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Lymphedema

What is the lymph system?

What is lymphedema?

What causes lymphedema?

How do I know if I have lymphedema?

Why does cancer or cancer treatment cause lymphedema?

Why do some people get lymphedema, while others do not?

Can lymphedema be prevented?

What can I do to help manage lymphedema?

What is the lymph system?

The lymph system is a series of collecting tubes (called lymph vessels or ducts) and filters (called lymph nodes) which work with the blood system to remove waste from the body. This “waste” is made up of dead cells and large proteins that are too big to be taken away by smaller blood vessels.

What is lymphedema?

Lymphedema is a collection of fluid in the tissues. It most often occurs in the arms or legs. It is not the same as water retention and it needs very different treatment.

What causes lymphedema?

It is caused by a blockage or slowdown in the lymph system.

How do I know if I have lymphedema?

You may have swelling in your arm, breast, leg, or genital area. The swelling may be present at all times or it can come and go. The affected area may also feel heavy or ache.

Why does cancer or cancer treatment cause lymphedema?

During surgery for cancer, lymph nodes are often taken out to see of the disease has spread. Sometimes this causes swelling in a limb. Radiation therapy is often used to treat lymph nodes which may have cancer inside them. While it kills cancer cells, it can also damage the healthy cells of the lymph node. The lymph node then works more slowly and it cannot filter fluid very well. Cancer in the lymph nodes can cause a blockage that results in lymphedema.

Why do some people get lymphedema, while others do not?

There is no easy answer to this question. If you had lymph nodes removed or had treatment in your armpit or groin, or if cancer returns in the lymph nodes, then you have a higher risk for developing lymphedema. Not everyone with these risk factors will develop swelling. There is no way of knowing who will develop lymphedema and who will not.

Can lymphedema be prevented?

If possible, surgeons only remove the lymph nodes that drain the area of the tumour. This is called sentinel node biopsy. Radiation oncologists always try to spare as much of the lymph system as possible when treating the cancer.

What can I do to help manage lymphedema?

If you notice swelling in your arms or legs, tell your doctors. You will need to be checked for other conditions, which can produce similar symptoms.

You should:

• Keep the affected limb clean and dry.
• Wash with a gentle soap, pat dry and apply a moisturizing cream.
• Avoid activities that may cause bruises, cuts, burns, scratches, and sprains to the affected arm or leg.
• Prevent sunburns and insect bites.
• Use sunscreen and insect repellant.
• Use oven mitts that cover the forearm.
• Use gloves for gardening, dishwashing, and other activities that may cause injury.
• Use an electric razor to shave underarms or legs.
• Choose bras that have wide straps or slip a shoulder pad under the strap.
• Raise the affected arm to shoulder height, whenever possible. If may be helpful to rest it on the back of a chair or on pillows.

You should avoid:

• Cutting cuticles when manicuring the hand on the affected side. No nail biting!
• Using the affected arm for blood tests, IV’s, or blood pressure readings.
• Pressure on the shoulder of the affected side. Shoulder purses, backpacks and tight narrow bra straps can reduce lymph fluid flow.
• Activities that can make the swelling worse. Repeated heavy lifting, rubbing, knitting, chopping, pushing and pulling may cause problems in some people. If in doubt, measure the distance around the limb (girth) before and after the activity.
• Temperature extremes while bathing, showering or washing dishes. If the limb feels “achy”, do not apply heat or ice to relieve the discomfort. No saunas or hot tubs!
• Wearing tight watch bands or rings on the affected arm.

If you have any concerns, contact your Primary Nurse or Oncologist and ask for a referral to the Lymphedema Clinic at the London Regional Cancer Program.