How to manage lymphedema when undergoing cancer treatments

Do know your risk

Lymphedema swelling, which often affects the arm or leg, is caused when extra lymph fluid builds up in tissues because lymph vessels are blocked, damaged, or removed by surgery. In addition to arms and legs, lymphedema can also affect the chest, breasts and genitals. While it more commonly affects breast cancer patients, it can affect patients who have endured radiation or surgery for virtually any type of cancer.

Whenever you undergo a procedure or therapy that puts you at risk, a lymphedema risk-reduction kit should be part of postsurgical care. The kit should include sunscreen samples, gloves (for skin protection), and informational booklets from the American Cancer Society, all with the intent of empowering patients to take proper steps to reduce their risk.

Do keep education first

An important step in lymphedema management is to begin education as soon as you are prescribed a treatment that might put you at risk. In advance of any treatment, ask your doctor if lymphedema might be a consideration for your specific situation.

Awareness about the early-warning signs of lymphedema and management can lead to better outcomes. The physical signs of lymphedema can be relatively easy to identify: swelling, pain in the affected areas, a loss of range of motion, and redness or changes to skin texture. You may also feel emotional and psychological symptoms.

Do see a certified lymphedema therapist

A certified lymphedema therapist, a professional specifically trained to care for patients with lymphedema, performs rehabilitation for lymphedema. Certification involves training in complete decongestive therapy, a combination of compression methods (including wraps or garments), exercise, and massage—all intended to reduce the swelling and the pain associated with lymphedema. Education on skin care to reduce the risk of infection and ways to avoid sun exposure (as sunburn can further tax the lymphatic system) are also included in the training.

Massage in lymphedema management involves what is known as “manual lymph drainage,” where the therapist uses hand strokes to encourage lymph fluid to flow out of the arm or leg. Compression is also applied to promote drainage—with compression garments, bandages wrapped around the affected limb and, sometimes, pneumatic compression (using a compression garment that is attached to a pump that applies pressure to the limb). The therapist can tell you when you should wear a regular compression garment.

Do use common sense

Use common sense when considering activities and consult your therapist before trying something new. A certified lymphedema therapist can help to determine which types of activities are appropriate.

Do not be afraid to ask

Doctors should make patients aware of the possibility of lymphedema if appropriate, but don’t be afraid to ask about your risk if you are preparing to undergo radiation or surgery. Awareness about the early-warning signs of lymphedema and management can lead to better outcomes. Far too often, patients say they wish they knew about the risk at diagnosis so that they could take preventive measures and understand the facts.

Do not wait!

Rehab should not be an afterthought. If patients have procedures that put them at risk of lymphedema, lymphedema specialists should be part of the recovery—even before lymphedema develops.

Do not ignore symptoms

If anything unusual or worrisome occurs, such as an increase in skin temperature or a change in skin color, contact your doctor immediately. Ask the specialist to help you learn about skin care—caring for cuts, scratches, and burns—and preventing infection.

Do not go it alone

Besides your healthcare team, friends, and family, there are a number of resources available for support. Consider checking out the National Lymphedema Network or look for support groups at local hospitals and organizations such as the Cancer Support Community.