Managing Lymphedema After Cancer Treatment

Lymphedema is swelling caused by a buildup of lymph fluid. This type of swelling most often occurs in the arms or legs, but it can also affect other parts of the body.

Lymphedema is very common in people who have had cancer. Understanding more about it may help you avoid it or manage it if it occurs.

What causes lymphedema?
Your body has a system of lymph vessels that are something like blood vessels. But instead of blood, the lymph vessels carry lymph fluid throughout your body. Lymph fluid has cells that help fight disease and infection. The lymph system also removes excess fluid and protein from your tissues. Lymph fluid flows through the lymph nodes, which filter out harmful substances.

Lymphedema occurs from damage to the lymph system. Having lymph nodes removed, radiation treatments, or cancer itself can block the flow of lymph fluid. This can cause fluid to build up in your tissues.

You can have lymphedema with any type of cancer, but you are more likely to get it if you’ve had:

•Breast cancer
•Prostate cancer
•Pelvic area cancers, such as uterine cancer
What symptoms should I watch for?
Lymphedema can develop right after cancer treatment or later on. Sometimes it shows up months or even years after treatment. Call your doctor if you notice signs of swelling, such as:

•Arm or leg aches, or heaviness of the arms or legs
•Feelings of tightness of the skin on your arms or legs
•Stiffness in your hands, wrists, or ankles
•Rings, shoes, or sleeves feeling tighter, even though you haven’t gained weight
It’s very important to call your doctor right away if you have swelling and your skin is hot, red, or tender – or you have a fever. These can be signs of a serious infection. Call 9-1-1 if you have sudden weakness in your arm or leg. This could be a sign of a stroke instead of lymphedema.

Can I prevent lymphedema?
You may be able to prevent or reduce lymphedema by taking some precautions.

Protect your skin
The lymph system responds to skin injuries by sending extra fluid to the injured area. So it’s important to protect your skin and prevent injuries and infections:

•Keep your skin clean.
•Use lotion or cream to prevent dry skin.
•Take steps to avoid cuts, bites, and burns. Use sunscreen and insect repellant when outdoors. Use gloves when doing yard work or housework. Use an electric razor. Don’t cut your cuticles.
•Offer your unaffected arm for shots or blood draws.
•For any minor scrapes or cuts, wash with soap and water, apply antibacterial cream, and cover with a clean bandage.
•Check your skin everyday. Treat any injuries right away. Call your doctor if you get a skin infection.
Avoid excess pressure on your arm or leg

•Choose jewelry and clothes that aren’t tight or binding.
•Don’t cross your legs when you’re sitting.
•Have your blood pressure taken on the unaffected arm.
•Don’t stay in one position for more than half an hour. Flex your affected arm or leg often, or get up and walk around.
•If you plan to travel by air, ask your doctor about a compression sleeve or stockings. Also, it is best to avoid alcohol and drink plenty of water when flying.
Exercise carefully
Exercise can help lymph fluid flow better, but overusing your arm or leg can bring on swelling.

•Learn the exercises your doctor or physical therapist prescribes, and do them regularly.
•Find out which exercises and sports to avoid.
•Use your arm or leg normally, but don’t overdo it. Avoid heavy lifting, pulling, or repeated motions.
•If your arm or leg aches, lie down and raise it above chest level.
Treatment for lymphedema
If you have lymphedema, your doctor may prescribe a treatment called complex decongestive therapy (CDT). This is usually done by a physical therapist who has special training. It consists of:

•A type of massage that can help lymph fluid flow better
•Exercises to help the fluid drain
•Bandaging or custom-fit compression sleeves or stockings
•Skin care
Surgery may be done if these treatments don’t work or if you have repeat infections or excessive swelling.

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