The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on May 24, 2021.


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:

  • Secondary lymphedema, which is caused by another condition that damages the lymph nodes or vessels, may be caused by a lymph node infection, cancer, radiation, surgery or injury
  • Primary lymphedema, which is rare, is a genetic condition in which the lymph nodes or vessels are missing or aren't fully developed.

How does lymphedema affect cancer patients?

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:

  • Swelling
  • Feeling of heaviness or tightness in the limbs
  • Reduced mobility in the limbs
  • Increased infections
  • Pain

Lymphedema causes include:

  • Cancer treatment
  • Removal of or damage to lymph nodes
  • 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
  • Obesity

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. Learn to understand the risk factors and identify common head and neck cancer symptoms.

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 manual manipulation 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:

  • Vascularized lymph node transfer surgery: This is an intricate microsurgical procedure used to treat patients with advanced lymphedema affecting the skin tissue in the arms or legs. Our plastic surgeons transfer working lymph nodes from another part of the body, typically the upper groin or lower abdomen, to the damaged site. We then divide the existing blood vessels that supply the nodes and connect them at the site where the lymph nodes are needed. We use reverse lymphatic mapping to reduce the chance of lymphedema occurring in the areas where lymph nodes were harvested.
  • Lymphaticovenular bypass surgery: This surgery is an intricate super-microsurgical procedure used to treat patients with mild to moderate lymphedema. Our plastic surgeons perform the surgery by shunting, or moving, fluid from several dilated lymphatics in the affected limb to adjacent venules (tiny veins) to reduce pressure.

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:

Behavioral health

Behavioral health interventions may include counseling, yoga, meditation, breathing practices and music therapy. For lymphedema, behavioral health may help with:

  • Stress management and relaxation techniques
  • Body image improvement
  • Self-awareness
  • Boosted motivation
  • Alternative ways to move and breathe

Learn more about behavioral health

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 and speech 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