Understanding Lymphedema -- For Cancers Other Than Breast Cancer

+ -Text Size

TOPICS

For people at risk for lymphedema

At this time there are no scientific studies to show that lymphedema can be prevented. Still, most experts say following these basic steps might lower your risk of lymphedema, delay its onset, or reduce its impact.

Get regular medical check-ups.

Regular check-ups should include screening for lymphedema. If you’ve been recording measurements of the affected part of your body, this may be part of the check-up. Talk to your health care team about how often you should be checked.

Report changes.

After surgery and/or radiation, you will learn how the affected part of your body normally feels. Any changes in size, color, temperature, feeling, or skin condition should be reported to your doctor right away.

Try to get to and/or stay at a healthy weight.

We know that obese people are at higher risk for lymphedema. Talk to your health care team about what a healthy weight is for you, and get their advice on how to get to or stay at that weight.

Exercise.

It’s important to use the part of your body that’s been affected by cancer for normal, everyday activities to help you heal properly and regain strength. Using your muscles also helps the lymph fluid drain like it should.

Certain types of exercise can reduce your lymphedema risk, too, and some exercises can make lymphedema better after it starts. If you’ve had surgery or radiation treatment, ask your doctor or nurse when you can start to exercise and what type of exercises you can do. Avoiding exercise and allowing your body to get out of shape may lead to lymphedema and episodes of swelling that are sometimes called flare-ups.

But keep in mind that some kinds of exercise can increase your risk of lymphedema or make lymphedema worse if you already have it. Overuse, which can result in injury, has also been linked with the start of lymphedema in some people. Work with a well-trained fitness or health professional to design a program that’s right for you and starts at a low level of intensity and progresses slowly to avoid overuse.

Follow these tips for exercising safely:

  • Use your affected body part as normally as you can. Once you are fully healed, about 4 to 6 weeks after surgery or radiation treatment, you can begin to go back to the activities you did before your surgery. But check with your doctor first.
  • Exercise regularly, but try not to over-tire yourself. Before starting any exercises, talk with your doctor, nurse, or physical therapist. They can help you set goals and limits so that you can work at the level of activity that’s right for you.
  • If the affected part of your body starts to ache or swell, lie down and raise it above the level of your heart.
  • Avoid repetitive overuse of the affected body part. Sudden increases in how long or hard you work out might trigger or worsen lymphedema.
  • Any exercise program should be started gradually, increased cautiously, and stopped if you have pain, more swelling, or other discomfort. Talk with your doctor if you have any of these problems. If they continue, ask about being referred to a lymphedema specialist.

Use of compression garments

Compression garments are fitted sleeves or stockings that can help control lymphedema. They can help prevent and reduce swelling by moving lymph fluid from the arm or leg back into the body. Careful fitting is needed and you should follow your health care professional’s advice on use and care of the garment.

Compression garments are most often used by people who already have lymphedema. But if you are at risk for lymphedema, you might want to use one to lower your risk in certain high-risk situations. For instance, lymphedema has been linked with air travel, possibly because of air pressure changes. But there are pros and cons to using a compression garment on long or frequent flights. Ask your doctor or therapist if you should be fitted for a garment to wear during air travel.

Do not use a poorly-fitting compression garment under any circumstances, as this may increase risk for lymphedema or make it worse if you already have lymphedema.

You usually do not need a compression garment to prevent lymphedema during exercise. But if you’ve noticed swelling while exercising, talk to your doctor or therapist.

Try to avoid infections, burns, and injuries.

Your body responds to infection, burn, or injury by sending extra fluid and white blood cells to the area. If lymph nodes and vessels are missing or damaged, it’s harder for your body to move this extra fluid, which can trigger or worsen lymphedema.

Some basic precautions, good hygiene and careful skin care may reduce the risk of lymphedema by helping you avoid infections, burns, and injuries. Follow these tips to help you care for the part of your body that had surgery and/or radiation:

  • Keep the affected area clean. Careful skin care can help you prevent infections.
  • Keep your hands, feet, and cuticles soft and moist by regularly using moisturizing lotion or cream. This will help keep your skin from chapping or cracking. Push your cuticles back with a cuticle stick while they are soft (after a bath) rather than cutting them with scissors. Try not to pick at or bite your cuticles.
  • Clean and protect any openings in your skin caused by cuts, scrapes, scratches, bug bites, hangnails, or torn cuticles. See “How to care for cuts, scratches, or burns” in the section “Take care of yourself.”
  • Watch for early signs of infection, like pus coming from a cut or scrape, rash, red blotches or streaks, swelling, increased heat, tenderness, chills, or fever. Call your doctor right away if you think you have an infection.
  • Be extra careful when shaving, and use a clean razor on clean skin.
  • Use an insect repellent to avoid bug bites when outdoors. If a bee stings you in the affected area, clean and raise the limb, put ice on the sting, and call your doctor if there are signs of infection (see above).
  • Avoid activities that irritate or chap your skin.
  • Protect your body, especially treated areas, from sunburn. Use a broad spectrum sunscreen that is labeled SPF 30 or higher, and try to stay out of the sun between 10 a.m. and 4 p.m.
  • Your affected limb might not sense hot or cold as well as it did in the past. Test bath water temperatures with an unaffected limb.
  • Avoid extreme temperature changes, such as heat from hot tubs and saunas. If you use a heating pad or ice pack on the affected area, limit the length of time you use it until you know how your body will respond. Both heat and cold can damage tissues and can increase fluid build-up. Some doctors may advise you to stay away from all sources of extreme temperatures.
  • Protect yourself against falls, fractured bones, and serious burns.

Be aware of cellulitis.

Cellulitis is an infection in the tissues just under your skin. Signs of this problem include redness, warmth, fever, pain, and flu-like symptoms. Report this urgent medical problem to your doctor right away. See the section “Take care of yourself” for ways to help prevent infection.

Cellulitis can lead to or worsen lymphedema. In fact, if it becomes a repeated problem, suppressive antibiotics may be used to keep it under control.

If your arm is affected

  • Whenever possible, have your blood drawn, IVs, and shots given in your unaffected arm. Get flu shots and vaccinations in your unaffected arm or somewhere else. Let all your health care providers know that you are at risk for lymphedema.
  • Wear protective gloves with sleeves when doing household chores using harsh chemical cleansers or steel wool, when gardening or doing yard work, and when working with animals that could scratch or bite.
  • Wear a thimble when sewing to cut down on needle and pin pricks.
  • Use oven mitts that cover your arms instead of hot pads. Be careful when frying foods, boiling liquids, and removing food from a microwave oven.
  • Keep pets’ claws trimmed to avoid getting scratched.

If your legs are affected

  • Always wear well-fitting, closed shoes instead of sandals or slippers. Do not go barefoot.
  • Keep your feet clean and dry. Wear soft protective socks (cotton or padded types).
  • Dry the creases between your toes after bathing.
  • Cut toenails straight across to help prevent ingrown toenails.

Try to avoid pressure or constriction.

Constriction or squeezing of the affected body part may increase the pressure in nearby blood vessels. This can lead to increased fluid and swelling (much like water building up behind a dam). Some people have linked this to the start of lymphedema. Here are some tips to help you with this:

If your arm is affected

  • Wear loose jewelry, clothing, and gloves. Do not wear anything that forms a snug band around your arm or wrist. Be sure compression garments fit well and are worn properly. Clothing and compression garments should be supportive and have smooth, even compression.
  • Do not use shoulder straps when carrying briefcases and purses.
  • Wear a loose-fitting bra with padded straps that do not dig into your shoulder.
  • Have your blood pressure taken on the unaffected arm. If both arms are affected, blood pressure can be taken on your thigh. Or, you can ask that blood pressure be measured by someone using a hand pump and stethoscope rather than using a machine; the machines often use high pressures for a longer time.

If your legs are affected

  • Avoid socks, stockings, undergarments, or pants with tight elastic bands.
  • Wear shoes that fit well.
  • Try not to stand or sit in one place for too long (more than 30 minutes). Do not cross your legs when sitting.
  • Most people with leg lymphedema benefit from wearing a compression stocking when up and walking around. A compression stocking can help squeeze the lymph fluid through the remaining vessels before it builds up. The stocking must be well fitted to apply the right pressure while avoiding too much tightness near the top of the stocking. Ask your doctor or physical therapist if you should be fitted for a compression stocking.

Last Medical Review: 04/05/2013
Last Revised: 04/05/2013