DEAR DR. DONOHUE: I have a question about lymph nodes. I have a 4 mm to 5 mm, palpable lymph node in my neck. I have noticed it for four months. I saw my family doctor, who told me not to worry about it. He did some tests, including a chest X-ray, and all were normal. I started to read things on the Internet and went into a panic. I can’t stop checking the lump. My wife assures me it has not grown. I saw an ENT doctor, who said it was so small that nothing need be done. Everyone I talk to has a story of someone who had cancer and it hit the lymph nodes and they all died quickly. I even saw a surgeon, who said the lump is so small that removing it would be dangerous. Am I freaking out over nothing? – Anon.

Cancer is far down on the list of possibilities for lymph node enlargement. Granted, it is the most important possibility, but it’s far from the only one. Look at this a bit more calmly. Three doctors have assured you that the node is not a cancerous node. Your wife says it’s not enlarging. After four months, a cancer node should be much larger.

A lymph node less than .4 inches (1 cm) in its longest dimension is almost never a cancerous node. Your node is less than half that size. Cancer nodes aren’t usually painful, and they tend to be rock-hard or rubbery. They become fixed to the adjacent tissues. You can’t push them around. A large lymph node is seldom the only cancer warning. Weight loss, a low-grade fever, night sweats and pain are other cancer indications. You have none of these.

The Internet is not always a source for the best information. Your doctors should be that source for you. You are freaking out, but that’s understandable. Who wants less than 100 percent assurance when it comes to cancer? If you can’t get the cancer fear out of your mind, see an oncologist – a cancer specialist – and listen to what that doctor says. I am sure he or she will be able to dismiss your cancer ruminations.

DEAR DR. DONOHUE: My husband has a couple of different cancers but is responding to treatment. We received a report from his doctor that says he has a lymph node under his arm and that it is slightly enlarged. What is the function of lymph nodes? – D.G.

The body has more than 600 lymph nodes that function as sanitation stations. They filter out germs and other foreign materials that make their way into the body. Tonsils are an example of lymph nodes that can be seen.

Infections are the most common causes of lymph node enlargement. Allergies and illnesses like rheumatoid arthritis can enlarge them too.

Cancer cells can spread to nodes near to the site of the cancer. Your husband’s doctor carefully looks for such nodes, evaluates them and makes a calculated decision if they are cancer-containing or not. I take it your husband’s doctor doesn’t think his node is a cancer node.

DEAR DR. DONOHUE: Something you wrote really has me worried. I have a digestive problem and have to take digestive enzymes. They help me greatly. You suggest that these enzymes inhibit stomach mucus production and lead to a stomach ulcer. Am I reading this correctly? – A.A.

No. It’s not your fault. I could have been clearer. You refer to a question about a person taking NSAIDs, medicines like aspirin, Aleve, Advil and Motrin. When taken in large doses or for protracted periods of time, these medicines reduce the stomach’s mucous layer. That layer protects the stomach from the corrosive effect of stomach acid and the digestive effect of enzymes. The result can be an ulcer. Your stomach mucus is intact. You have no worry. You can continue taking your digestive enzymes without fear.

DEAR DR. DONOHUE: I have atrial fibrillation. It seems to be the forgotten child of heart disease, because I am having a difficult time finding information about it, especially the kind of diet to follow with this condition. Thanks for your help. – J.B.

ANSWER: Atrial fibrillation isn’t a forgotten child. It’s one of the most common heartbeat abnormalities. The regular lub-dub, lub-dub of the normal heartbeat turns into a rapid, chaotic heartbeat, with a number of serious consequences. The heart’s two upper chambers, the atria, aren’t beating; they’re squirming (fibrillating). As a result, blood stagnates in those chambers, and stagnant blood forms clots. Those clots can find their way into the circulation, be transported to the brain and cause a stroke. Second, the rapid irregular heartbeat compromises heart pumping, and people having it can suffer from dizziness or tire easily. Treatment of atrial fibrillation has three goals: slowing the heartbeat; restoring it to a regular cadence; preventing strokes.

Medicines can slow the heartbeat and sometimes can convert the beat to a normal, regular rhythm. At times, a small jolt of electricity gets the job done. At other times, a regular rhythm can’t be achieved, but a slow, irregular rhythm is the next best thing. If the irregularity persists, then clot prevention is attained by prescribing the blood thinner Coumadin.

Ablative procedures, in some circumstances, can restore a normal beat. “Ablative” means “destructive.” The heart tissue generating the abnormal rhythm is destroyed with a catheter that emits radio waves. The doctor inches the catheter into the heart through a surface blood vessel.

I haven’t answered your question about diet. There is no special diet for atrial fibrillation. Since it’s often a consequence of heart artery disease, a heart-healthy diet is the one you should follow – a diet low in fats and cholesterol and high in grains, vegetables and fruits.

The booklet on heartbeat irregularities discusses atrial fibrillation in detail. Readers can order a copy by writing: Dr. Donohue – No. 107, Box 537475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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