By Amy Pontzloff, MOT, OTR/L, Certified Lymphedema Therapist, Massage Therapist and Skin Care Specialist. Owner of Lymphatic Face & Body Therapy
What is Lymphedema?
Lymphedema is the swelling of one or more parts of the body, usually an arm or a leg. It can also occur in the abdominal area, face or genitals. Arm and hand lymphedema tend to be the most common after breast cancer, but it can occur in any areas where lymph vessels or nodes were removed or damaged. The swelling is an accumulation of high protein fluid just beneath the skin. If left untreated it can pose a health risk for worsening conditions including changes in the appearance of the limb and skin, infections/wounds or loss of function. It is a chronic, lifelong condition that can be treated and managed.
Although breast cancer treatment is the most common cause of secondary lymphedema in developed countries, it can also be the result of burns, trauma, venous disease, parasites or immobility. Lymphedema can occur in breast cancer patients who have had all or part of their breast removed or axillary lymph nodes removed. Lymphedema can also occur in the legs after surgery or radiation for ovarian cancer. Generally, lymphedema is mostly likely to happen within 1-5 years after treatment, although the risk never entirely goes away.
Risk factors include the following:
- Removal and/or radiation of lymph nodes in the underarm, groin, pelvis or neck. The risk of lymphedema increases with the number of lymph nodes affected. There is less risk with the removal of only the sentinel lymph node
- Being overweight or obese
- A tumor that affects or blocks the lymph nodes or vessels
- Scar tissue from surgery or radiation in the lymph ducts near the collar bones or in the axillary region
What are signs & symptoms?
- Swelling of an arm or leg, which may include fingers or toes
- A fullness or heavy feeling in an arm, chest, breast, underarm, hand or leg
- A feeling of tightness in the skin
- Changes in the texture of skin or appearance, such as hardening or redness
- A feeling of tightness in clothing, shoes, jewelry
- A burning or itching sensation in the legs or toes, shooting pain sensations or “pins and needles”
- Decreased flexibility in joints such as the shoulder, wrist or hand
How can I reduce my risk?
In the months and years following your surgery or radiation, you can lower your risk for developing lymphedema by following a few general guidelines:
- Maintain an Optimal Weight~lose weight if needed: Obesity is a high risk factor for lymphedema. Eat a low sodium, high fiber, fresh food balanced diet. Drink plenty of water and avoid smoking and keep alcohol to a minimum.
- Protect Your Skin: Take care of the skin on the limb and side of your body that was treated for cancer. If a trauma happens or bacteria gets into the skin, your lymphatic system may get overloaded. Use a UVA/UVB physical blocker SPF 30 daily and reapply every 2 hours if outdoors in direct sun to prevent a sunburn. Try to avoid any cuts, burns, or bug bites. Try to avoid getting blood draws or needle punctures (including acupuncture) in the affected arm. Apply moisturizer daily to prevent drying/cracking of the skin.
- Protect the Limb from Extremes: Avoid excessive pressure on the limb such as blood pressure cuffs or tight/restrictive clothing. Avoid overuse or heaving lifting including heavy shoulder purses. Exercises such as push ups or downward dog in yoga can put excessive pressure on the arm. Avoid extreme temperatures of hot or cold which can cause more swelling.
- Lower Extremity Risk Reduction: Avoid prolonged standing, sitting or crossing legs. Avoid restrictive clothing and wearing improper, tight fitting shoes.
Be mindful of your health and if you have any concerns, always see your physician right away.
Dr. Vodder’s Manual Lymph Drainage, Wittlinger, H. 2011.
National Lymphedema Network, www.lymphnet.org