Cancer Treatment Centers of America

Managing and treating lymphedema



For many cancer patients, the side effects that come with treatment can prove challenging. Lymphedema is one relatively common example that impacts some patients who undergo surgery or radiation. But advances in treating lymphedema offer new options for an improved quality of life.

Lymphedema occurs when lymphatic fluid accumulates, causing painful swelling under the skin. The fluid buildup occurs most frequently in the arms or legs, often as a result of disease or treatment that damages or removes lymph nodes. The standard of care for managing lymphedema includes physical therapy to help stimulate the lymphatic system. Patients may also wear compression garments, such as sleeves or bandages, or use pumps to reduce swelling.

For some patients, though, standard therapies don’t bring sufficient relief. In those cases, when symptoms persist for six to 12 months despite therapeutic intervention, emerging microsurgical procedures may be an option. “Advancements in microsurgery have expanded treatment options for patients who do not respond to physical therapy alone,” says Dr. Daniel Liu, a Plastic and Reconstructive Surgeon at our hospital outside Chicago. “These innovative procedures hold great promise.”

Karin Nowatzke, a breast cancer survivor at our Illinois hospital, knows firsthand how surgical treatment of lymphedema can affect quality of life. She says living with and managing lymphedema became an obstacle she didn’t expect after undergoing a mastectomy. After cancer treatment, which included the removal of several lymph nodes, Nowatzke turned to compression garments and physical therapy to cope with the lymphedema that developed in her arm. Her condition “would get a little better, but it was gradually getting worse,” she says in this video.

After a year and a half of frustrating functional limitations, Nowatzke chose to undergo a microsurgical procedure called a vascularized lymph node transfer. Her surgical team included Dr. Liu and Dr. Aaron Pelletier, a Plastic and Reconstructive Surgeon at our hospital near Chicago. The surgeons performed the lymph node transfer at the same time as her breast reconstruction, reducing her time in the operating room. The first benefit Nowatzke noticed after her surgery was a renewed ability to grip, “fully grip,” she says. With the swelling in her arm diminished, she says much of the pain subsided. “I feel much more confident and comfortable,” Nowatzke says.

Standard lymphedema treatments may include skin care, manual lymph drainage, massage and exercise to help stimulate the lymphatic system. Lymphedema patients are also urged to take these additional steps to reduce symptoms:

  • Avoid extreme temperatures.
  • Protect the affected area from injury or irritation like an insect bite or sunburn.
  • Check all swollen areas for signs of infection.
  • Wear loose-fitting clothing and jewelry.
  • Support the affected limb and elevate it above the heart as much as possible.
  • Take doctor-prescribed medications to help reduce inflammation, prevent blood clots and alleviate pain.

Learn more about the microsurgical advancements to treat lymphedema.

Get additional tips for living with and managing lymphedema.

No case is typical. You should not expect to experience these results.