Lymphedema and Cancer Treatment

Lymphedema is a condition in which the lymph fluid does not drain properly. It may build up in the tissues and cause swelling. This can happen when part of the lymph system is damaged or blocked, such as during surgery to remove lymph nodes, or radiation therapy. Cancers that block lymph vessels can also cause lymphedema.

Lymphedema usually affects an arm or leg, but it can also affect other parts of the body, such as the head and neck. You may notice symptoms of lymphedema at the part of your body where you had surgery or received radiation therapy. Swelling usually develops slowly, over time. It may develop during treatment or it may start years after treatment.

At first, lymphedema in an arm or leg may cause symptoms such as:

• swelling and a heavy or achy feeling in your arms or legs that may spread to your fingers and toes
• a dent when you press on the swollen area
• swelling that is soft to the touch and is usually not painful at first

Lymphedema that is not controlled may cause:

• more swelling, weakness, and difficulty moving your arm or leg
• itchy, red, warm skin, and sometimes a rash
• wounds that don’t heal, and an increased risk of skin infections that may cause pain, redness, and swelling
• thickening or hardening of the skin
• tight feeling in the skin; pressing on the swollen area does not leave a dent
• hair loss

Lymphedema in the head or neck may cause:

• swelling and a tight uncomfortable feeling on your face, neck, or under your chin
• difficulty moving your head or neck

Tell your health care team as soon as you notice symptoms. Early treatment may prevent or reduce the severity of problems caused by lymphedema.

Ways to manage lymphedema

Steps you may be advised to take to prevent lymphedema or to keep it from getting worse:

• Protect your skin. Use lotion to avoid dry skin. Use sunscreen. Wear plastic gloves with cotton lining when working in order to prevent scratches, cuts, or burns. Keep your feet clean and dry. Keep your nails clean and short to prevent ingrown nails and infection. Avoid tight shoes and tight jewelry.
• Exercise. Work to keep body fluids moving, especially in places where lymphedema has developed. Start with gentle exercises that help you to move and contract your muscles. Ask your doctor or nurse what exercises are best for you.
• Manual lymph drainage. See a trained specialist (a certified lymphedema therapist) to receive a type of therapeutic massage called manual lymph drainage. Therapeutic massage works best to lower lymphedema when given early, before symptoms progress.

Ways to treat lymphedema

Your doctor or nurse may advise you to take these and other steps to treat lymphedema:

• Wear compression garments or bandages. Wear special garments, such as sleeves, stockings, bras, compression shorts, gloves, bandages, and face or neck compression wear. Some garments are meant to be worn during the day, while others are to be worn at night.
• Other practices. Your health care team may advise you to use compression devices (special pumps that apply pressure periodically) or have laser therapy or other treatments.

Talking with your health care team about lymphedema

Prepare for your visit by making a list of questions to ask. Consider adding these questions to your list:

• What can I do to prevent these problems?
• What symptoms should I call you about?
• What steps can I take to feel better?
• Would you recommend that I see a certified lymphedema therapist?
• If lymphedema advances, what special garments should I wear during the day? During the night?