How to check your lymph nodes

You have been diagnosed with a skin cancer that on occasions can spread into the lymphatic system. That is why as part of your examination your lymph nodes are examined by your doctor or Skin Cancer Clinical Nurse Specialist at follow-up appointments. The lymph nodes examined depend on the location of your skin cancer e.g. if your skin cancer was on your leg then the lymph nodes in your inguinal area (groin) will be felt or if on your face then the nodes in the head and neck would be examined. The aim is to detect any enlargement of the lymph nodes and undertake investigation at an early stage. Some people express a interest in knowing which lymph nodes to examine and how to undertake this procedure between clinic appointments.

The Lymphatic System

This system consists of lymphatic vessels and tissue which drains lymph fluid from the tissues of the body, helping to protect you from infection and disease. Lymph nodes are small oval lumps of lymphatic tissue found at certain parts of the body.

These lymph nodes filter out bacteria and disease cells from the lymphatic fluid before it is returned to the blood stream. Lymph nodes can only be felt in the areas shown in the diagram.

Usually lymph nodes are not enlarged and thus not able to be felt, but if you have previously had an infection (such as tonsillitis) you may have noticed and felt lymph node becoming enlarged, painful and tender. Lymph nodes can also become enlarged due to cancer cells lodging in them.

There is also a YouTube video which illustrates this, which you may find beneficial:

How often should I check my lymph nodes?

Checking the lymph nodes once a month is sufficient and this can be done at the same time as you check your skin for any changing moles. Checking them more often may result in difficulty noticing any change.

Do not panic if you feel a lymph node, 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 to check lymph nodes in the head and neck

Examine in the order shown starting at number 1.

With your fingertips and a gentle circular motion feel the lymph nodes illustrated

Start with the nodes in front of the ear (1) then follow in order finishing just above the collar bone (10)

Check both sides for comparison. If you have an enlarged lymph node it may feel like a swelling the size of a pea, sometimes they can be larger.

When feeling for the nodes in the neck (marked 8), tilt your head towards the side you are examining, this helps to relax the muscle

Now press your fingers under the muscle

When checking the lymph nodes above the collar bone, hunch your shoulders and bring your elbows forward to relax the skin

Now feel the area illustrated in diagram 4.

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.

1. Feel in the central area of the armpit. Now move your fingers firmly against the chest wall as follows
2. Along the front border of the armpit
3. Along the back border of the armpit
4. Feel along the inner border of the arm

How to check for lymph nodes in the groin

There are two areas to look for inguinal (groin) nodes:

1. Feel the horizontal chain of nodes in the right groin just below the ligament.
2. Feel the vertical chain along the upper thigh.
3. Check the lymph nodes in the other groin.

If you have any concerns or feel you have detected enlarged lymph nodes. Contact your Skin Cancer Nurse Specialist.

Leaflet developed by Skin Cancer CNS’s NHSCT with permission from the British Association of Dermatologists