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Coping with Cancer > Side Effects > Lymphedema > Lymphedema: What You Need To Know

Did You Know... The Facts About Lymphedema?

Carolyn Vachani, RN, MSN, AOCN
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: March 1, 2008

• Lymphedema is a swelling of tissues that happens because the lymphatic system does not develop properly or is damaged.

• Lymphedema can be primary or secondary:
  • Primary lymphedema can affect any number of limbs or other parts of the body. It can be present at birth or develop at puberty or in adulthood.
  • Secondary lymphedema results from damage to the lymphatic system, such as with surgery to remove lymph nodes, radiation therapy, deep vein thrombosis (DVT) or lymphangitis (infection).

• Lymphedema is thought to affect 1% of the U.S. population (nearly 3 million Americans), yet is poorly understood by the medical community.

• The lymph nodes allow lymph fluid to drain normally. When the lymph system is damaged or undeveloped, this lymph accumulates and causes swelling.

• Lymph fluid is protein-rich and when this fluid accumulates, it becomes a perfect environment for bacteria to thrive, leading to infection. This is why infection is a serious complication of lymphedema.

• In cancer survivors, lymphedema can develop weeks to many years after the damaging therapy. This is why it is important to remain vigilant about lymphedema prevention.

• Lymphedema in cancer survivors is seen in arms, legs, the abdomen, genitals and the head and neck, depending on where the lymphatic system has been damaged.

• Many at-risk patients do not receive information about prevention of lymphedema and recognizing lymphedema early.

• The National Lymphedema Network (NLN) has developed 18 Steps to Prevention of Lymphedema.

• Sentinel node biopsy greatly decreases the risk of developing lymphedema, but it cannot completely eliminate the risk.

• People with lymphedema or those at risk for developing it can exercise, but should gradually increase the duration and intensity of exercise. The lymphatic system in the affected area no longer works at 100%; therefore you must monitor your body's response to increased blood flow, which in turn can increase you lymphatic flow 10-fold. If your lymph nodes in the affected area cannot handle this sudden increase in lymphatic volume, you run the risk of swelling due to sudden lymphatic overload. Learn more about exercise and lymphedema through the NLN.

• Obesity impairs lymphatic flow and a body mass index over 25 increases the risk of developing lymphedema or swelling in those who already have a diagnosis of lymphedema.

• Lymphedema treatments offered in the United States include surgery, medication, pneumatic compression pump therapy, compression garments, Manual Lymph Drainage (MLD), and Complete Decongestive Therapy (CDT).

• People with lymphedema must become knowledgeable about their condition and inform healthcare providers of it. Alert bracelets can also be helpful.

Resources

• OncoLink’s Lymphedema Section
• The National Lymphedema Network
• Lymph Notes
• Norton School of Lymphatic Therapy