Lymphedema - MD Anderson Cancer Center

Cutaneous B-Cell Lymphoma and Lymphedema, Cutaneous T-cell lymphoma and Lymphedema, Hodgkins Lymphoma, Kidney and Renal Cancer, Cervical Cancer, Renal Cell Carcinoma, Breast Cancer, Ovarian Cancer, Testicular, arm swelling, Skin Cancer, angiosarcoma, kaposi's sarcoma, gallium scan, axillary node dissection, gynecological cancer, axillary reverse mapping, lymphatic cancers, inguinal node dissection, cancer treatment, Complete decongestive therapy for arm lymphedema, lymphedema therapy, intensive decongestive physiotherapy, breast cancer related lymphedema, upper limb lymphedema

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Lymphedema - MD Anderson Cancer Center

Postby patoco » Sat Jun 24, 2006 1:34 pm

Thought this page was interesting as it actually is one of the very very few cancers centers that I've seen list lymphedema and the possible causes as they have.


Lymphedema - MD Anderson Cancer Center

For some women with breast cancer, successful surgery doesn’t always mean the end of their health problems. Lymphedema—a chronic fluid buildup in the arm after removal of lymph nodes in a mastectomy or lumpectomy—can be a lifelong battle. "Breast cancer patients over the age of 55 have a 22% chance of getting lymphedema after surgery," says Jan Scheetz, PT, supervisor of outpatient physical therapy in M. D. Anderson’s Rehabilitation Services Center. "Women under 55 still have a 14% chance of suffering from this condition."

Lymph nodes are pinhead- to olive-sized vessels throughout the body that work in concert with the venous (vein) system to remove impurities from the blood. Veins carry out 90% of the waste materials in blood, while the lymphatic system handles the other 10%. "When lymph nodes are removed in cancer surgery, your body’s ability to handle these waste proteins is compromised, and it begins to build up in the tissues under your skin," says Scheetz. "Soon, the lymphatic system is overwhelmed and can no longer move the fluid out on its own."

Obviously, the most common risk factor for lymphedema is the removal of lymph nodes. Others include:

Radiation therapy
Chemotherapy, particularly Taxol® and Taxotere®
Age: older women are more likely to get lymphedema
Weight: obese women or those who gain weight after surgery are at higher risk
Post-surgery complications, including delayed wound healing, wound separation and infections in the arm or chest wall
Repeated exposure to extreme heat (over 100 degrees) from hot showers, saunas or living in a warm climate
Airplane travel
Long road trips in a car or bus
Trauma to the affected limb, such as bruising or a broken bone
Repetitive activity to the point of fatigue
Activities that cause sustained pain after activity ends

Some patients may never get lymphedema, even with one or more of the above risk factors. It’s not just a woman’s disease, either. Up to 70% of men who have had lymph nodes removed for prostate cancer get lymphedema in their legs. Although onset typically occurs within two years after surgery, some people can get it several years or even decades later. "In my 27 years of experience, I had a patient who got lymphedema 40 years after surgery," says Scheetz.

If not managed in a consistent and timely manner, lymphedema can cause permanent changes in the tissue. "Timing is crucial," Scheetz says. "The best chances for reversing the effects of lymphedema are within six to eight weeks after the onset of symptoms. After that time, the affected limb becomes firm and hard, and the fluid takes on the consistency of honey."

There are ways to lessen the effects of lymphedema. The key is to stimulate movement of built-up fluid away from the affected area. Strict observance of limb care guidelines is the best place to start. "You need to follow your physical therapist’s instructions to the letter," says Scheetz. "That means using your compression sleeve, wrapping your limb at night and massaging the area as directed." Stretching exercises and low-impact aerobics such as swimming, stationary biking, walking and light weightlifting can help, as long as you don’t overexert yourself or get overheated. Staying hydrated is also very important. "You can’t drink too much water with lymphedema," Scheetz says.

Although lymphedema may be inevitable for some cancer patients, the power to control it is largely in your hands. "Even though it’s a chronic condition, I’ve seen many people reverse the symptoms by being compulsive about following their care guidelines."

Symptoms of Lymphedema

Tingling sensation
Feeling of heaviness

Check your body every day for signs of change. Make a fist. Look for a lack of definition between your knuckles and at the elbow, the loss of natural wrinkles at your wrist, and any puffiness. Daily inspections increase the chances of detecting lymphedema symptoms.

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