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Lymphedema is a collection of fluid that causes swelling (edema) in the arms and legs.
One of the causes of lymphedema is surgery to remove lymph nodes, usually during cancer treatment. Normally, lymph nodes filter fluid as it flows through them, trapping bacteria, viruses, and other foreign substances, which are then destroyed by special white blood cells called lymphocytes. Without normal lymph drainage, fluid can build up in the affected arm or leg, and lymphedema can develop. Medicines such as tamoxifen (Nolvadex), radiation therapy, and injury to the lymph nodes can also cause lymphedema. This type is called secondary lymphedema.
Primary lymphedema can be present at birth or develop during puberty or adulthood. The cause of primary lymphedema is not known.
Symptoms of lymphedema include feeling as though your clothes, rings, wristwatches, or bracelets are too tight; a feeling of fullness in your arms or legs; and less flexibility in your wrists, hands, and ankles.
Treatment for lymphedema depends on its cause and includes wearing compression garments such as stockings or sleeves, proper diet and skin care, and fluid drainage.
Elevating an arm or leg that has swelling can help ease the drainage of lymph fluid from the affected limb. Whenever possible, rest a swollen arm or leg on a comfortable surface, above the level of your heart. Don't put pressure on your armpit or groin area, and don't hold a limb up without support for very long since this can increase swelling.
Gentle exercise can help reduce swelling. The use of muscles during exercise naturally helps lymph fluid to circulate, which can reduce swelling. But exercise also increases blood flow to the muscles being used, which can increase the amount of lymph fluid present. If you have swelling, it is important to properly bandage an affected limb before exercising. Ask your doctor how to use a bandage for this purpose and what exercises are appropriate for your condition.
After surgery or radiation treatment
If you have had surgery to remove some lymph nodes, use your affected arm or leg as normally as possible. Most people are healed about 4 to 6 weeks after surgery, and able to go back to their normal activities.
If you have had lymph nodes removed or have had radiation therapy as part of cancer treatment, you may be able to avoid lymphedema or keep it under control by following the tips below.
If you have been diagnosed with lymphedema and plan to travel by air, you'll need to use a compression garment. Changes in cabin pressure during flight can cause swelling or make it worse. A compression garment that doesn't fit right can also make swelling worse, so be sure your garment fits correctly.
If you have lymphedema, you may want to wear a lymphedema alert bracelet. These bracelets, available through the National Lymphedema Network, are worn to protect people who have lymphedema from receiving treatment such as blood pressure readings, injections, or blood draws to their affected limbs. These treatments could make their conditions worse.
Other Works Consulted
Lawenda BD, et al. (2009). Lymphedema: A primer on the identification and management of a chronic condition in oncologic treatment. CA: A Cancer Journal for Clinicians, 59: 8–24.
Stubblefield MD (2015). Rehabilitation of the cancer patient. In VT DeVita Jr et al., eds., DeVita, Hellman, and Rosenberg's Cancer Principles and Practices of Oncology, 10th ed., pp. 2141–2162. Philadelphia: Walters Kluwer.
Current as of: August 21, 2019
Author: Healthwise StaffMedical Review: Sarah A. Marshall, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineDouglas A. Stewart, MD, FRCPC - Medical Oncology
Current as of: August 21, 2019
Sarah A. Marshall, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Douglas A. Stewart, MD, FRCPC - Medical Oncology
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