Cancer-Related Lymphedema


Lymphedema is a buildup of clear lymphatic
fluid under the skin which causes swelling. The location and amount of swelling is different
for each person. It is most often seen in one, or both of your
arms or legs. This swelling can also be found in the breast,
head, neck or genitals. Lymphedema can happen to both men and women. There is no cure for this problem. However, with early diagnosis, treatment and
ongoing care, lymphedema can be managed to help reduce the swelling and pain. To understand lymphedema, it is important
to know how your lymphatic system works. Your body has a large system of lymph vessels,
lymph nodes and lymphatic tissue. The lymph vessels work to move lymphatic fluid
throughout your body. Lymphatic fluid carries white blood cells
that help fight infection. Lymph nodes act as “filtering stations”
to help your body’s natural defense system fight off bacteria and viruses. The lymphatic system is an important part
of your body’s immune system. If any part of the lymphatic system is damaged,
or missing, the lymphatic fluid can start to collect in the tissue in a part of your
body and cause swelling. This swelling can cause this tissue in your
body to harden. If extra fluid stays in your body tissue,
it can make it difficult for oxygen and other important nutrients to get to the area. As a result, there is a higher risk of infection
in the swollen tissue, and it may be harder for a wound in this area to heal. There are different types of lymphedema. The most common type happens because of some
type of damage to the lymphatic system. This can be due to trauma, injury, cancer,
surgery, radiation therapy, infection or being overweight. In many cases, cancer or cancer treatment
is the cause. For example, surgery to remove a tumor can
result in the removal or damage of lymph nodes or lymph vessels. The more lymph nodes affected, the higher
your chance of having lymphedema symptoms. Radiation therapies, used to destroy cancer
cells, can also injure healthy parts of the lymphatic system in the area where radiation
is given. In some cases, the cancer tumor itself may
cause the damage to your lymphatic system. Symptoms of lymphedema are different for each
person. These symptoms show up most often within the
first 2 to 3 years following treatment. Lymphedema can often develop very slowly. Early symptoms of lymphedema may include a
feeling of heaviness or tightness, aching or fatigue in an arm, leg or other part of
your body. Swelling may or may not be present at this
time. Tell your doctor as soon as possible if you
have any of these symptoms. Treatment may help to slow, prevent or even
reverse lymphedema at this early stage. If lymphedema gets worse, you may see a hand,
foot or other part of your body begin to look swollen. You may have jewelry that feels tight or see
a change in the way your shoes or clothing fit. This swelling may increase and become more
uncomfortable. The skin in the swollen part of your body
may feel tight. If the swelling is near a joint in your body,
such as an elbow or knee, it may become harder to bend and move this body part. Often the swelling is less in the morning–after
you have been lying down through the night–and becomes worse during the day when you are
up. Some people with lymphedema have a tingling
feeling, like pins and needles …or may have an ache in this area. If lymphedema increases, the swollen body
tissue may start to feel spongy and leave an indent when you push on the skin. Sometimes the skin in this area becomes thick
or hardened. The skin may also become shiny and may not
grow hair. Blisters or small growths may appear on this
part of your body. – Treatment for lymphedema is focused on making
your symptoms better or to keep them from getting worse. Treatments are often provided in a clinic
setting. Your doctor, nurse or physical therapist can
help you find the right treatments for you. They will also teach you how to manage this
problem at home. – Ask your doctor if it would be helpful for
you to see a health care professional with special training in lymphedema, such as a
certified lymphedema therapist. The James Cancer Hospital in Columbus Ohio
has a team of health care professionals and lymphedema therapists who can check your lymphedema
and develop a treatment plan to meet your needs. You will be taught how to care for your skin
in the area where you have lymphedema, or areas at risk for developing this problem. The goal is to keep the skin healthy and free
of infection. Infection or injury can make lymphedema worse
and lead to even more tissue damage. Infection in the area affected by lymphedema
can be hard to treat and may put you at risk of becoming very ill. Good care of your skin should include:
– Keeping your skin clean. – Skin that is dry and cracked can be an entry
point for infection. Put lotion on each day to prevent dry, chapped
skin. Choose a lotion with a low pH that is free
of perfumes and dyes. Use an amount that quickly soaks into the
skin, especially if used on your feet. Lotion not rubbed completely into the feet
might cause you to slip and fall. – As directed, use sunscreen with an SPF of
30 or above and insect repellent when you are outside. To lower your chance of infection, you should
also take actions to prevent cuts, scratches or injuries to the skin. – It is important to protect your skin from
bug bites that can cause infection and irritation to the area. Travel to certain areas of the world may increase
your risk of infection from certain parasites through bug bites. – Keep your pet’s nails trimmed. This can help keep you from being scratched. – If you shave, use an electric razor to lower
your chance of cutting the skin. – If you see a cut or change in your skin,
watch it closely and treat it right away, as directed by your doctor. – Each day, check your body for changes or
breaks in the skin. Use a mirror for areas that may be hard to
see, like the bottom of your feet. Look for signs of infection that may include
redness, pus, rash, red blotches, swelling, tenderness, chills, fever or areas that are
warm to touch. – When working outside, wear long sleeves,
pants, and shoes with a closed toe and closed heel. – Keep your nails short but be careful when
you clip them. If you have a manicure or pedicure, do not
have the cuticles cut to reduce the risk of infection. If your arm is affected by lymphedema make
sure you: – Wear heavy gloves when using chemicals,
doing outside work or gardening. Use a thimble when sewing. If your leg is affected by lymphedema you
will also need to: – Keep your feet clean and wear clean socks
every day. Do not go barefoot, especially outside. Your doctor may suggest you use an anti-fungal
foot powder to prevent Athlete’s feet. – Make sure your shoes fit properly and do
not wear tight knee-high socks or panty hose. Call your doctor right away if you seriously
injure the part of your body affected by lymphedema, or see any signs of infection. – Lymphedema is a lifelong condition. It is important to know how to take proper
care of yourself. Your health care team will encourage regular
exercise, good nutrition and hydration. – Other ways to help with lymphedema include:
– Wear clothes, shoes and jewelry that do not rub or irritate your skin. – Do not lift heavy items with your affected
arm. This includes not carrying bags or heavy objects
with shoulder straps on this arm. – When possible, do not have your blood pressure,
shots, blood draws or IVs put in your affected arm. – You may find it helpful to wear a medical
alert necklace or bracelet, to let health care workers know about this problem. – When traveling, try to keep your muscles
active by doing ankle pumps and squeezing a ball in your hand. Limit your use of salt. – Do not stand or sit for long periods. Do not cross your legs while sitting. – Ask your doctor how to treat cuts, scratches,
bug bites or other small injuries if they happen to the part of your body with lymphedema. – Lymphedema may cause changes in how you
look. This may affect how you feel about your body
and sexuality. When needed, reach out to those who give you
support and ask for help. Professional counseling or a support group
may also be helpful. It is important to call the doctor right away
if you have: – … changes in the size, color or temperature
in the area of your body with lymphedema. – Let your doctor know about any cuts, rashes
or changes in feeling in this area. – Call if you have less flexibility or are
unable to move or bend your affected arm or leg or…
– …see any signs of infection, including increased redness, pain, swelling, blistering,
skin that is warm to touch, or a fever of 100.4 degrees Fahrenheit or higher. – Tell your doctor if you have increased redness
or drainage from an existing wound or… – … any new symptoms in an area with lymphedema. We hope this information has helped you better
understand the importance of self-care for your lymphedema. Write down any questions you might have for
your health care team and bring them with you to each appointment. We are honored to care for you during your
cancer treatment. Thank you for choosing The James.

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