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Are You at Risk for Lymphedema?


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The lymph system is a network of lymph vessels, tissues, and organs that carry lymph, a clear fluid that contains lymphocytes (white blood cells) and plasma, throughout the body. Lymphedema occurs when the lymph system is damaged or blocked. Fluid builds up in soft body tissues and causes swelling. Lymphedema usually affects an arm or leg, but it can also affect other parts of the body.

There are two types of lymphedema: primary and secondary. Primary lymph­edema is caused by the abnormal development of the lymph system. Symptoms may occur at birth or later in life. Secondary lymphedema is caused by damage to the lymph system. The lymph system may be damaged or blocked by infection, injury, cancer, lymph node removal, radiation to the affected area, or scar tissue from radia­tion therapy or surgery.

Lymphedema may develop within days of or many years after treatment.

Lymphedema may develop within days of or many years after cancer treatment. Most lymphedema develops within three years of surgery. Risk factors for lymphedema include:

  • Removal or radiation of lymph nodes in the underarm, groin, pelvis, or neck. The risk of lymphedema increases with the number of lymph nodes affected. There is less risk with the removal of only the sentinel lymph node (the first lymph node to receive lymphatic drainage from a tumor).
  • Being overweight or obese
  • Slow healing of the skin after surgery
  • A tumor that affects or blocks the left lymph duct or lymph nodes or vessels in the neck, chest, underarm, pelvis, or abdomen
  • Scar tissue in the lymph ducts under the collarbones caused by surgery or radiation therapy

Lymphedema often occurs in breast cancer survivors who had all or part of their breast removed and axillary (underarm) lymph nodes removed. Lymphedema in the legs may occur after surgery for uterine cancer, pros­tate cancer, lymphoma, or melanoma. Lymphedema may also occur with vulvar cancer and ovarian cancer. One of the most noticeable signs of lymphedema is swelling of the arms or legs. Your doctor should make sure that there are no other causes of swell­ing, such as infection or blood clots, because other conditions may cause the same symptoms. Consult your doctor if you experience any of the following symptoms of lymphedema:

  • Swelling of an arm or leg, which may include fingers and toes
  • A full or heavy feeling in an arm or leg
  • A tight feeling in the skin
  • Trouble moving a joint in the arm or leg
  • Thickening of the skin, with or without skin changes such as blisters or warts
  • A feeling of tightness when wearing clothing, shoes, bracelets, watches, or rings
  • Itching of the legs or toes
  • A burning feeling in the legs
  • Trouble sleeping
  • Loss of hair

These symptoms may occur very slowly over time, or more quickly if there is an infection or injury to the arm or leg. It’s important to tell your doctor right away if you have any of these symptoms. Lymphedema can disrupt your daily activities and hinder your ability to work and enjoy hobbies. This condition can also cause long-term physical, psychological, and social problems. However, the sooner you begin treatment, the better your chances are of improving the condition and maintaining your quality of life.

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Source: National Cancer Institute

This article was published in Coping® with Cancer magazine, September/October 2013.

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