Tips for Preventing Secondary Lymphedema
If you have had ]]>radiation]]> treatments, surgical removal of some lymph nodes, or an infection or trauma to your lymphatic ducts or veins, you need to know how to reduce your risk of ]]>lymphedema]]>. Lymphedema is an accumulation of lymphatic fluid in tissue that causes swelling. (Lymphatic fluid is a clear fluid carried through the lymph system in the body to lymph nodes, which filter out bacteria and other debris). If left untreated, lymphedema can interfere with the healing of wounds and cause an infection called lymphangitis.
There are two types of lymphedema—primary and secondary. Primary lymphedema can develop when lymphatic vessels are missing or impaired. Secondary lymphedema can develop when lymphatic vessels are damaged as a result of radiation, infection, trauma, or surgical removal.
Signs and Symptoms to Watch For
Secondary lymphedema occurs most often in the arms and legs, and sometimes in other parts of the body. It may occur immediately after surgery, or weeks, months, even years later. Symptoms to watch for include:
- Feelings of tightness in your arm or leg
- Rings, bracelets, wristwatches or shoes that become tight
- Decreased flexibility in your hand, wrist, or ankle
- Weakness, pain, aching, or heaviness in your arm or leg
- Redness, swelling, or signs of infection
If you notice persistent swelling, seek medical care right away.
Factors That Can Increase Your Risk
You may be at increased risk for lymphedema if you have:
- ]]>Breast cancer]]> and have received radiation therapy or had lymph nodes removed
- Surgical removal of lymph nodes in the underarm, groin, or pelvic regions
- Radiation therapy to the underarm, groin, pelvic, or neck regions
- Scar tissue in the lymphatic ducts or veins under the collarbones caused by surgery or radiation therapy
- Cancer that has spread to the lymph nodes in your neck, chest, underarm, pelvis, or abdomen
- Tumors growing in your pelvis or abdomen that involve or put pressure on the lymphatic vessels and/or the large lymphatic duct in the chest (This can block lymph drainage.)
- An inadequate diet or overweight
Ways to Reduce Your Risk
If you are at risk for lymphedema, you may be able to prevent its occurrence with the following tips from the Abramson Cancer Center at the University of Pennsylvania:
- Keep the affected area clean.
- Use moisturizing soaps and lotions.
- If you must shave the affected area, use an electric razor instead of a blade.
- Use sunscreen with a minimum SPF 15.
- Prevent insect bites by wearing insect repellent.
- When resting, elevate the affected extremity so that gravity can help move the lymph fluid.
- When traveling by plane, wear a compression stocking on the affected extremity.
- Avoid having injections, vaccinations, blood draws, and blood pressure measurements on the affected extremity.
- Maintain your ideal body weight.
- Do not take hot showers or use saunas and steam rooms.
- Do not ]]>smoke]]> or ]]>drink excessively]]>.
If you had lymph nodes in your armpit removed during breast cancer surgery, participating in a physical therapy program may help to prevent lymphedema.
When Your Arm Is Affected
- Do not wear a wristwatch or jewelry on the affected arm.
- Do not carry heavy objects with the affected arm.
- Use the unaffected side for carrying heavy shoulder bags.
- Avoid getting a manicure on the affected side.
- Wear rubber gloves when cleaning dishes.
- Use protective gloves when working outside.
When Your Leg Is Affected
- Do not go barefoot inside or outside.
- Wear comfortable shoes.
- Wear very sturdy shoes or work boots to protect your feet when working outside.
- Have a podiatrist cut your toenails.
- Avoid getting a pedicure on the affected side.
If you have had surgery and radiation therapy to the lymph node region, be sure to talk to your doctor about additional ways to reduce your risk of lymphedema.
National Cancer Institute
National Lymphedema Network
Lymphedema Association of Quebec
Abramson Cancer Center. University of Pennsylvania website. Available at: http://penncancer.org/. Accessed May 5, 2009.
Lymphedema. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/patient. Accessed May 5, 2009.
1/22/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010;340:b5396.
Last reviewed January 2009 by ]]> Rosalyn Carson-DeWitt, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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