and those above the collarbone (supraclavicular lymph nodes)

  • Finding cancer in these areas usually indicates the disease has significantly advanced

In the context of cervical cancer, the involvement of more distant lymph nodes, such as the para-aortic or supraclavicular lymph nodes, is concerning as it suggests that the cancer has metastasised (spread). Indicating metastatic disease, which often necessitates more aggressive systemic treatments like chemotherapy. 

How lymph nodes help diagnose the stage of and determine prognosis for cervical cancer 

The presence of cancer in lymph nodes is a critical factor in determining the stage of cervical cancer. This directly impacts treatment choices and one's prognosis. The staging system used for cervical cancer is the FIGO (International Federation of Gynaecology and Obstetrics) staging system, which takes into consideration lymph node involvement as follows:

• Stage IIIC1: 

  • Involvement of pelvic lymph nodes.

• Stage IIIC2: 

  • Involvement of para-aortic lymph nodes.

Lymph node involvement often indicates a more advanced stage of disease and is associated with a poorer prognosis. 

Learn more about the FIGO staging system here.

Determining if a lymph node is cancerous

How do doctors know if lymph nodes are affected by cancer? They can use several diagnostic methods to detect cancer in lymph nodes.

Imaging tests

• Magnetic resonance imaging (MRI) or CT scans are commonly used to evaluate the lymph nodes around the pelvis and abdomen.

• PET-CT scans are particularly effective in identifying cancerous lymph nodes throughout the body, including cervical lymph nodes in the neck.

Lymph node biopsy

• If the imaging performed suggests that the lymph nodes are affected by cancer, a biopsy may be performed to confirm the presence of cancer cells.

• A biopsy is a process where cells, tissue, or fluid are removed from the area of interest and sent to a lab for further analysis by a pathologist.

Sentinel lymph node biopsy 

• In some cases, a sentinel lymph node biopsy may be performed to determine whether cancer has spread to the first lymph node in the drainage path from the cervix.

Physical changes in lymph nodes and symptoms of cervical cancer

While changes in lymph nodes don't automatically indicate cervical cancer, certain symptoms warrant medical attention. Here are important signs to watch for:

Observable changes

• Swelling in the neck or above the collarbone that persists for more than two weeks

• Lymph nodes that feel hard or don't move when touched

• Unexplained swelling in one area that doesn't go down

• Nodes that are growing in size

Associated symptoms

When lymph node changes occur with cervical cancer, you might also notice:

• Unexplained tiredness

• Unexplained weight loss

• Night sweats

• Persistent pain in the pelvic area

• Unusual vaginal bleeding or discharge

Learn more about the symptoms of cervical cancer here.

It’s important to note that most swollen lymph nodes are not caused by cancer, as common illnesses like colds or infections can cause them to swell as well. However, if you’re experiencing multiple of the above symptoms, seeking professional input and going for a health screening is highly recommended. Request for an appointment with our specialists at Thomson Medical today.

Treatment of cancer in lymph nodes

• Radiation therapy: 

  • If the pelvic or para-aortic lymph nodes are involved, radiation therapy is often directed at the affected lymph nodes and the primary tumour site.

• Chemotherapy: 

  • Systemic chemotherapy is used in conjunction with radiation therapy (chemoradiation) to improve the effectiveness of treatment in cases of lymph node involvement.

• Surgery: 

  • Lymphadenectomy, or the surgical removal of affected lymph nodes, may be performed in certain cases, particularly if only a few nodes are involved. However, in cases where multiple lymph nodes are affected, surgery may not be an option, and chemoradiation becomes the primary treatment.

Cervical cancer treatment can significantly improve outcomes and quality of life when managed early and effectively. With tailored treatment plans, our specialists at Thomson Medical are here to support you every step of the way. To discuss your treatment options and receive personalised care, request for an appointment with our specialists.

Survival rate and prognosis of cervical cancer

The involvement of lymph nodes in cervical cancer is typically associated with a worse prognosis compared to cases where the lymph nodes are not affected Factors that influence prognosis include:

• Number of affected lymph nodes: 

  • The more lymph nodes that are involved, the harder it is to treat.

• Location of lymph node involvement: 

  • Cancer confined to the pelvic lymph nodes has a better prognosis than cancer that has spread to the para-aortic or distant lymph nodes (such as cervical lymph nodes in the neck).

• Response to treatment: 

  • Patients who respond well to chemoradiation may have better survival outcomes even with lymph node involvement.

Early detection and monitoring of lymph node changes play a vital role in cervical cancer care. Regular cervical cancer screenings can help detect problems early, improving one's prognosis and chance of recovery. Your health matters. If you notice any concerning changes or are due for your regular screening, request for an appointment with our specialists at Thomson Medical today. 

FAQ

How are lymph nodes involved in cervical cancer?

The lymph node is a key factor in determining the stage of cervical cancer. It helps to assess how far the cancer has spread, which is crucial for deciding on the most effective treatment strategy and predicting the patient’s prognosis.

Can cervical cancer spread to lymph nodes in the neck?

Yes. Although it is uncommon in early-stage disease, cervical cancer can spread to the lymph nodes in the neck (cervical lymph nodes) in advanced or metastatic stages. The presence of cancer in these distant lymph nodes often indicates a more aggressive and advanced disease.

How do doctors check cervical lymph nodes for cancer?

Doctors typically use imaging techniques such as PET-CT, CT, or MRI to check if lymph nodes are enlarged or suspicious. A biopsy may be performed to confirm if cancer cells are present in the lymph nodes.

What is the difference between pelvic lymph nodes and cervical lymph nodes?

Pelvic lymph nodes are located in the lower abdomen and pelvis and are commonly involved in cervical cancer spread. Cervical lymph nodes are located in the neck and are less commonly involved unless the cancer has progressed to a more advanced stage.

What are the symptoms of cervical lymph node cancer?

Lymph node involvement may not cause specific symptoms in the early stages. However, if cancer spreads to cervical lymph nodes in the neck, patients may experience swollen or enlarged nodes in the neck, unexplained weight loss, fatigue, or other symptoms of advanced cancer.

What treatments are available if cancer has spread to the lymph nodes?

If cervical cancer has spread to lymph nodes, treatment typically involves a combination of radiation therapy and chemotherapy. In some cases, surgery to remove the affected lymph nodes may be performed, but chemoradiation is often the preferred treatment for advanced or widespread lymph node involvement.

Is lymph node removal always necessary in cervical cancer?

Not always. While lymph node removal (lymphadenectomy) is sometimes performed, it depends on the stage and extent of lymph node involvement. In many cases, radiation therapy combined with chemotherapy is sufficient to treat affected lymph nodes.

Does lymph node involvement mean the cancer is incurable?

Lymph node involvement suggests a more advanced disease, but it does not necessarily mean the cancer is incurable. With appropriate treatment, including chemoradiation, some patients with lymph node involvement can still achieve long-term remission or manage the disease effectively.

What is sentinel lymph node biopsy in cervical cancer?

Sentinel lymph node biopsy is a procedure where the first lymph node (or group of nodes) that drains lymph from the cervix is identified, removed, and tested for cancer cells. If this sentinel node is free of cancer, it may reduce the need for more extensive lymph node surgery.

How does lymph node involvement affect survival rates in cervical cancer?

Lymph node involvement is generally a sign that the cancer has grown worse. However, treatment advances, especially the combination of radiation therapy and chemotherapy, have improved survival rates even in patients with affected lymph nodes.

What causes cervical lymph nodes to swell?

Cervical lymph nodes can swell due to infections, such as those caused by bacteria or viruses (e.g., the common cold or strep throat), autoimmune conditions, or cancers like lymphoma. Swelling occurs as the immune system activates to filter harmful substances and fight off illness.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request for an appointment with Thomson Medical today.