Understanding Lymphedema

Lymphedema is a buildup of lymph fluid that causes swelling. It can happen if lymph nodes or lymph vessels are blocked, removed, or damaged. Surgery and radiation to treat cancer can cause this damage. Then lymph fluid may collect and cause swelling in the treated parts of your body. This can happen any time, even many years after treatment.

After cancer treatment that removes or damages lymph nodes, you're at risk for lymphedema for the rest of your life. But you can do things to help reduce your risk. And there are ways to reduce or relieve swelling if it happens. If left untreated, lymphedema can get worse. It may not go away. It can also lead to other problems, such as trouble moving that part of your body, pain, and infections.

What is the lymphatic system?

The lymphatic system is part of your immune system. It’s a network of tiny vessels and small organs called lymph nodes. These nodes are found along the vessels. This system carries lymph throughout your body. Lymph is a clear fluid that contains proteins, salt, water, and white blood cells. It also carries waste from your body cells.

The lymphatic system helps protect your body and keep it healthy. It helps keep your fluids at the correct level. The nodes filter lymph to help fight infection.

How lymphedema happens

Lymph nodes and lymph vessels can be blocked by the cancer itself. Also, lymph nodes and vessels are removed during surgery to treat many kinds of cancer. Or they might be treated with radiation. This scars and damages them. It disrupts the normal flow of lymph fluid. So instead of lymph draining into your body like it should, the fluid collects in the fatty tissues under your skin. This causes swelling. The changes in the flow of lymph also keep the lymph from being filtered the way it should. This can increase the risk for infection, skin sores, and other skin changes. It can affect wound healing in the swollen areas.

Lymphedema can happen in 1 or both arms or legs, the groin, the face, the head and neck, chest, or the belly (abdomen). It depends on which part of your body was treated. The swelling can get worse over time and cause problems.

Symptoms of lymphedema

Lymphedema can happen in your arm, armpit, leg, groin, abdomen, chest, head, neck, face, or other parts of the body. Common symptoms can include:

• Swelling

• A feeling of fullness or heaviness

• Skin that feels stiff, tight, or hard

• Weakness

• Aching, itching, burning, or pain

• Skin that looks red

• Trouble bending or moving a joint in your fingers, wrist, elbow, shoulder, or ankle

• Shoes, clothing, bra, or jewelry that feels tight

• Voice change

• Trouble swallowing or speaking

Lymphedema can happen after surgery or radiation treatment for nearly any type of cancer, but it’s most common with:

• Breast cancer

• Prostate cancer

• Cancer in the pelvic area (bladder, penile, testicular, ovarian, endometrial, vulvar, or cervical cancer)

• Lymphoma

• Melanoma

• Head and neck cancer

Can lymphedema be prevented?

Not all experts agree on what might help reduce risk. But one of the most important things you can do is watch for signs of lymphedema. As you heal, be aware of how your hands, arms, chest, legs, and feet normally feel and look. Compare the sides of your body. Watch for changes. If you notice any changes, let your provider know right away. The sooner any swelling is treated, the better the chances of reducing it and keeping it from getting worse.

Here are some other things to do:

• Get follow-up care after cancer treatment. See your healthcare provider on a regular basis for checkups. Ask about your risk for lymphedema. You may want to ask about seeing a certified lymphedema specialist. They can teach you more about how to try to prevent lymphedema.

• Protect your arms. For arms at risk for lymphedema, ask your healthcare provider if it is OK to have your blood pressure taken, blood drawn, or an IV (intravenous) line put in the arm.

• Prevent infection and inflammation. Wash, treat, and cover any skin wounds, even a small cut, scratch, or burn. Keep your skin clean and use lotion to keep it moist. Check your skin often. Get treatment right away at the first sign of infection.

• Be active. Ask your healthcare team about the type of exercise that’s best for you. A lymphedema specialist can help you learn safe exercises.

• Manage your weight. Talk with your provider about what’s a healthy weight for you. Ask them for help with how to get to or stay at that weight.

When to call your healthcare provider

Lymphedema needs to be treated right away. Call your healthcare provider if you have any of these:

• Symptoms of lymphedema

• Fever of 100.4° F (38° C) or as advised by your healthcare provider

• Red blotches, warmth, or pain in the area

• Cracking or peeling skin

• New unexplained pain in the part of your body at risk for lymphedema