Side Effects > Lymphedema

Last update: 03/12/2013

Lymphedema | Open Studies - ClinicalTrials.gov

Lymphedema is an accumulation of lymph fluid that causes swelling, usually, but not exclusively in the limbs. 
 
It's a side effect associated with surgical removal of lymph nodes, or after radiation therapy to lymph nodes.

Lymphedema may also occur as a result of tumors blocking the flow of lymphatic fluids.  In such cases the condition can improve or resolve completely with treatment of the lymphoma.

"Lymphedema is categorized as either primary or secondary.

Primary lymphedema is caused by congenital absence or abnormalities
of lymphatic tissue and is relatively rare. 
  
Secondary lymphedema is generally caused by obstruction or interruption of the lymphatic system, which usually occurs at proximal limb segments (i.e., lymph nodes) due to infection, malignancy, or scar tissue (see table below).[1] 

The pelvic and inguinal groups of nodes in the lower extremities and the
axillary nodes of the upper extremities are the primary sites of obstruction."  ~ Cancer.gov

Signs and symptoms:
PDQ ® Cancer.gov

	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 (in the affected limb)

 

To prevent lymphedema or keep it from getting worse
PDQ ® Cancer.gov

	Tell your health care provider right away if you notice symptoms of lymphedema.
	Keep skin and nails clean and cared for, to prevent infection.
	Avoid blocking the flow of fluids through the body.
	Keep blood from pooling in the affected limb (such as elevate limbs when resting).

Studies have shown that carefully controlled exercise is safe for patients with lymphedema.

 

Risk Factors

	Lymphoma can cause lymphedema Advanced cancer causing bulky lymphadenopathy of the anterior cervical, thoracic, axillary, pelvic, or abdominal nodes.  cancer.gov
	Radiation therapy to the axilla following axillary node dissection increases the incidence of lymphedema.  Approximately 41% (range, 21%-51%) of patients who underwent axillary radiation and surgery,  compared with 17% (range, 6%-39%) of those receiving axillary surgery without radiation.   The extent of axillary dissection also increases the risk of lymphedema.  cancer.gov
	Nodal dissection of axillary, inguinal, or pelvic regions.   "Arm edema occurs in 20 to 30 per cent of patients who undergo axillary lymph node dissection ... " ncbi.nlm.nih.gov
	Radiation therapy of axillary, inguinal, or pelvic regions, or supraclavicular (mantle field) radiation.
	Scarring of the left or right subclavian lymphatic ducts and veins by either surgical or radiation procedures.  cancer.gov
	Intrapelvic or intra-abdominal tumors that involve or directly compress lymphatic vessels and/or the cisterna chyli and thoracic duct.  cancer.gov
	Poor nutritional status and obesity, that may lead to delayed wound healing, which in turn is an important risk factor for the development of lymphedema.[9-11]  Cancer.gov

Recommended resources 

	HIGHLY RECOMMENDED: Lymphedema (PDQ®) Patient Version Last Modified: 08/19/2011  Cancer.gov Signs and Symptoms | Tips to Prevent | Treatment of lymphedema | Exercise | Skin care | Compression device | Weight loss | Laser therapy | Drug therapy | Massage therapy
	Lymphedema PDQ  cancer.gov
	The Lymphedema Program  Cancer Supportive Care  (John P. Cooke, MD, PhD and Gary Abrams, MD) Comprehensive site
	Treatment for Lymphedema  Cancer Supportive Care

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Related Information and News

	The Lymphatic System PAL
	Lymphoscintigraphy  a diagnostic test for lymphedema.