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Preventing and treating lymphedema

Lymphedema is the swelling of the arms and legs that occurs when the lymph nodes are damaged or removed, which can occur during cancer treatment.

When the lymph nodes are damaged or removed, your lymphatic system (part of your immune system) can become blocked. If the lymphatic system is blocked, lymph fluid is unable to drain, which leads to swelling in the limbs.

While there is no cure for lymphedema, there are several ways you and your care team can manage it to reduce symptoms.

"In old days, we tried to just to get the swelling down as far as we could, but now because we catch it so early, it can be minimized or even resolved," says Gwen Forbes-Kirby, PT, CLT-LANA, a certified lymphedema therapist at Piedmont Atlanta Hospital. "If a person is diagnosed with lymphedema before they experience significant swelling, it's really just a matter of using self-care skills to prevent further symptoms and to address their specific risk factors."

Lymphedema symptoms and risk factors 

Catching lymphedema early is crucial.

"Anyone at risk should monitor themselves," says Forbes-Kirby. "The earlier it's addressed, the better the outcome."

Signs of the condition, which can occur in the arms, legs, and in some cases just the fingers, include:

  • A feeling of relief when the limb is elevated (early symptom)

  • A change in sensation in the limb

  • Decreased range of motion

  • Discomfort

  • Heaviness

  • Tightness

  • Visible swelling

Lymphedema can occur months or even years after cancer treatment. Contact your doctor if you experience any swelling in your limbs after cancer treatment.

Lymphedema risk factors include:

  • Decreased range of motion/poor mobility

  • Genetics

  • History of post-operative infection

  • Obesity

  • Removal of lymph nodes

Injury, illness and infection can also trigger lymphedema symptoms because the immune system releases lymphatic fluid to aid the healing process. With difficulty draining, the excess fluid can lead to swelling.

Lymphedema treatment

Forbes-Kirby says there are five components to successfully managing lymphedema:

  • Compression therapy. Lymphedema therapists use special bandages to reduce swelling in the hours and days after manual lymph drainage. After the reduction phase is complete, your therapist will recommend compression garments to keep the fluid from building up again. "If we catch lymphedema early enough, we can have patients skip the reduction phase and begin wearing compression garments immediately," she adds.

  • Education. "The well-informed warrior fights best," she says. Your certified lymphedema therapist can provide screening and helpful information on ways to manage or monitor the condition. She urges caution when researching lymphedema online: "There's a lot of misinformation on the web."

  • Exercise. In the past, people with lymphedema were told not to exercise, says Forbes-Kirby. "Now we encourage at least 150 minutes of moderate to intense exercise per week," she says. "Exercise moves the whole circulation system and can help with weight loss, an important part of managing lymphedema. We also know that exercise decreases the risk for certain types of recurrent cancers." Your therapist can help you determine which exercises are best for your needs.

  • Manual lymph drainage. This involves special massage techniques performed by a lymphedema therapist to encourage lymph fluid drainage. Your therapist can teach you how to perform manual lymph drainage on yourself at home as well.

  • Skin care. It is important to keep your skin moisturized if you have lymphedema. "When your skin is dry and tight, it is more apt to cut or tear, which can allow bacteria in, putting you at risk for an infection," explains Forbes-Kirby. "When you're out in yard, wear gloves to minimize your risk of getting cut or poked."

If you experience swelling in your limbs even just in one or two fingers and have had cancer treatment that involved lymph node removal, talk to your doctor immediately. He or she can refer you to a certified lymphedema therapist for treatment. The sooner you are treated, the less likely you are to experience significant, long-term swelling.

See more wellness tips for your cancer treatment journey.

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