Lymphedema refers to swelling that generally occurs in one of your arms or legs. Sometimes both arms or both legs swell.
Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling.
While there is presently no cure for lymphedema, it can be managed with early diagnosis and diligent care of your affected limb.
Lymphedema signs and symptoms, which occur in your affected arm or leg, include:
The swelling caused by lymphedema ranges from mild, hardly noticeable changes in the size of your arm or leg to extreme changes that make the limb hard to use. Lymphedema caused by cancer treatment may not occur until months or years after treatment.
Make an appointment with your doctor if you notice persistent swelling in your arm or leg.
If you already have the diagnosis of lymphedema of a limb, see your doctor if there is a sudden dramatic increase in the size of the involved limb, as it may suggest a new process is occurring.
Your body's lymphatic system is part of your immune system, which protects you against infection and disease. The lymphatic system includes your spleen, thymus, lymph nodes and lymph channels, as well as your tonsils and adenoids.
Lymphedema is swelling in an arm or a leg. In rare circumstances it affects both arms or both legs. It can also affect the chest wall and abdomen on occasion.
Your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste products. Your lymphatic system carries this fluid and harmful substances through your lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes — infection-fighting cells that live in your lymph nodes — and ultimately flushed from your body.
Lymphedema occurs when your lymph vessels are unable to adequately drain lymph fluid, usually from an arm or leg. Lymphedema can be either primary or secondary. This means it can occur on its own (primary lymphedema), or it can be caused by another disease or condition (secondary lymphedema). Secondary lymphedema is far more common than primary lymphedema.
Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema. Causes include:
Primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in your body. Specific causes of primary lymphedema include:
Factors that may increase your risk of developing lymphedema after cancer, from cancer treatment or from other secondary causes include:
Lymphedema in your arm or leg can lead to serious complications, such as:
If you have had or you are going to have cancer surgery, ask your doctor whether your procedure will involve your lymph nodes or lymph vessels. Ask if your radiation treatment will be aimed at lymph nodes, so you'll be aware of the possible risks.
To reduce your risk of lymphedema, try to:
If you're at risk of lymphedema — for instance, if you've recently had cancer surgery involving your lymph nodes — your doctor may diagnose lymphedema based on your signs and symptoms.
If the cause of your lymphedema isn't as obvious, your doctor may order imaging tests to get a look at your lymph system. Tests may include:
There's no cure for lymphedema. Treatment focuses on reducing the swelling and controlling the pain. Lymphedema treatments include:
Exercises. Light exercises in which you move your affected limb may encourage lymph fluid drainage and help prepare you for everyday tasks, such as carrying groceries. Exercises shouldn't be strenuous or tire you but should focus on gentle contraction of the muscles in your arm or leg. A certified lymphedema therapist can teach you exercises that may help.
Wrapping your arm or leg. Bandaging your entire limb encourages lymph fluid to flow back toward the trunk of your body. The bandage should be tightest around your fingers or toes and loosen as it moves up your arm or leg. A lymphedema therapist can show you how to wrap your limb.
Massage. A special massage technique called manual lymph drainage may encourage the flow of lymph fluid out of your arm or leg. And various massage treatments may benefit people with active cancer. Be sure to work with someone specially trained in these techniques.
Massage isn't for everyone. Avoid massage if you have a skin infection, blood clots or active disease in the involved lymph drainage areas.
Pneumatic compression. A sleeve worn over your affected arm or leg connects to a pump that intermittently inflates the sleeve, putting pressure on your limb and moving lymph fluid away from your fingers or toes.
Compression garments. Long sleeves or stockings made to compress your arm or leg encourage the flow of the lymph fluid out of your affected limb. Wear a compression garment when exercising the affected limb.
Obtain a correct fit for your compression garment by getting professional help. Ask your doctor where you can buy compression garments in your community. Some people will require custom-made compression garments.
If you have difficulties putting on or taking off the compression garment, there are special techniques and aids to help with this; your lymphedema therapist can review options with you. In addition, if compression garments or compression wraps or both are not an option, sometimes a compression device with fabric fasteners can work for you.
Complete decongestive therapy (CDT). This approach involves combining therapies with lifestyle changes. Generally, CDT isn't recommended for people who have high blood pressure, diabetes, paralysis, heart failure, blood clots or acute infections.
In cases of severe lymphedema, your doctor may consider surgery to remove excess tissue in your arm or leg to reduce swelling. There are also newer techniques for surgery that might be appropriate, such as lymphatic to venous anastomosis or lymph node transplants.
It can be frustrating to know there's no cure for lymphedema. However, you can control some aspects of lymphedema. To help you cope, try to:
Here's some information to help you get ready for your appointment with your doctor.
List the following:
For lymphedema, some basic questions to ask your doctor include:
Don't hesitate to ask other questions, as well.
Your doctor is likely to ask you a number of questions, such as:
Keep your swollen limb elevated as much as possible and protect your skin from injury. The swelling from lymphedema might dull pain from an injury or burn, so don't use heating pads on the affected limb. Moisturize your skin daily.