Cancer treatment may involve damage to or removal of parts of the lymphatic system. As a result, lymph fluid can’t drain from tissues around the affected areas. That leads to swelling, also called lymphedema. If left untreated, it can have major effects on your health and mobility. Fortunately, a variety of treatments are available to help you control the swelling and keep moving forward after a lymphedema diagnosis.
What Is Lymphedema?
Your lymphatic system has many important jobs, including supporting the immune system by:
- Protecting against bacteria, viruses, parasites, fungi and other foreign invaders
- Carrying and filtering waste and abnormal cells away from the lymph to help your body fight infections
- Helping to maintain fluid levels in your body
- Absorbing fats from the digestive tract
Lymph fluid is made up of water, proteins and waste that is located between the cells in our body. Lymph fluid moves around the body via a network of lymph vessels. Clusters of lymph nodes located throughout the body filter waste from lymph fluid. Eventually, the fluid re-enters the bloodstream in the heart.
Lymphedema occurs when disease, removal of lymph nodes or damage to the lymph vessels prevents lymph fluid from draining toward the heart, so it collects in surrounding tissues and causes swelling and other symptoms.
Lymphedema Causes
There are two classifications of lymphedema:
- Primary lymphedema occurs due to abnormalities of the lymphatic system that are present at birth.
- Secondary lymphedema is far more common and occurs because of damage to or obstruction of the lymphatic system, often due to cancer or cancer treatment.
Cancer can lead to lymphedema in a variety of ways. For example, a tumor can block a lymph vessel, causing lymph fluid to accumulate in tissues. This can also occur if you undergo lymph node or vessel removal as part of cancer surgery, or if radiation therapy damages your lymph vessels.
Lymphedema can occur following surgery to treat many different types of cancer, including:
- Breast cancer
- Head or neck cancer
- Lymphoma
- Melanoma
- Ovarian cancer
- Prostate cancer
- Uterine cancer
- Colorectal
In most cases, lymphedema occurs within three years after surgery, according to the National Cancer Institute.
Cancer and its treatment aren’t the only factors that can lead to lymphedema. Others include:
- Blood vessel problems
- Frequent skin infections
- Obesity
Lymphedema Symptoms
Swelling is the main symptom of lymphedema, and it usually occurs in the area of the body where the cancer is located and treatment occurs. Lymphedema is most often seen in the arm and leg. Minor swelling occurs at first, but it may increase over time.
In addition to swelling, you may experience:
- A feeling of heaviness in the affected arm or leg
- Difficulty moving your arm or leg, sometimes called “lymphedema legs”
- Hair loss
- Itching or burning in your arm or leg
- Skin changes, such as tingling, tightness, redness or thickening
- Sleep problems
- Snugness when wearing clothes, shoes or jewelry
Determining the Diagnosis
If you’ve had or are scheduled to have surgery or radiation therapy for cancer, ask your medical provider to see a certified lymphedema therapist who can educate you on ways to possibly reduce your risk for developing lymphedema. It’s important to watch for signs of lymphedema and notify a medical provider if you develop symptoms. Your medical provider will start by conducting a physical exam and asking you about your symptoms and medical history, especially about any cancer treatment. Your provider will look for physical symptoms of lymphedema, such as swelling and skin changes.
Tests may be necessary to confirm a diagnosis of lymphedema and rule out other causes of symptoms, such as blood clots. These tests may include:
- Imaging tests. CT and MRI allow medical providers to see inside swollen areas of the body and determine what’s keeping lymph fluid from draining.
- Lymphoscintigraphy. For this test, you’ll receive an injection of a small amount of radioactive dye. A scanner shows how the dye moves through your lymphatic system. The scan can also reveal blockages.
Lymphedema Treatment
There’s no cure for lymphedema, but symptoms can be managed to reduce its effect on your life. According to the American Cancer Society, lymphedema occurs in four stages, and treatment is most likely to be successful in the earliest ones, stages 0 and 1. Stage plays an important role in shaping your lymphedema treatment plan, which makes early detection and treatment key to the best possible outcome.
For many patients, lymphedema care involves several forms of treatment.
- A compression sleeve or stocking can help move lymph fluid and reduce swelling by putting pressure on swollen areas of the body. Another type of compression treatment applies pressure by using a pneumatic pump to inflate a wearable sleeve.
- Exercise encourages movement of lymph fluid and treats swelling. Ask your medical provider or a lymphedema therapist for recommendations for safe, effective forms of exercise.
- Losing weight may help if you developed lymphedema due to breast cancer or its treatment.
- Manual Lymphatic Drainage from a certified physical or occupational therapist who has experience working with individuals who have lymphedema can help lymph fluid drain from swollen tissue.
- Surgery may be an option for severe lymphedema, but most patients are able to manage swelling without a procedure.
Tips for Improving and Maintaining Quality of Life
In addition to following your treatment plan, you can take these steps to make living with lymphedema easier:
- Encourage lymph fluid to flow. From what you wear to how you sit, everyday decisions can affect lymph fluid’s ability to drain. Choose loose-fitting clothes and jewelry instead of items that squeeze your arms or legs. If you have lymphedema in a leg, keep your foot on the ground when sitting instead of crossing your legs. Better yet, elevate the affected leg or arm above your heart.
- Reduce your risk of infection. Areas of lymph fluid buildup are attractive places for bacteria, which can enter the body through cuts, scratches and burns. Protect your skin by wearing gloves when cooking or doing yardwork, and wear sunscreen to prevent sunburn. Use lotion to keep your skin moisturized.
- Practice healthy habits. Along with regular exercise, follow a nutritious, low-salt diet to reach and maintain a healthy weight.
Managing lymphedema takes commitment, but it’s worth the effort. By working with your medical providers and taking steps to stay healthy, you can reduce this condition’s impact on your life and spend more time focusing on the people and activities that bring you joy.
