Lymphedema: Managing Challenges After Cancer Treatment

Tuesday, January 14, 2014 - 11:50am
Lymphedema Therapist, RPCI

Dealing with a cancer diagnosis, and all that comes with it, can be difficult. However, some patients afflicted with lymphedema after treatment may undertake a whole new set of challenges.

Lymphedema is an accumulation of protein-rich fluid, typically found in the arm or leg and usually resulting as a side effect of cancer treatment. If you’ve had surgery to remove lymph nodes, you may be at high risk of developing lymphedema. Certain chemotherapies, specifically tamoxifen, may also put you at risk. Multiple incidences of cellulitis can also be a risk factor.

The lymphatic system is the smallest vessel of the circulatory system. Think of it as a pipeline, like plumbing. If the flow is interrupted, water can’t travel through the pipes. In a similar way, when blocked, lymphatic fluid can’t flow through vessels. This blockage causes a backup, eventually resulting in the enlargement of an arm or a leg. We also see some head and neck cancers that trigger lymphedema in the neck or inside the mouth.

Lymphedema is typically found in breast cancer patients because of surgical removal of lymph nodes near the armpit/breast area, resulting in swelling of the arm. It’s estimated that between 17–30 percent of breast cancer patients who either have a mastectomy and/or radiation are at risk of developing this condition. The more nodes removed, the greater a patient’s risk of developing lymphedema. Fortunately, that number continues to decrease as sentinel node biopsies continue to become standard breast cancer treatment.

So, how is lymphedema treated? Unfortunately, lymphedema cannot be cured, but it can be managed. That’s where the RPCI Lymphedema Clinic comes in. The RPCI Lymphedema Clinic adheres to the gold standards of care developed in Germany over 30 years ago. We believe in high-intensity treatment over a shorter period of time. At our clinic, patients can expect to receive the following types of therapy:

  • Complete decongestive therapy: Also known as CDT, this therapy is a multifaceted treatment that includes manual lymphatic drainage, meticulous skin care, compression bandaging and physical therapy education for lifetime management.
  • Massage: Lymphatic vessels lie directly beneath the skin and this treatment, which involves very light stretching of the skin, helps move fluid along.
  • Compression sleeves/bandages: In many cases, patients are instructed to wear a sleeve or stocking over the affected area during the day and compression bandaging at night. Again, because lymphedema cannot be cured, these sleeves and bandages are typically worn on a full-time basis for the remainder of a patient’s life.

For more information, please view our web chat, "Managing Lymphedema." The chat explains why lymphedema occurs and provides management strategies. A Q&A session follows the presentation.