Lymphedema

Lymphedema

What is lymphedema?

Lymphedema is swelling caused by a buildup of lymph fluid in the body between the skin and muscle. Lymph fluid is part of the lymph system, which plays a role in your body’s ability to fight infection and disease. If you have cancer, the cancer or cancer treatment can disrupt the flow of lymph fluid and cause lymphedema (also known as secondary lymphedema). Lymphedema may arise soon after cancer treatment, or it may develop years after treatment has ended. Most often, it develops slowly over months or years.

What causes lymphedema?

Anything that blocks or changes the flow of lymph fluid in the body can cause lymphedema. Cancer and cancer treatments can cause lymphedema when:

• cancer or a tumor blocks the flow of lymph fluid
• surgery for cancer disrupts the flow of lymph fluid
• radiation therapy causes scar tissue that blocks the flow of lymph fluid

Your risk for lymphedema depends on the type and location of your cancer and the treatments you have. Other risk factors for lymphedema include having an infection, healing slowly after surgery, having lymph nodes removed, past surgeries or radiation, having advances cancer, and being overweight or having obesity. Talk with your doctor to learn about your risk of lymphedema.

Lymphedema and breast cancer

Treatment for breast cancer often involves surgery that removes one or more lymph nodes in the underarm area, increasing the risk of lymphedema. If you have been treated for breast cancer with radiation therapy or surgery, you may develop lymphedema in your hand, arm, or chest on the side of the body where lymph nodes were removed or damaged.

Lymphedema stages

If you are diagnosed with lymphedema, your doctor will use a staging system to describe the severity of your lymphedema.

• Stage 0: The flow of lymph in the body is not moving as it should. You may or may not have symptoms.
• Stage I: The affected area is swollen and feels heavy. Pressing on the swollen area leaves a pit (dent) in the skin. Resting and elevating the limb can help reduce swelling at this stage.
• Stage II: The affected area is more swollen and may feel firmer than the area around it. Pressing on the swollen area does not leave a pit. Resting and elevating the limb no longer reduces swelling.
• Stage II:The affected area is extremely swollen and the skin feels hard and thick. You may also have decreased mobility and dry, blistered skin in the affected area.

How is lymphedema treated?

Treatments are available for managing the symptoms of lymphedema. Your health care team will talk with you about management techniques that can be done at home or under the supervision of a trained professional such as a nurse or a certified lymphedema therapist (CLT), a physical or occupational therapist trained to treat lymphedema. Treatments include:

Short stretch bandaging, compression wraps, leggings, or stockings

These can help move fluid around in your arms and legs to prevent it from building up. They may also be called compression garments. Your nurse or CLT will help you find garments that fit properly and will show you how to use them.

Manual lymphatic drainage

Manual lymphatic drainage, also called lymphatic drainage massage, involves gentle massage that helps move lymph fluid through the body. Lymphatic drainage is part of a treatment called complete decongestive therapy, which is managed by a CLT. Complete decongestive therapy may also include bandaging, exercises, and skin care to manage symptoms.