Lower Extremity Lymphedema
Last Modified: April 5, 2007
Dear OncoLink "Ask The Experts,"
Can you tell me the current data on the incidence of lymphedema in the legs and genitals following surgery, external and internal radiation and chemotherapy for uterine cancer?
Is there good documentation?
Linda McGrath Boyle PT, DPT CLT-LANA, Cancer Rehab Specialist and OncoLink Lymphedema Team Editor, responds:
In women with stage IB-IIA cervical cancer, the occurrence of lymphedema has been documented from 3-21%. In a recent article by Bergmark et al., published in the International Journal of Gynecological Cancer, 21% of women with stage IB-IIA cervical cancer reported lymphedema symptoms. The women had been treated for cervical cancer with varying treatments, including radical hysterectomy. When compared with population controls (without cancer), they had an 8-fold increase in symptoms indicating lymphedema. Twenty-five percent of these women reported distress due to the lymphedema. Ninety percent of the patients stated they were not willing to trade off survival for freedom from symptoms.
A study in 2003 by Ryan et al. from Australia looked at all types of gynecologic cancers. The diagnosis of lower limb lymphedema was made in 18% of the total sample (490): 53% of these were diagnosed within 3 months of treatment, a further 18% within 6 months, 13% within 12 months, and the remaining 16% up to 5 years following treatment. Women most at risk for developing lymphedema were those who had treatment for vulvar cancer with removal of lymph nodes and follow-up radiotherapy. For this group of women, the prevalence was 47%. In addition, this study determined that many cases occurred within the first year of treatment, which was earlier than previously thought.
Of course, the co morbidities depend upon the stage of the cancer at diagnosis, the surgical approach (i.e. lymphadenectomy), and the radiation dose received. Obesity is also a risk factor for Lymphedema.
This is just a sample of the evidence found in medical literature. You can use PubMed to search for medical literature.