###Human: Why is lymph node growing even when chemo is being given to cancer patient? ###Assistant: Hello. So, I have gone through your queries. I would like to know a few details which will help me in answering your questions. So before surgery what was his stage? What did baseline CT or PET (whichever was done) showed? Did he receive any chemotherapy prior to surgery? Or was the decision taken to go ahead with surgery? What chemotherapy is he receiving? What surgery did he have and what was post-surgery histopathology report? His age, general fitness, and any other illness? Now coming to your questions. LN (lymph node) growing during chemotherapy means usually disease is not responding in 95 % cases. Rarely there are nonmalignant causes (usually infective) which can also cause LN enlargement. So depending on the clinical picture, risk, and possibility of other etiology and imaging, the decision is taken to change treatment. Your physician sometimes may want to be sure that the LN is due to disease only then he can sometimes suggest FNAC or biopsy of LN. When one chemotherapy is not working, we go to the second line. Usually, idea is to start chemotherapy which is standard and which patient can tolerate. So it is not like we try different choices before finding the right one. We start with a standard one and if the patient is not responding we go to the second line. If first-line treatment is not working the chances of next line working also goes down. Also, second line options may have more side effects. This decision is taken usually with patient and physician preference.