Lymphedema happens when the lymph system is damaged or blocked, which can be a result of cancer treatment. During cancer surgery, lymph nodes are removed and/or radiated, and the flow of lymph fluid is impaired.
Lymphedema symptoms may appear years after treatment, or they may appear very slowly. Sometimes it is a swollen arm or leg, and sometimes a swelling of the face (depending on the site of the cancer). Left untreated, lymphedema will increase in volume, and fibrosis or thickening of the tissues can occur. The skin also changes from spongy to hard.
Lymphedema often occurs after mastectomy, when the axillary lymph nodes are removed, and on the legs after surgery for uterine cancer, prostate cancer, lymphoma, melanoma, vulvar or ovarian cancer.
The best evidence available indicates that exercise and weight management help in risk reduction. Some of the ways to treat lymphedema are physiotherapy or exercise to help the fluid move, manual lymphedema drainage applied by a specialist, compression garments or bandages, laser therapy, and other treatments. It is crucial to care for your skin and prevent infections. It is important to avoid heat and cold, keep the skin hydrated and clean, avoid scratches or insect bites, and to not put pressure on the limb affected. Mild exercise increases muscle tone, may increase fluid mobility from the affected limb, and helps maintain a healthy body weight.
Lymphedema is classified according to a scale from mild to severe:
- Stage 0. There is damage to the lymph system but there is no swelling yet. This stage might last for months or even years.
- Stage I. When pressed, the skin indents, but there is no evidence of scarring.
- Stage II. There no indentation on the skin when pressed, and there is moderate to severe scarring.
- Stage III. The skin hardens and there is much swelling of the limb that doesn’t go away. The texture of the skin changes and there is fibrosis or thickening.
It is important to avoid strenuous exercises such as running, aerobics or ball games. Take care of your skin to limit entry points for germs or infection by using a pH balanced skin moisturizer and insect repellant when outdoors. Clean and apply antibiotic cream to any cuts, scratches or grazes right away. Keep your nails and cuticles clean and cared for and protect your hands and arms when you garden or take something hot from the oven. Use high factor sunscreen and avoid sunburn. If you need to have an injection, blood work done or your blood pressure checked, inform the healthcare provider that you are at risk for lymphedema. It also helps to maintain a healthy weight and practice deep breathing and moderate exercise, ideally every day, to help get your heart rate up, blood pumping and lymph flowing.