Aortocaval lymph node enlarges when turned

What are the chances of recovery if metastases are found in the lymph node?

In addition to their other tasks, the lymph nodes are the filter system of the lymphatic vessels. That is the reason why, under unfavorable circumstances, they can easily become metastasized. The chances of recovery depend on the location, size and type of the original tumor (primary tumor) and how far the spread has progressed.

Why does cancer actually "spread"?

Metastases are basically wandering cancer cells. In order for a primary tumor to spread, the cells have lost certain properties that healthy cells actually have. In return, they have developed other properties that healthy cells do not have. Normally, so-called “adhesive molecules” (e.g. catenins and cadherins) ensure that the body's cells stay connected. Cancer cells lack these molecules. That is why they can come off more easily. In addition, these cells have the ability to penetrate the so-called basement membrane. They do this by releasing protein-dissolving molecules. In this way, they can actively get into neighboring tissue, the lymphatic system and the bloodstream.

What if a metastasis develops in the lymph node?

The lymph nodes form, among other things, the filter system of the lymphatic channels. If cancer cells get into the lymph, sooner or later they will reach the first lymph node in the respective lymphatic system (the so-called sentinel lymph nodes). Some cancer cells have changed their genetic makeup to such an extent that the immune system does not perceive them as intruders. They then succeed in attacking the lymph nodes and forming metastases (daughter tumors) there. Cancer cells can also spread further and, under the appropriate constellation, form what are known as distant metastases. If the lymph node is affected by malignant metastases, it usually does not cause any further symptoms. Because the cancer cells multiply in an uncontrolled manner, it swells. If the lymph node is close to the surface of the body, it is usually visible to the naked eye. In addition, it is easy to feel.

The healing prognosis

The best chance of recovery is when the cancer has not yet metastasized. One of the prerequisites for this is that no tumor tissue is found in the lymph node either. In these cases, often only the original tumor has to be removed.

If metastases have formed in the lymph nodes, the chances of recovery are worse and the probability is higher that metastases also exist elsewhere. However, the lymph node metastasis may be the only one, and after the primary tumor and this metastasis have been removed, the patient will be healed. In most cases, the course of the cancer is determined by what are known as distant metastases that have affected other organs. Another important role is how many lymph nodes have already metastasized.

The staging, in which the extent of the original tumor, lymph node metastases and distant metastases play a role, is used to estimate the chances of recovery. The prognosis also depends on the exact type of cancer; it can be very different for different origins and cell types. Thus it cannot be generalized how good the chances of recovery are, but this has to be assessed individually, taking into account various points.

Treatment depends on the chances of recovery

Which therapy is selected by the attending physician depends on various factors, for example where the metastases are located. If “only” neighboring lymph nodes are affected, they are usually removed surgically or subjected to targeted radiation therapy.

Thanks to medical progress, it is now possible to combat daughter tumors much better. By specifying the treatment methods, a wide variety of drug (chemotherapeutic) and surgical options are available for therapy. Radiation therapy may also be an option.

The chances of recovery from metastases can be significantly improved if the patient undergoes chemotherapy, radiation therapy or nuclear medicine therapy after the surgical removal of the metastases. A combination of such methods is also often useful. Only when the tumor and metastases can be completely eliminated can a final cure be achieved.

If a cure is no longer possible, the cancer and its metastases (also in the lymph nodes) are treated palliatively. This means that measures are carried out so that the patient is spared unnecessary pain and discomfort as far as possible and the quality of life is increased. Distant metastases mean in a large part of the cases that only palliative therapy is sensible.