This is the condition that is most threatening to your health and function following treatment for cancer. The American Cancer Society (ACS) states that the incidence of lymphedema is as follows:
Mild lymphedema, may be considered as only a minor nuisance resulting in cosmetic differences, or difficulty with clothing and jewelry. Moderate to severe lymphedema can result in significant losses in range of motion, functional ability, and overall health. In any case, your risk for infection is significantly increased.
What is lymphedema?
Lymphedema is a swelling in some area of the body, usually an arm or a leg. resulting from an abnormal accumulation of lymph fluid.
Lymph fluid is a transparent fluid composed of proteins, fats, water, and cells. It is collected from body tissues and is normally removed by the lymphatic system. This system runs throughout the body, delivering the lymph fluid to lymph nodes located in central areas of the body (armpits, groin, neck, and deep in the abdominal area). The nodes will produce lymphocytes, agents used to destroy any infection that may be present (this is why you will experience swelling in the areas of the lymph nodes if you have any infection or are ill). The lymph nodes finally deposit the lymph fluid into the circulatory system where it is either utilized or eliminated in the urine.
In the case of lymphedema, the body’s ability to circulate the lymph fluid is compromised. This is usually the result of lymph nodes being removed, causing a “back-up” of lymph fluid in the lymph vessels that deposit into that area. This causes a continual cycle of increased swelling as more lymph fluid is produced in the lymph vessels, without a way to transport it out. Also, if the lymph nodes have been removed, lymphocytes are never produced and the risk for infection increases.
If the lymphatic system has been sufficiently compromised by significant swelling, it may never return to its previous state, requiring life-long care. This is why lymphedema is considered a chronic condition.
Causes of Lymphedema
Lymphedema is classified as either primary or secondary.
You are HIGHLY susceptible to infections in your arm or leg if you have had lymph nodes removed. This risk increases even more if you are already experiencing lymphedema.
To decrease the risk of infection, meticulous hygiene must become part of your daily routine. Maintain a skin environment that will better fight infection by performing the following:
Your skin is your “barrier of defense” against infection. It has a low pH level (5.9 pH) which is acidic, thereby helping kill off bacteria. As a continued adjunct to proper skin care and to further reduce the risk for infection caused by bacteria, you must use lotions that not only decrease the chances of rough, cracked skin, but they must also have a low pH level (5.0 to 6.9 pH level). Lotions that are alkaline/basic (greater than 7.0 pH) not only decrease the effectiveness of fighting off infection, but actually provide a healthier environment for bacteria to grow. Also, because they act against your skin’s natural acidic pH, you will need to apply them more often.
Low pH or “acidic” lotions:
High pH or “alkaline” lotions:
***If you are unsure if your favorite lotion is acidic or alkaline, check to see if there is an address or 800 number located on the bottle. They can usually get back to you in a few days with the information. Tip: If you find you are reapplying your lotion frequently throughout the day, then your lotion is most likely high pH/alkaline.
No matter what the cause, lymphedema can lead to not only decreased range of motion, decreased function, and (in the case of significant swelling) discomfort/pain, but it can become life-threatening if not properly cared for. As with any condition, the best way to treat it is to try to prevent it from occurring in the first place.
If you’ve been treated with lymph node surgery or radiation for cancer of the breast, prostate, bladder, colon, or elsewhere, keep a constant watch for lymphedema. Secondary lymphedema can develop immediately following surgery, or up to 20 years later.
To prevent the onset of this condition, at-risk individuals should avoid the following:
Although frequently recommended to be avoided if you already have lymphedema, traveling by plane is often the only option available to business people, vacationers, in cases of family emergencies, etc.
By following the guidelines below, you can safely fly with minimal discomfort and decrease the chance of aggravating your condition.
If You are Diagnosed with Lymphedema…
Relax and don’t panic: Lymphedema is a treatable condition and medical awareness of how the lymphatic system functions grows daily with continued research.
Seek out a qualified therapist who specializes in treating lymphedema: The specialist should be local as it may be uncomfortable and even unhealthy for you to travel long distances. Make sure the therapist has received specialized training in lymphatic management techniques as traditional schooling does not include instruction in this complex method. Also, check with your insurance company regarding coverage for treatment, as many will only pay for treatment administered by a certified therapist.
The earlier treatment is begun, the better and quicker the results: If left untreated, lymphedema results in hardening (fibrosis) of tissue, which harbors bacteria that can lead to skin breakdown, loss of limb function, chronic infections, and even lymphatic cancer. Monthly measurements, as instructed by your therapist, will help you monitor whether treatment should be initiated as minor increases in sizes of the arm may not be noticeable to the eye.
Keep a constant watch for the following:
***If any of these exist, halt your treatment and contact your physician immediately.
Treatment for Lymphedema
Complete Decongestive Therapy (CDT) is the most effective method to lessen or remove the symptoms of lymphedema. Practiced in Europe for decades, CDT is just now beginning to make an appearance as a treatment option in the United States. In order to insure that treatment is performed safely and effectively, certification in this method is becoming the standard and is often required by insurance companies before payment for services is accepted.
CDT is composed of four elements:
If all of the components of CDT are used, during both the intensive treatment phase and the maintenance phase, the limb can be returned to a normal or near-normal shape and function, depending on the severity of the lymphedema. As this is a chronic condition, you may need to receive continued treatment for flare-ups on a yearly basis. This is why continued measurements, skin care, bandaging, garment wear, and adherence to exercise instruction are important in maintaining a reduction in lymphedema.
***The information in this packet is compiled from information provided in part by the National Lymphedema Network, the Lymphedema Therapy Center, The Vascular Surgery and Diagnostic Center, and the American Cancer Society. Supporting information provided by Linda Fike-Looser, Physical Therapist and Certified Lymphedema Therapist – Lymphology Association of North America (CLT-LANA).
National Lymphedema Network
The Susan G. Komen Breast Cancer Foundation
Linda Looser, PT, CLT-LANA
This information brought to you by…
New Horizons Physical Therapy
(406) 363-2570 Fax (406) 363-7214
120 S. Fifth Street, Suite 102
Hamilton, MT 59840