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Lymphedema

What is lymphedema?

Lymphedema is swelling caused by excess buildup of fluid under the skin, often when lymph nodes are removed or damaged. It is a common side effect of some cancer treatments, including surgery or radiation therapy. The resulting blockage prevents fluid from draining sufficiently, causing it to collect in the fatty tissue under the skin, most often in the arms and/or legs. The risk of lymphedema grows with the number of lymph nodes affected.

Symptoms of lymphedema include:

  • Swollen extremities, such as the arm, hand, leg or foot
  • Swelling in the breast, chest, shoulder, pelvis, groin or genitals
  • Limited movement and stiffness in the joints, especially the hand, shoulder or wrist, but also in the hips, knees, ankles, neck, face or mouth
  • Skin discoloration and texture changes
  • Pain and/or a pins-and-needles sensation around the area where lymph nodes have been removed or damaged
  • Heaviness in a limb
  • Difficulty fitting comfortably into jewelry or clothes, such as pants, jackets, shirts or bras

Lymphedema is also caused by conditions other than cancer treatment, including:

  • Tumors that have returned and/or spread to the lymph nodes
  • Lymph system blockages from lesions
  • Infected and/or damaged lymphatic vessels
  • Scar tissue
  • Blockages caused by a blood clot

The most common type of lymphedema caused by breast cancer or its treatment develops in the upper body and extremities. Lower-extremity lymphedema is more often associated with other cancers, including lymphoma, melanoma, prostate cancer and uterine cancer. Facial lymphedema is more often associated with head and neck cancers.

How likely are cancer patients to experience lymphedema?

While the incidence of lymphedema has been actively studied, especially in breast cancer patients, the research is inconsistent as to how many patients struggle with the condition as a result of cancer. But it is widely considered a common cancer-related side effect, and the National Cancer Institute points out that it is important to diagnose and promptly treat even mild cases to avoid “preventable severe, debilitating lymphedema.” Lymphedema can occur within days, weeks, months or years after surgical treatments, or it may develop during radiation therapy. It often develops slowly but becomes apparent within two years of cancer treatment.

How can integrative care help?

If left untreated, lymphedema raises the risk of infection and may lead to other problems that could alter the patient’s ability to move or operate affected limbs or other body parts. More advanced cases may also lead to skin breakdown and other complications.

A combination of supportive therapies may help patients manage the condition. Surgical options are also available to some patients. Integrative therapies that may help include:

Oncology Rehabilitation

Education helps to raise patients’ awareness about how they can prevent risk factors that can lead to lymphedema. For patients diagnosed with lymphedema, certified lymphedema therapists use decongestive techniques as part of physical, occupational, speech and/or massage therapy services to help them manage symptoms. Skin care, and specialized manual lymph drainage techniques, may help stimulate the lymphatic system and/or reduce swelling. Upper- and lower-body exercises may help restore range of motion and strength, and support the movement of lymphatic fluid to further reduce swelling. Therapists may recommend sleeves, stockings and/or compression bandages to help reduce swelling and the future buildup of fluid under the skin. 

Pain Management

Pain management physicians support other integrative clinicians working to decrease lymphedema. The swelling of the tissues from the buildup of lymphatic fluid may cause pain. The pain team at Cancer Treatment Centers of America® (CTCA) may recommend over-the-counter medications for mild pain caused by lymphedema, while more severe pain may require prescribed painkillers. Other medications may be used to help reduce inflammation, calm nerves, treat infections and prevent blood clots.