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Generalized lymphadenopathy and itchy foot. Skin Cancer?

Hannah-B
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Hello all,

So, I've had an enlarged lymph node situated in left supraclavicular region. Ultrasound last year showed it was normal albeit larger than usual. 

Now I also have enlarged lymph nodes in elbow creases, left measures approximately 10mm and right a little smaller as well as an enlarged lymph node on right side of neck just above base of shoulder. The supraclavicular node is still raised with no change. I have a DRs appointment next Tuesday, it's taken me 3 weeks to just get a face to face appointment, but he's already said he is no longer allowed to order scans etc so I'd likely be referred depending on what he thinks. 

 I have a bad feeling but I'm sure we all do, it's natural. I have had a very itchy patch on my foot (I have a picture but can't find how to attach it) for years now and it's spread from affecting just my little toe to almost half the top of my foot. I've done some research, rightly or wrongly, and I'm almost convinced that this is no longer athlete's foot but is in fact skin cancer and the root cause of the lymphadenopathy. 

 

Does anyone have any experience of similar and what has been the outcome? 

 

How can I ensure the Dr takes this seriously enough to refer or order relevant tests as it sounds as though he's already telling me there's nothing he can do?

Thank you so much

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    Hi Hannah,

    Can I start with the problem with your foot? It would be unusual for it to be skin cancer but it definitely needs checking thoroughly by your GP to get it ruled out. Acral Lentiginous Melanoma (melanoma on the foot) usually presents as an existing mole that's changed or looks like a new ugly mole or brown, bruise type mark rather than an itchy patch. Also, ALM is a very aggressive skin cancer and spreads to internal organs very quickly rather than over a number of years. If it is skin cancer, it may be basal cell or squamous cell carcinoma, although these rarely occur on the foot. 

    However, if it does turn out to be skin cancer I very much doubt it has any connection with your lymph node problems. It's rare for a BCC to spread internally and it's uncommon for a SCC to do so. Melanoma is the most invasive of the skin cancers and, when it spreads via the lymphatic system, it does so in a certain way. Melanoma on a lower limb travels upwards to the Sentinel Node (in this case it would be behind the knee) and onwards to the groin and eventually towards the heart & pumps back around the body again. It wouldn't go to the supraclavicular area, neck, shoulder or down the arms. A raised lymph node in the supraclavicular area, shoulder or neck would be caused by a spread of melanoma from the torso or the head whilst one in the elbow (a Sentinel Node) would be caused by a melanoma on the hand or lower arm. It would also be very unusual for nodes in several areas to be affected by melanoma. Usually it travels to a main node (groin or armpit or neck) and then spreads to internal organs, bones or the brain. 

    So it may be that you have two different health issues, one concerning the foot that hopefully will be an easily treatable skin condition (of which there are several other than athlete's foot) and a problem with raised lymph nodes in different areas of your body. I hope your GP can refer you to the relevant consultants. Good luck and please let us know how you get on,

    Angie (Stage 3 melanoma patient since 2009)

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