Download Understanding Lymphedema

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Avoid activities that can make the swelling worse. Repeated heavy lifting, rubbing, knitting, chopping, pushing and pulling may cause problems in some people. If in doubt, measure the distance around the limb (girth) before and after the activity. •
Avoid temperature extremes while bathing, showering or washing dishes. If the limb feels sore and aches, do not apply heat or ice to relieve the pain. Do not go into saunas or hot tubs! •
Raise the affected arm to shoulder height, whenever possible. If may be helpful to rest it on the back of a chair or on pillows. •
Avoid wearing tight watch bands or rings on the affected arm. If you have any concerns, ask your Primary Nurse or oncologist for a referral to the Lymphedema Clinic at the London Regional Cancer Program. Patient Information
Understanding
Lymphedema
(Swelling of a Limb)
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Contact Patient and Professional Education 519‐685‐8742 Email: [email protected] 790 Commissioners Road East London, Ontario N6A 4L6 519‐685‐8600 www.lhsc.on.ca/About_Us/LRCP/ NS4765 (2008/06/02)
What is the lymph system? The lymph system is a series of collecting tubes (called lymph vessels or ducts) and filters (called lymph nodes), which work with the blood system to remove waste from the body. This waste is made up of dead cells and large proteins that are too big to be taken away by smaller blood vessels. What is lymphedema? Lymphedema is a collection of fluid in the tissues. It most often occurs in the arms or legs. It is not the same as water retention which needs a very different treatment. What causes lymphedema? It is caused by a blockage or slowdown in the lymph system. How do I know if I have it? You may have swelling in your arm, breast, leg, or genital area. The swelling may be present at all times or it can come and go. The affected area may also feel heavy or ache. Why does cancer or cancer
treatment cause lymphedema? During cancer surgery, lymph nodes are often taken out to see of the disease has spread. Sometimes this causes swelling in a limb. Radiation therapy is often used to treat lymph nodes, which may have cancer inside them. While it kills cancer cells, radiation can also damage the healthy cells of the lymph node. If the lymph node is damaged, it will not be able to filter lymph fluid very well, which can lead to a blockage. Cancer in the lymph nodes can also cause a blockage that results in lymphedema. Why do some people get
lymphedema, and others do not?
There is no easy answer to this question. If you had lymph nodes removed or had treatment in your armpit or groin, or if cancer returns in the lymph nodes, then you have a higher risk for developing lymphedema. Not everyone with these risk factors will develop swelling. There is no way of knowing who will develop lymphedema. Can lymphedema be prevented? If possible, surgeons only remove the lymph nodes that drain the area of the tumour. This is called sentinel node biopsy. Radiation Oncologists always try to spare as much of the lymph system as possible when treating the cancer. What Can I Do?
If you notice swelling in your arms or legs, tell your doctors. You will need to be checked for other conditions that can produce similar symptoms. You should: •
Keep the affected limb clean and dry. Wash with a gentle soap, pat dry and apply a moisturizing cream. •
Avoid activities that may cause bruises, cuts, burns, scratches, and sprains to the affected arm or leg. •
Prevent sunburns and insect bites. •
Avoid cutting cuticles when manicuring the hand on the affected side. Do not bite your nails! •
Avoid using the affected arm for blood tests, IV’s, or blood pressure readings. •
Use oven mitts that cover the forearm. •
Use gloves for gardening, dishwashing, and other activities that may cause injury. •
Use an electric razor to shave underarms or legs. •
Avoid pressure on the shoulder of the affected side. Shoulder purses, backpacks, and tight, narrow bra straps can reduce lymph fluid flow. •
Choose bras that have wide straps or slip a shoulder pad under the strap.