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Lymphedema

What is lymphedema?

Lymphedema is swelling caused by the excess buildup of fluid under the skin, and is often caused when lymph nodes are removed or damaged. The lymph nodes act as a filter for waste, which is swept up and carried to the lymph nodes by the protein-rich lymphatic fluid. When the lymph nodes are damaged or blocked, the lymphatic fluid may accumulate beneath the skin in the lymph vessels and cause gradual swelling.

There are two types of this condition:

How does lymphedema affect cancer patients?



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Lymphedema 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 grows with the number of lymph nodes affected.

Lymphedema symptoms include:

Lymphedema causes include:

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 may 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.

What are some lymphedema treatments?

Although no cure has been developed for lymphedema, certain treatments are available that may be used to reduce the swelling and manage the pain associated with the condition. Lymphedema treatment may include compression garments, which are sleeves worn over the affected arm or leg to help move fluid out of the limb. A pneumatic compression is another type of compression garment used in lymphedema treatment that connects to a pump to inflate the sleeve, which puts pressure on the limb and moves fluid away from the fingers and toes. Exercises and massages designed to draw out fluid from the limbs may also be recommended.

More extensive forms of treatment involve surgery and may be suitable for some patients. At Cancer Treatment Centers of America® (CTCA), we offer two surgical options to treat this condition:

Learn more about the Philadelphia Lymphedema Clinic

How may 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. Supportive care therapies that may help include:

Acupuncture

Acupuncture is a form of ancient Chinese medicine in which fine, sterile needles are applied to specific areas of the body, or acupoints. The needles are usually left in place for 20 to 40 minutes.

Acupuncture has been found to safely treat swelling in patients with lymphedema. If you choose to incorporate acupuncture into your care plan, the recommended frequency is two to three times per week for four to six weeks.

Learn more about acupuncture

Mind-body support

Mind-body interventions may include counseling, yoga, meditation, breathing practices and music therapy. For lymphedema, mind-body medicine may help with:

Learn more about mind-body support

Nutritional support

The risk of lymphedema increases if you are carrying extra body weight. Our registered dietitians may help you develop a plan to lose excess weight or maintain a healthy body weight.

Learn more about nutritional support

Oncology rehabilitation

Education helps to raise patients’ awareness about how they may prevent risk factors that may 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.

Learn more about oncology rehabilitation

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 management 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.

Learn more about pain management