Is lymph node metastatic cancer serious? Let's take a look

Cancer is very harmful to patients. Many cancer patients even lose confidence in treatment and think they will not live long, so they want to give up treatment. So, let's learn about lymph node metastasis today. Is it serious?

The main manifestation is the appearance of hard, stone-like enlarged lymph nodes in the lateral neck area or supraclavicular fossa. At first, they are usually single, painless, and can be moved. Soon, multiple lymph nodes will appear and invade the surrounding tissues. At this time, the mass is nodular, fixed, and has local or radiating pain. In the late stage, the mass may become necrotic, rupture, become infected, bleed, and have a cauliflower-like appearance, with a foul-smelling secretion. The primary site of metastatic cancer is different, and its symptoms and signs are also different.

1. Metastatic cancer originating from the head and neck is mostly distributed in the lymph nodes in the internal jugular vein area, manifested as enlarged lymph nodes around the sternocleidomastoid muscle. Squamous cell metastatic cancer is generally very hard; but a few may become cystic due to tissue necrosis and liquefaction, either single or multiple, and progressively enlarge. They often adhere to the surrounding soft tissues and eventually become fixed. They are generally painless and are mostly accompanied by symptoms and signs caused by the primary cancer.

2. Metastatic cancers originating from the chest, abdomen, and pelvis mainly appear in the left supraclavicular lymph nodes. A few may also appear in the right supraclavicular area below or in the middle area of ​​the internal jugular vein. Some may appear in the submandibular, upper neck, or even posterior cervical triangle. They are all in the late stage and are often accompanied by symptoms and signs of the primary cancer.

3. Metastatic cancer of unknown primary site is more common in men aged 50 to 60 years old. There is no limit to the site of metastatic cancer, and the majority of them are from the middle third of the neck to the supraclavicular area. Generally, there are no symptoms or signs caused by the primary lesion.

General treatment principles

(1) Metastasis of squamous cell carcinoma in the upper jugular region, especially poorly differentiated carcinoma, should be considered as a cryptic primary cancer of the nasopharynx and should be treated with radical radiotherapy as nasopharyngeal carcinoma.

(2) Poorly differentiated squamous cell metastasis in the middle and lower regions of the internal jugular vein may be considered to be occult cancer of the tongue base or pyriform sinus, and radical radiotherapy including this area should be performed; isolated well-differentiated squamous cell carcinoma metastasis should be treated with cervical lymph node dissection. If necessary, the above treatments can be combined. For isolated metastatic adenocarcinoma or malignant melanoma, cervical lymph node dissection combined with chemotherapy can be considered.

(3) For supraclavicular lymph node metastasis, appropriate chemotherapy or radiotherapy should be considered according to the pathological type. For metastatic cancer in the internal jugular vein area with unknown primary lesions, especially metastatic cancer in the middle and upper neck area, 20% to 50% of patients can achieve a 3-year survival rate after the above treatment. A few survive for more than 5 years. The treatment effect of metastatic squamous cell carcinoma is better, while that of adenocarcinoma is very poor, especially supraclavicular adenocarcinoma, which is rarely controlled for a long time.