New laser therapy among treatment options for lymphedema
Lymphedema -- which causes swelling in the arms or legs -- can be a frustrating and chronic long-term side effect of cancer treatment.
What is lymphedema and why does it occur?
Lymphedema is an accumulation of fluid in tissue that causes swelling, most often in the arm(s) and/or leg(s), and occasionally in other parts of the body. Lymphedema can develop when lymphatic vessels are missing or impaired (primary), or when lymph vessels are damaged or lymph nodes removed (secondary). In people with cancer lymph node dissection and radiation both result in trauma to the lymphatic system.
With what types of cancers is this most commonly associated?
Breast, gynecological cancers (ovarian/uterine), prostate, colon, head and neck, and melanoma.
What are the signs?
Initially, someone might feel heaviness or achiness in the at risk body part. During the next stage firmness in the affected body part occurs. You might be able to push your thumb into your arm or leg, and the thumbprint remains. As swelling continues to develop a change in the limb size may occur and you may not be able to see the veins in the at risk areas.
What treatments are available?
People with lymphedema should see an occupational therapist or physical therapist for manual lymph drainage, a directional massage, deep breathing, stretching exercises, low level laser and pump use if indicated all of which can increase the rate of fluid return to improve tissue health. Bandages, compression garments, or night garments may be helpful for self-management.
If we're being honest, most of us don't remember our high school biology classes well enough to remember what the lymphatic system does. Can you give us a refresher?
Lymphedema is an accumulation of fluid in the tissue space that causes swelling, most often in the arm(s) and/or leg(s), and occasionally in other parts of the body. Lymphedema can develop for a variety of reasons.
When the impairment becomes so great that the fluid exceeds the transport ability, an abnormal amount of protein-rich fluid collects in the tissues of the affected area. Left untreated, this stagnant, protein-rich fluid reduces oxygen availability to the tissue, interferes with wound healing, and can result in infection.
Are some people at higher risk of developing lymphedema?
Anyone who has undergone lymph node dissection or radiation that has damaged the lymph nodes is at risk. People who are overweight, have thyroid disease or have diabetes at the time of their surgery are at greater risk. But we don't fully understand why one person may develop lymphedema immediately, while another person may develop it several years down the road and a third person may never develop it. We do think that inflammation may play a role in its development, so we caution patients to be careful to prevent any type of trauma to the body, particularly to the limb affected by treatment.
Information on Reducing Your Risk of Lymphedema
We urge patients who have had lymph node dissections and/or radiation to follow the risk reduction guidelines [pdf] issued by the National Lymphedema Network.