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8 tips for coping with cancer-related lymphedema

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By Pam Schlembach, M.D.

Thanks to recent developments in the medical field, more and more people are surviving and thriving after cancer treatment. However, patients who undergo this rigorous process can experience uncomfortable side-effects years after treatment, such as lymphedema. While researchers are identifying solutions to these side-effects, patients need to know there are methods available to help them cope with lymphedema.

Lymphedema symptoms
Lymphedema occurs when the body's lymph system has been damaged or blocked.  It is typically caused by an abnormal flow of protein-rich lymphatic fluid into the arm or leg. The flow of lymphatic fluid flowing into the arm or leg should be equal to that flowing out. Lymphedema develops when the amount of lymphatic fluid entering the area is greater than what is coming out, causing blockage and swelling. It is most common in patients who are overweight, had axillary surgery and radiation, a large number of lymph nodes removed, or developed an infection after surgery.

Lymphedema can range from mild to severe cases. In some circumstances, it can cause extreme swelling and limit mobility. It is important to notify your physician if you experience any lymphedema-like symptoms, which can include:
•    Swelling in your arm or hands
•    Pain or redness in your arm or hand
•    Feeling of tightness in the arm or hand

How to manage lymphedema
There is currently no known cure for lymphedema, but there are techniques to help you cope, including:

Skin care. It is essential to avoid infection following surgery. Your care team can help you identify the best techniques for proper hygiene to help minimize your risk of injury and infection. Wear gloves when gardening and cooking.  Cut toe nails straight and keep your feet clean and dry. Try to wear shoes outdoors. Avoid testing water temperatures with the limb affected. Avoid needle-sticks and animal teeth/claws in the affected limb.

Exercise. Daily exercise is critical for all aspects of healthy living. New research shows that carefully controlled exercise and stretching can help loosen tissue and provide better movement of lymphatic fluid. Talk with a certified lymphedema specialist before beginning exercise.

Massage. Two types of massage are used to treat lymphedema, including a very precise and gentle massage, and soft tissue mobilization that helps loosen scar tissue that can cause swelling.

Compression Garments. These elastic fabric garments are worn over the arm or leg to help move fluid out of the area and prevent new fluid from developing.  These devices should be supervised by a trained professional.  Too much pressure can cause damage to lymph vessels.

Medicine. Antibiotics can be used to treat or prevent infection associated with lymphedema.

Surgery. While lymphedema can usually be managed by self-care and other therapies, surgery is a rare, but available treatment to drain excess fluid and reduce swelling.  Laser vascular surgery is being investigated.

Weight Loss. Obesity is associated with a higher chance in developing lymphedema. Weight loss can improve conditions.

Avoid high temperatures:  Do not apply heat to the affected limb.

Not every cancer patient will develop lymphedema symptoms. Discussing all symptoms and concerns with your care team is very important. Follow their recommendations and advice to begin healthier living post-treatment.

Pam Schlembach is an associate professor of radiation oncology at MD Anderson in the Woodlands.

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