Answer by Dr Bobby V, MD (oncologist) on Fri 11, Apr 2008 02:52am:
Hi Emma,
Your concern is regarding the possibility that your smoking habit may somehow be linked to the palpable lymph nodes. Your other concern is if the lymph nodes could be cancerous.
You have described the nodes as being hard and fixed. Is that your own feeling, or has a medical doctor described them thus?
The fact that you have had the neck node for several years makes the possibility of cancer remote. Cancers linked to smoking, like Head and Neck cancers, esophageal cancer, lung cancer, stomach cancer, pancreatic cancer, bladder cancer etc. will present with localized symptoms. Once they spread (metastasize)to distant sites like lymph nodes, their further spread is fairly rapid. It is extremely unlikely that your lymph nodes represent metastatic cancer, as they have been around for years.
Can your enlarged lymph nodes actually be some other type of cancer like lymphoma? Unlikely. The common forms of Hodgkins and Non-Hodgkins lymphomas are fairly fast growing. Their natural history suggests that groups of contiguous (nearby) lymph nodes enlarge in a period of weeks to months. There is, however, a type of a slow growing lymphoma called Follicular lymphoma, which may take several months or even years to grow. This is more common among older individuals (you have not mentioned your age).
So what should you do? Please make an appointment with an internist, who will seek to diagnose the cause of these lymph nodes. He/she should rule our non-cancer causes like infection in the draining area, cyst, suppurative hydradenitis, etc. Additional tests including hemogram and a chest x-ray should be advised. If no other diagnosis is reached, then an FNAC (fine needle aspiration cytology) should be done to clinch the diagnosis, and this will hopefully lay your doubts to rest!
Another extremely important intervention that you must make is to quit smoking. Pl seek the help of professionals if needed, but make sure you give up the habit for good!
All the best.
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