What are the aims of this leaflet?
This leaflet has been written to help you to understand more about how to check your lymph nodes yourself. It tells you why you should be doing it, what lymph nodes should be checked, how often they should be checked and how to check them, and where you can find out more about this issue.
What are lymph nodes?
The Lymphatic System
Lymph nodes are part of the lymphatic system, which is a network of tiny tubes that carry a colourless fluid called lymph through the skin and deeper parts of the body. Lymph fluid contains immune cells (lymphocytes) nutrients and waste materials.
Diagram 1. Position of lymph nodes
It bathes the cells of the skin and internal organs and drains into lymphatic vessels then larger ducts in the neck before joining the blood stream near the heart (see Figure 1).
Lymph nodes (‘glands’) are small oval nodules and contain millions of infections fighting lymphocyte cells. They are found at intervals along the lymphatic vessels like ‘beads on a string’ (see Diagram 1). The lymph nodes filter out harmful organisms and abnormal cells before the lymph reaches the blood stream. Lymph nodes can only be felt in certain areas:
- head and neck
- axilla (armpit)
- inguinal area (groin)
- back of knees
Lymph node are usually too small to feel except in slim people when they can be felt as smooth pea-sized lumps in the groin. Another common exception is when people get a sore throat or an ear infection, which can make the neck lymph nodes enlarged, painful and tender.
Lymph nodes can also become enlarged if cancer cells lodge in them. In this case, they are usually painless.
Why should you be checking your lymph nodes?
A doctor will usually examine the lymph nodes around the location of your skin cancer at check up visits. e.g. if the skin cancer was on your leg then the lymph nodes behind your knee and in your groin, will be felt, or, if the skin cancer was on your face then the nodes around your ears and neck would be examined. The aim is to detect any enlargement of the lymph nodes at an early stage.
Some people are advised to check their lymph nodes between clinic appointments. If you are worried about enlarged lymph nodes, tell your doctor or nurse specialist straight away, rather than waiting until your next clinic appointment.
If you are unsure about anything in this leaflet please talk to your doctor or clinical nurse specialist, whocan show you how and which lymph nodes to check.
How often should I check my lymph nodes?
Doctors usually advise check your lymph nodes once a month. This can be done at the same time as you check your skin for new or changing moles, lumps and bumps.
Do not be alarmed if you feel a lymph node (especially if it is tender) as it may be due to an infection, but if it has not gone in a week, contact your doctor or clinical nurse specialist.
How do I check lymph nodes in the head and neck?
- With your fingertips and a gentle circular motion feel the lymph nodes illustrated
- Start with the nodes in front of the ear (no. 1 in Figure 2) then follow in order finishing just above the collar bone (no. 10 in Figure 2)
- Always check your nodes in this order
- Check both sides for comparison. If you have an enlarged lymph node it may feel firm and the size of a pea or grape.
Figure 2. Location of lymph nodes (green) around the jaw and neck
Examine in the order shown, starting at no. 1.
Figure 3. How to Check lymph nodes in front of the ear
Figure 4. How to check lymph nodes in the neck
To feel for nodes in the neck (no. 8 in Figure 2):
- Tilt your head towards the side you are examining, this helps to relax the muscle
- Now press your fingers under the muscle
Figure 5. How to check lymph nodes above the collar bone
To check lymph nodes above the collar bone:
- Hunch your shoulders and bring your elbows forward to relax the skin
- Now feel the area illustrated in Figure 5
How to check lymph nodes in the armpit?
Figure 6. How to check lymph nodes in the armpit; location of lymph nodes in the armpit
Remove top clothing down to the waist to get easy access to the armpits:
- Sit in a comfortable position
- Check each armpit in turn
To check the left side lift your arm slightly then place the fingers of your right hand high into the armpit and then lower your arm.
- Feel in the central area of the armpit
Now move your fingers firmly against the chest wall as follows:
- Along the front border of the armpit
- Along the back border of the armpit
- Feel along the inner border of the arm
Now check the other armpit in the same way.
How do I check lymph nodes in the groin?
There are two areas to feel in the groin (see figure 7) :
- orizontally along the groin crease
- Vertically along the upper thigh
Check both sides
Figure 7. Checking your lymph nodes in the groin
Where can I get more information about checking lymph nodes?
Wessex Cancer Trust
For details of source materials used please contact the Clinical Standards Unit (firstname.lastname@example.org).
This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.
This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel
BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLET
PRODUCED AUGUST 2011
REVIEW DATE NOVEMBER 2017
REVIEW DATE NOVEMBER 2020