Lymphedema: A Common Complication of Cancer Treatment
Lymphedema is the buildup of fluid
in the fatty tissue just under your skin. The fluid is made up of lymph, which
is part of your immune system and helps fight infection and disease. It's
common for doctors to remove some lymph nodes during many different types
off cancer surgery to determine whether the cancer has spread. This removal,
while necessary, can sometimes make it more difficult for fluid to move throughout
the body. The fluid can build up, causing painful swelling, usually in the
arm or leg.
Lymphedema can be an inherited
condition, called primary lymphedema. In these cases, the lymph nodes and
lymph vessels are abnormal or absent. But in this article, we're talking about
secondary lymphoma, which is a result of damage to the lymph node.
Surgeries that require removal
of a lymph node create the risk of lymphedema. These can include surgeries
for breast, prostate, gynecological, head and neck, testicular, bladder and
colon cancer and melanoma. Radiation, which can damage lymph nodes, can cause
lymphedema as well.
Lymphedema sometimes occurs in
the very early days after surgery. This is usually a milder version, and typically
lasts a short time. The affected area may become warm and red, but generally
improves within about a week if you keep the area elevated and if you contract
the appropriate muscles. For example, if you develop lymphedema in your arm
just after surgery, your doctor may recommend that you keep your arm raised
and that you periodically make and release a fist.
Lymphedema also sometimes occurs
six to eight weeks after surgery or during radiation treatment. In a case
like this, you need to keep the area elevated and take anti-inflammatory medication.
The most common type of lymphedema
that cancer patients experience develops slowly. You may not notice it until
18 or 24 months after surgery or radiation, or even after that time frame.
Symptoms include skin discomfort and aching in the neck, shoulders, spine
or hips. The pain is caused by the stretching of the soft tissue due to swelling.
Additionally, the weight of the swollen limb can change your posture, which
can also cause pain.
Lymphedema can be temporary
When lymphedema is temporary, it
lasts less than six months. Your skin may remain pressed in when you push
on it, but it doesn't become hard. You'll need to keep your arm or leg elevated,
do gentle exercises and perhaps wear elastic garments that keep the area compressed.
Chronic lymphedema is more complicated,
more painful and harder to treat. As the body tissues continue to swell with
lymph fluid, the lymphatic system, which has been damaged, is unable to keep
up with the need to drain that fluid. Pain, heat, redness and swelling increase.
The skin becomes hard and stiff. Elevation, gentle exercise and elastic compression
typically no longer improve the condition. Chronic lymphedema increases the
risk of infection.
Know the early signs of lymphedema
Your recovery from lymphedema is
likely to be more successful and faster if you recognize and address the early
symptoms. These include:
" A tight feeling in the arm
" Rings or shoes becoming tight
" Weakness in the arm or leg
" Pain, aching or a heavy feeling in the arm or leg
" Redness or swelling
Prevention is extremely important
In addition to having surgery to
remove lymph nodes and having radiation treatment, there are other factors
that increase your risk of lymphedema. These include being overweight, eating
an unhealthy diet and not getting enough exercise. You're most likely to prevent
lymphedema if, after surgery and radiation, you follow instructions for your
care. Be sure to follow through on all prescribed exercises your doctor or
physical therapist recommend.
You can also help avoid lymphedema
by keeping all of your regularly scheduled medical appointments and by checking
your arms and legs every day for early symptoms
Be sure to read our August
2003 Cancer E-Magazine article, which talks about ways that dance and
movement therapy can be beneficial for lymphedema.