Lymphedema

Lymphedema may occur when an abnormal level of protein-rich lymphatic fluid collects in the interstitial (connective) tissues, exceeding the lymphatic transport capacity. It causes swelling, usually in the arm(s) and/or leg(s), but occasionally in other parts of the body. Lymphedema can develop when lymphatic vessels are missing, impaired or damaged (primary), or when lymph nodes are removed (secondary).

Left untreated, the excess fluid causes tissue channels to increase in size and number. It also reduces the amount of oxygen in the transport system, interferes with wound healing, and provides an environment in which bacteria can grow, resulting in infection.

Lymphedema is not the same thing as edema (swelling), which can occur when the vein valves in the legs do not work properly (venous insufficiency). If swelling is left untreated, it can progress into a combined venous/lymphatic disorder, which is treated in the same way as lymphedema.

Secondary Lymphedema

Secondary, or acquired, lymphedema can develop after surgery, radiation therapy, an infection or trauma.

People who have surgery for melanoma, breast, gynecological, head, neck, prostate, testicular, bladder or colon cancer, all of which require lymph node removal, are at a higher risk for developing secondary lymphedema. The condition can develop immediately or over the course of weeks, months or years.

Prevent Lymphedema

Take Care of the Limb

• Avoid any constriction, like from a blood pressure cuff.
• Avoid extreme hot or cold temperatures (weather, bath water).
• Avoid standing, sitting or crossing your legs for long periods of time.
• Wear loose fitting clothing, socks, shoes and jewelry.
• Wear well-fitting compression garments during intense exercise and air travel.

Increase Activity

• Maintain an ideal weight.
• Monitor the limb during and after activity for any change in size, shape, tissue, texture, soreness, heaviness or firmness.
• Rest the affected limb often during activity.

Take Care of Skin

• Apply moisturizer daily. To help with circulation, rub it in using motion toward your heart, not away from it.
• Avoid injections, blood draws and other skin punctures on the affected limb.
• Keep the limb clean and dry.
• Pay attention to fingernails; do not cut cuticles.
• Use razors carefully to avoid nicks and skin irritation.
• Wash skin punctures and scratches with soap and water, apply antibiotics, and observe them for signs of infection (like redness).
• Wear gloves while doing activities that may cause skin injury.
• Wear sunscreen and insect repellent.

When to Call the Doctor

Call the doctor or nurse if any of the follow symptoms occur:

• Fever of 100.5°F or higher or flu-like symptoms
• Rash
• Itching
• Redness
• Pain
• Increased skin temperature
• Limb feels heavier or cooler, even if no one else notices

These may be the first signs of lymphedema. The earlier it is diagnosed and treated, the better the outcome.

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