Monday, January 09, 2012
How does lymphedema affect some survivors?
affects the lymphatic system. The lymphatic tissues and organs produce,
store and carry the white blood cells that help fight infections and
other diseases. There is an accumulation of protein-rich fluid in the
interstitial spaces of an affected body part due to a blockage or
malfunction in the lymphatic system. It is often associated with
swelling that you can see and feel. This occurs most frequently in the
arms and legs.
The swelling of arms, legs, trunk, or other body
part occurs from the build-up of lymph fluid. Lymph fluid is the clear
fluid that travels through the lymphatic system and carries cells that
help fight infections and other diseases. There are two types of
lymphedema: primary and secondary.
Sometimes radiation damages
lymph nodes and these changes can contribute to lymphedema. In
addition, surgeries that remove lymph nodes are sometimes a necessary
part of treating cancer. The side effects from some treatments can
Lymphedema can occur during treatment,
immediately following treatment, or years after cancer treatment ends.
Because there is not an exact risk time period, it is important to go
for regular check-ups and look for changes in your body that might be
symptoms. Whether or not you will get lymphedema really depends on the
type of treatment you had, other predisposing factors, and your body's
response to treatment.
If you do experience lymphedema, it does
not mean that your health care team did not do a good job. The primary
goal of your health care team is to treat your cancer. They then work
to manage any aftereffects you might experience. It is important to be
aware of the risks of lymphedema and other aftereffects of treatment.
Watch for symptoms to increase your chances of early detection. This
will enable you to inform your doctor and get treated as early as
What are some symptoms of lymphedema?
and swelling may appear for a short time, disappear without treatment,
and then return. If you notice any symptoms, write down when they
happened, what you were doing and if anything made it better.
when the swelling comes and goes often, it might be the beginning of
chronic lymphedema. Early detection and treatment are very important.
Once swelling becomes chronic, it is only manageable and not
reversible. You are likely to be the first to notice symptoms of
lymphedema. Check your body regularly for changes.
affect survivors physically and emotionally. You may have concerns
about your appearance, increased risk of infections, functional
limitations and pain. Talk with your doctor about any concerns you
Common symptoms of lymphedema include:
- Swelling of the arms, legs or trunk on the affected side of the body
- Feeling of heaviness or discomfort in an arm or leg
- Loss of flexibility in the hand, wrist, or ankle
- Difficulty fitting into your clothes
- Tightness of rings, watch or bracelet
- Infections that won't go away or keep coming back in the same area
- Feeling of tightness in the skin (this may be felt even before there is noticeable swelling)
- Pitting of the skin
Why does cancer and treatment sometimes cause lymphedema?
though other non-cancer conditions can cause lymphedema, it often
happens after a treatment that changes your lymph nodes and lymphatic
vessels. Lymphedema does not happen because treatment was not done
The lymphatic system can function at a higher level
when your body needs it to do so--but only for a brief period of time.
Once the lymphatic system fails to keep up with how much fluid your
body needs it to pump, it may not be able to move the fluid where it
needs to go in your body.
An infection can also cause damage to
the lymphatic system. It is very important to protect the body from
infection in order for the lymphatics to work as well as they can.
types of treatment may bring a greater risk for lymphedema. Talk with
your health care team about treatments whether there is a risk for you.
Ask what can be done to try to prevent this from happening.
Cancer-related procedures that may bring increased risks of developing lymphedema include:
A biopsy is when your tumor and surrounding tissue is removed for
testing. This may damage lymphatic pathways and may allow bacteria to
enter the body through the break in the skin. Damage to the lymph
pathway and infection both cause increased congestion. This can be a
first step in the development of lymphedema.
- Surgery: You may
have lymph nodes removed during surgeries for melanoma or breast,
gynecological, head and neck, prostate, testicular, bladder, colon or
other type of cancer. Lymph vessels may also be cut during the course
of surgery to remove tumors and surrounding tissue. This puts survivors
at risk of developing lymphedema.
- Radiation therapy: Radiation
kills cancer cells that might be left behind after surgery. Radiation
therapy often causes fibrosis or thickening of the tissues in the area
of your body that received radiation. The thickening of the tissue may
make it harder for lymph fluid to flow from your legs and arms into the
middle of your body.
Lymphedema can be managed with
effective treatment, but there is no cure. However, it is believed that
an early diagnosis and treatment of any temporary swelling can help
prevent chronic lymphedema from happening.
Who might be at most risk for lymphedema?
People who have had the following surgical procedures may be at greater risk for developing lymphedema:
Survivors of the following cancer types are at risk for developing lymphedema:
- Simple mastectomy
- Modified radical mastectomy with node dissection in the armpit
- Surgical removal of lymph nodes
- Traumatic injury
- Impaired lymphatic structure and function
- Surgery or biopsies that sample lymph nodes or disrupt lymph flow in the groin or axilla (armpit).
- Individual predisposition and basic conditioning factors yet to be fully understood
- Breast cancer
- Prostate cancer
- Ovarian cancer and other gynecological cancers
- Head and neck cancers
- Colorectal cancer
- Cancers involving lymph node sampling or dissection
- Radiation to the lymph nodes
factors can also put a survivor at risk for lymphedema. These include
being seriously overweight, having diabetes and taking certain
medications. However, there has not yet been a great deal of research
about how or whether these factors increase your risk for lymphedema.
Discuss these factors with your health care team, if they apply to you.
What can be done to minimize risks for developing lymphedema?
To decrease your risk of developing lymphedema, talk with your health
care team about treatment alternatives. Ask about strategies to
minimize your risk and learn about lymphatic therapy. Contact Melissa
Gallagher, Certified Lymphatic Therapist in St. Petersburg Fl. Contact Melissa for more informatio: 727-502-3464 or visit her website: http://www.healthybeingllc.com
Lymphedema Risk Reduction Practices â?? National Lymphedema Network http://www.lymphnet.org/pdfDocs/nlnriskreduction.pdf
SH. "Breast cancer lymphedema: pathophysiology and risk reduction
guidelines." Oncology Nursing Forum 29(9) (Oct. 2002): 1285-93.
National Lymphedema Network Position Papers online:http://www.lymphnet.org/lymphedemaFAQs/positionPapers