What are the aims of this information?
This page has been written to help you to understand more about checking your lymph nodes (‘glands’) yourself. It tells you what lymph nodes are, why you should check them and how often you should do a check. It also explains how to check lymph nodes. At the end of the page there is further information on where you can find out more.
What are lymph nodes?
The lymphatic system
Lymph nodes (‘glands’) 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.
Lymph fluid bathes the cells of the skin and internal organs. It drains into lymphatic vessels then larger lymphatic vessels called ducts in the neck before joining the blood stream near the heart (see Figure 1).
Lymph nodes (‘glands’) are small ‘bean-shaped’ nodules that contain millions of infection fighting lymphocyte cells. They are found at intervals along the lymphatic vessels like ‘beads on a string’. 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 of the body (see Figure 1):
- head and neck
- axilla (armpit)
- inguinal area (groin)
- back of knees
Lymph nodes are usually too small to feel. However, sometimes they can be felt in slim people as smooth pea-sized lumps, usually in the groin. Another time when they can be felt is when you have an infection, (for example, a sore throat or an ear infection which can make the neck lymph nodes enlarged, painful and tender as these are the nearest lymph nodes to the site of infection).
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?
You may have been diagnosed with a skin cancer that can sometimes spread into the lymphatic system, for example, melanoma or squamous cell carcinoma.
At your check-up visits you will usually have the lymph nodes around the location of your skin cancer examined. For example, if the skin cancer was on your face then the nodes around your ears and neck will be examined, or, if the skin cancer was on your leg then the lymph nodes behind your knee and in your groin will be felt. 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, who can show you how and which lymph nodes to check.
How often should I check your lymph nodes?
It is usually advised that you 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.
Non-urgent advice: When lymph nodes appear
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 reduced in size in a week, contact your doctor or clinical nurse specialist.
How to check lymph nodes in the head and neck
Use your fingertips and a gentle circular motion to feel the lymph nodes in the areas illustrated in in the image below. Examine in the order shown, starting at Number 1.
- Start with the nodes in front of the ear (number 1 in Figure 2) then follow in order finishing just above the collar bone (number 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
To feel for nodes in the neck (number 8 in Figure 2):
- Tilt your head towards the side you are examining, this helps to relax the muscle
- Now gently press your fingers under the muscle
To check lymph nodes above the collar bone (number 10 in Figure 2):
- 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
- 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 underside of the upper 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):
- Horizontally along the groin crease
- Vertically along the upper thigh
Where can I get more information about checking lymph nodes?
Wessex Cancer Trust
Bellis House, 11 Westwood Road
Southampton SO17 1DL
Tel: (023) 80672200
Fax: (023) 80672266
For details of source materials used please contact the Clinical Standards Unit (firstname.lastname@example.org).