Am i just overthinking or could i have lymphoma?

[Hockeyfreak889]

Hi,
Sorry in advance, this is going to be a long question.
Back in August I noticed a lump in my groin area and I kept an eye on it for a while but it didn’t seem to go away although it did grow and shrink. By the time I decided I should probably get it checked out it was time for me to move back to school, and so I wasn’t able to get it checked out. The lump was never painful, although at times it had a strange/tender feeling. I spent the whole semester constantly worrying about it and as the semester went on other symptoms appeared (these may or may not have been caused from anxiety and over thinking it) such as a strange feeling in my armpit(s). Im not sure how to describe it besides a strange feeling because it didn’t hurt, it just felt almost as if I had a shirt on that was too small, even when I wasn’t wearing a shirt. I never found any kind of lump in either armpit (which leads me to believe I was only experiencing the feeling because I was afraid the lump in my groin was lymphoma). I also had a lump on/below my earlobe, but this lump would come and go. Towards the end of the semester i noticed I was constantly tired and had a decreased appetite, but I convinced myself it was because I was stressed from school and not sleeping well. I had also lost anywhere from 5-10 pounds, but as I have an incredibly fast metabolism and can lose weight by sitting on a couch eating ice cream I didn’t think much of it at  first. When the semester was over (just after Christmas) I went to my regular doctor about the lump in my groin. I meant to ask about the other symptoms but I figured if I had cancer they would be able to find it from the lump and the other symptoms weren't as tangible. The doctor said he wasn’t worried about it, but just to be sure sent me to a urologist to get it checked out. The urologist again said he wasn’t worried after a physical examination. His explanation was that its normal for lymph nodes to grow (and sometimes stay enlarged) and that it was probably only noticeable because of how skinny I am. After this I put the whole thing out of my mind for a while, until I found a lump in my neck. When I found the lump in my neck I was utterly convinced I had cancer but I had already gone back to school. The lump in my ear (that had been coming and going) moved to more of the back of my ear. When school started to pick up I noticed I was constantly tired, but also "out of it" all the time, almost as if I was watching someone else live my life as points.
Other notes: The lump in my neck went away after a couple of weeks, and looking back on it, it was probably just a pimple. Also another reason why I was/am so freaked out is that my dad had lymphoma when he was my age.
My question is how urgent is it that I go back to the doctors. I know I should go again, if for nothing else but peace of mind, but right now I am at school and can't go to my usual doctor. I'd have to miss school to go to the doctors again, so can I wait a month or so until spring break to go to the doctors?
My thoughts: I looked up feeling out of It all the time cause this really bothered me, and I found that it can be caused by anxiety (its called depersonalization or something like that) which made be start to think that I really don’t have many tangible symptoms and maybe this could all be in my head? The lingering issues such as the lumps in my groin/ear still have me concerned though.
Thanks for any feedback!

[Mochadelicious]

I'm glad to hear that you plan on seeing a doctor soon.  Most likely it will turn out to be nothing, but I think you have had symptoms long enough to cause some concern.  You asked if people always experience B symptoms.  The answer is no.  Usually B symptoms don't show up until the disease has progressed.  Many people don't have B symptoms when they are diagnosed (I was one of them), but what usually sends people to the doctor is the ongoing swollen nodes.  You have a lot of lymph nodes throughout your body, and sometimes you can have swollen nodes deep within that you can't see or feel, and sometimes they can push against organs and cause pain and other problems as well.  This too prompts people to see their doctor.

I'm not sure what kind of testing they do for STD's, but you can probably call the doctors office that did the test and see if you can get a copy sent to you before seeing the doctor.  A CBC (complete blood count) test is a general blood test that is done to look for many kinds of diseases including cancer.  However, a CBC isn't used to diagnose cancer, but often is used more as a tool to see if any levels are off.  However, it is possible to have normal blood levels and still have blood cancer.

The most definitive way to diagnose a blood cancer is with a biopsy of a swollen node (excisional, not needle).  If your doctor is concerned that it may be cancer, he will probably recommend a biopsy.  However, if he doesn't think there is any reason for concern, he probably won't recommend it because a biopsy is considered surgery and doesn't come without it's own risks.   However it probably wouldn't hurt to bring up the subject of biopsy just to see what they say.

By the way, to give you some peace mind, it has yet to be proven that lymphoma is hereditary.  Scientists haven't nailed down any concrete causes, but they think environmental exposures to things such as chemicals, pesticides, hair dyes, etc. may be to blame.  Good luck and please keep us posted.

[Hockeyfreak889]

Thanks for the response! As you assumed I am still on my parents healthcare, and I will talk to them about finding a doctor's office closer to school. To the best of my knowledge I haven't had any illnesses or infections since/just before I noticed the lump, besides a cold I had sometime in November.
Do people always experience B symptoms? I haven't had any night sweats, or to the best of my knowledge any fevers. I have lost some (possibly insignificant) weight but there are explanations for it (I stopped going to the gym and probably have lost muscle mass, and my appetite has been decreased so I am probably eating a bit less than I used to). I also haven't had any all over itching. The fatigue is interesting though, because while it is definitely noticeable, it could be from a crappy sleep schedule at school, or maybe it stems from not eating as well as I should. Either way when I go to the doctors(it might be a week or 2 as I'm in the  middle of exams this week and next week) I will mention the fatigue and weight loss.
You mentioned getting blood work done. I actually had blood taken when I originally went to the doctors, but this was to test for STDs because of the area the lump was in. If the blood test was specifically to check for STDs, would something that would indicate cancer show up without specifically looking for it? Or would they have to be looking for something specific? I was never told the result of the blood test and assumed that meant everything was fine.

[Mochadelicious]

I do think you should go to the doctor, and if possible, a doctor that is near your school.  I'm assuming you're a student still on your parents medical insurance?  Find out what kind of medical insurance you have and then call around to several family physicians in your area and ask if they accept your insurance.  6 months is a long time to have swollen nodes.  Have you had any illnesses or infections during this time period?  

In general, most blood cancers start off with swollen node/s, usually not painful, and sometimes they wax and wane (come and go).  Swollen groin nodes are usually associated with a some sort of infection in the lower body or near that general area, but sometimes it can be due to malignancy.  With blood cancers, as the the disease progresses, you can experience one or more of what is known as B symptoms.  These symptoms are night sweats (where you have to change your clothes and sheets), low grade fevers, unintentional weight loss (10% of total body weight in 6 months), and an all over itching.  Some people also experience extreme fatigue.  

You have had several nodes that have come and gone, had some weight loss (although I doubt 10%), and extreme fatigue (which could be due to your busy student lifestyle).  It's too bad that you didn't explain all your symptoms to the previous doctor, but now you know how important it is to tell them everything (even if it seems irrelevant).  Even for peace of mind, I would recommend inquiring about having some blood work done and ask about getting a biopsy of your groin node.  

Please keep us posted on what you find out.