Lymph nodes are small, bean-shaped glands that are part of the lymphatic system. The lymphatic system is a network of tissues, vessels and organs that work together to help fight infection and disease. Lymph nodes play an important role in this as they contain white blood cells that help capture and destroy bacteria, viruses and other causes of illnesses.
Quick Answer: Oncologists and Hematologists Often Specialize in Lymph Nodes
Oncologists and hematologists are the two main types of doctors who specialize in treating conditions related to lymph nodes. Oncologists treat patients with cancer, which can often spread to lymph nodes. Hematologists treat diseases related to blood, bone marrow and the immune system, which are closely tied to lymph nodes.
Lymph Nodes Explained
Lymph nodes are small glands that store white blood cells and filter lymph fluid. Lymph fluid travels through the lymphatic system, passing through lymph nodes throughout the body. As it passes through, lymph nodes trap bacteria, viruses, cancer cells and other causes of illness and infection. They contain white blood cells called lymphocytes that destroy these threats.
There are hundreds of lymph nodes throughout the body. They are located in the neck, armpits, chest, abdomen, groin and other areas. Lymph nodes range in size from a few millimeters to about the size of a lima bean. Some key facts about lymph nodes include:
- Act as filters for the lymphatic system
- Contain white blood cells called lymphocytes
- Trap and destroy bacteria, viruses and other invaders
- Help identify infection and illness
- Swollen or enlarged lymph nodes can signal infection or disease
- Cancer often spreads first to nearby lymph nodes
Doctors Who Specialize in Lymph Nodes
There are a few different types of doctors who have expertise in diagnosing and treating conditions related to lymph nodes:
Oncologists
Oncologists specialize in treating patients with cancer. Cancers such as breast cancer, lymphoma and melanoma often first spread to nearby lymph nodes, so oncologists need extensive knowledge of lymph node anatomy and function. They diagnose cancer spread through lymph node biopsies and imaging tests. Treatment may include surgery to remove affected lymph nodes or radiation therapy targeting lymph node areas.
Hematologists
Hematologists treat diseases and disorders related to blood, bone marrow and the immune system. Lymph nodes play an integral role in the immune system, containing the white blood cells that fight infection and disease. Hematologists treat cancers like leukemia and lymphoma that arise in the blood and lymph nodes. They also treat immune disorders that affect lymph node function.
Infectious Disease Specialists
Doctors who specialize in infectious diseases treat conditions caused by bacteria, viruses and other pathogens. They often evaluate and treat lymph node swelling, which can signal an infection. Infectious disease specialists identify the type of infection through lymph node exams, blood tests and other diagnostic procedures.
General Surgeons
General surgeons perform various surgeries, including procedures to remove swollen or enlarged lymph nodes for diagnostic testing. This is called a lymph node biopsy. Surgeons take a sample of an abnormal looking lymph node and have it analyzed by a pathologist to identify potential causes such as cancer, infection or inflammation.
Radiologists
Radiologists specialize in interpreting imaging tests like CT scans, MRIs and PET scans. They assist with diagnosing lymph node conditions by identifying enlarged or abnormal looking lymph nodes on these tests. This can help doctors evaluate potential cancers or infections in the lymph nodes.
When to See a Doctor About Lymph Nodes
In most cases, minor lymph node swelling resolves on its own without needing medical treatment. But in some situations, it’s important to see a doctor for evaluation of enlarged lymph nodes, including:
- Lymph nodes are enlarging steadily over time
- One node or a cluster of nodes feel very hard or immobile
- Nodes are swollen for longer than 2-4 weeks
- You have other potential infection symptoms like fever or chills
- You have potential cancer symptoms like an unexplained lump or unintentional weight loss
- Swollen nodes are accompanied by fatigue, night sweats or itchy skin
Seeing your primary care doctor is a good place to start if you have concerns about lymph nodes. They can examine your nodes and determine if any tests or referrals to a specialist are needed. If cancer is suspected, you will likely be referred to an oncologist. Infectious causes may be evaluated by an infectious disease specialist. Ongoing immune disorders may warrant seeing a hematologist.
Diagnosing Lymph Node Conditions
Doctors use a combination of procedures and tests to evaluate abnormal or swollen lymph nodes and determine an underlying cause:
Physical Exam
Your doctor will closely examine all lymph node sites, feeling for enlarged, swollen, or hard nodes. They will note the location, size, texture and mobility of nodes. Enlarged nodes close to a potential cancer site raise suspicion for metastatic disease.
Lymph Node Biopsy
A lymph node biopsy involves removing some or all of an affected node to examine under a microscope. Analysis can definitively diagnose cancers like lymphoma. It can also identify infections and some causes of inflammation.
Blood Tests
Blood tests check for potential signs of infection, inflammation or cancers that could impact lymph nodes. A complete blood count evaluates white blood cell levels, which can increase with infections. Other tests like LDH and erythrocyte sedimentation rate can suggest cancers like lymphoma.
Imaging Tests
CT scans, MRIs and PET scans provide detailed lymph node evaluation and help doctors determine next steps. Enlarged or abnormal lymph node shape on imaging may warrant biopsy. Imaging can also reveal potential cancers in organs near affected nodes.
Additional Testing
Other diagnostic tests that may be used include:
- Chest x-ray: Checks nodes in chest
- Ultrasound: Evaluates node size and texture
- Fine needle aspiration: Extracts lymph node cells for evaluation
Lymph Node Treatment Options
Treatment depends on the cause of lymph node swelling. Some options include:
Watchful Waiting
Minor infections can often resolve on their own. Your doctor may recommend watchful waiting for mildly swollen nodes with no other symptoms.
Antibiotics
Bacterial infections are treated with antibiotics, which kill bacteria and stop infection progression. This helps reduce lymph node swelling.
Surgery
Enlarged lymph nodes or affected groups of nodes may be surgically removed. This is done for diagnostic testing or to treat cancers like melanoma that have reached nearby nodes.
Radiation Therapy
Radiation targets and kills cancer cells. It may be used to shrink enlarged lymph nodes with cancer spread. Radiation can also reduce recurrence risk after lymph node surgery.
Chemotherapy
Chemotherapy medications kill rapidly dividing cancer cells throughout the body, including lymph nodes. It may shrink involved nodes or be used following surgery.
Immunotherapy
Drugs are used to boost the immune system to kill cancer cells. This is used to treat some lymph node cancers like lymphoma.
Steroids
Corticosteroids reduce lymph node inflammation. They may rapidly shrink swollen nodes caused by immune or inflammatory conditions.
Outlook for Lymph Node Conditions
The outlook depends on the cause of lymph node swelling. With proper treatment, many causes of inflamed nodes resolve completely. Mild infections often clear up within a few weeks with monitoring or antibiotics. Cancers involving lymph nodes have varied outlooks based on the cancer type, location and stage.
Cancer stage refers to how far it has advanced when initially diagnosed. Catching cancer early when it is confined to nearby lymph nodes generally has a better prognosis. Modern treatments allow many patients with lymph node spread to still have long term cancer remission and survival.
When to Seek a Second Opinion
It is reasonable to seek a second opinion if:
- Your diagnosis is unclear after initial evaluation and testing
- You are unsure if recommended testing or procedures are necessary
- You are not confident in your doctor’s chosen treatment plan
- Your lymph nodes do not improve with treatment as expected
- Your cancer recurs after treatment
Reputable cancer centers, university hospitals and larger community practices often have multiple oncologists you can get a second opinion from. Your insurance may require a referral. But this expertise may provide added insight and confidence in your diagnosis and chosen treatment course.
Preventing Lymph Node Problems
There is no guaranteed way to prevent lymph node issues altogether. But the following healthy lifestyle practices may help lower your risks:
- Get regular medical care including cancer screenings
- Maintain a healthy weight
- Exercise regularly
- Eat a nutrient-rich, varied diet
- Get adequate sleep and manage stress levels
- Avoid smoking and limit alcohol intake
- Practice good hygiene to prevent infections
- Use sun protection including sunscreen
- Get appropriate vaccinations
Being proactive with your health through preventative steps optimizes overall well-being. Alert your doctor about any unusual or persistent lymph node swelling to determine if further evaluation is advised.
Finding a Lymph Node Specialist
If you need evaluation or treatment for a lymph node issue, how do you find the right specialist?
Start by asking your primary care physician for recommendations. They may have colleagues they often refer patients to that specialize in lymph nodes. Your insurance provider can also provide a list of network oncologists, hematologists, surgeons or other specialists that see patients with lymph node conditions.
The following tips can help you locate an appropriate specialist:
- Verify board certification in their specialty
- Look for an academic medical center or hospital affiliation
- Consider doctors associated with reputable medical schools
- Check if they are accepting new patients
- Evaluate their credentials and experience treating your condition
- Read online reviews from other patients
You may meet with multiple specialists to find one you are comfortable with. Have a list of questions ready to help determine if their expertise matches your needs.
Key things to evaluate:
- Years in practice
- Volume of patients treated with your specific disorder
- Participation in research and clinical trials
- Use of latest diagnostic tests and treatment approaches
- Bedside manner and communication skills
- Office location, availability and insurance acceptance
Finding a knowledgeable specialist you communicate well with helps ensures the most accurate diagnosis and effective treatment. Do not hesitate to seek second opinions from appropriate lymph node experts.
Conclusion
Oncologists and hematologists are the main doctors who evaluate and treat conditions involving the lymph nodes. Nodes that are persistently enlarged or swollen may require medical testing to check for potential cancers or infections. An accurate diagnosis relies on a combination of a physical exam, imaging tests like CT or MRI scans, and sometimes, a lymph node biopsy. Treatment options vary based on the cause but may include watchful waiting, medications, radiation, surgery, or other cancer therapies. Getting prompt medical attention for unusual lymph node swelling provides the best chance for effective treatment and positive outcomes.
