As the title suggests, lymphedema is swelling. It usually occurs when lymph nodes are removed or the lymphatic system is damaged in some way. Damaged or blocked lymph nodes are unable to process the lymph (lymphatic fluid) that flows throughout our bodies normally, and the liquid begins to collect. Thus, we get swelling.
How is it the lymphatic system and lymph nodes in particular become damaged? In a cancer diagnosis, the two most common causes are the disease and its treatments.
The lymphatic system is a very important part of our immune system. The lymph nodes serve as outposts for immune cells throughout the body and provide a sort of filtering function where foreign particles such as bacteria and viruses are collected to be dealt with and cleared.
Cancer, being one of those foreign particles, may not begin in the lymph nodes, but it’s not unusual for cancer cells to nonetheless collect there. If the nodes (or the immune cells within) can’t render the cancer cells harmless and eradicate the pestilence, they themselves can become diseased. A node tumor may block the lymphatic system or damage the node sufficiently to affect it’s ability to perform it’s job, leading to swelling in the areas around or below that node.
When I had my prostate surgery, the doctor also removed several of the closest lymph nodes in case prostate cancer cells had reached them. We didn’t have any evidence that was true, but it’s a common enough occurrence that the removal of lymph nodes during a prostatectomy is standard practice.
Chemotherapy and other cancer medications may cause harm to lymph nodes. Whether that’s because the disease is present in the node and is therefore affected by the medication’s attack on the disease or whether the medication itself is to blame, it isn’t uncommon for chemo patients to experience lymphedema during and after treatment. Radiation treatment may also cause harm to the lymphatic system.
My first and most memorable experience with lymphedema was following the prostate procedure I mentioned earlier, but that was remarkable enough to deserve a post of it’s own. And it seemed to resolve.
My second run-in with this type of swelling occurred during chemotherapy. It wasn’t especially bad, and it lessened somewhat over time. The swelling has, however, become a permanent part of my life. It’s in my lower extremities. You see, the lymphoma has decided to invade nodes near my hips, so the fluid obeys the law of gravity and collects in my legs and feet.
The lymphedema I experience isn’t constant; it waxes and wanes. A couple of years ago, I finally broke down and bought some support socks to help reduce the occurrence. They work quite well, limiting the swelling and reducing the resultant discomfort. I’m also happy to report that these days they look pretty much like normal knee-high socks. I’ve even got my partner wearing them at work because they don’t slip down. LoL
After my almost year-long Brentuximab regimen, the edema worsened. It isn’t unbearable, but I do wear the support socks more frequently now. I used to have skinny feet. Not any more! While I’m on the subject, a friend of mine had cancer in a lymph node under his arm. He underwent a shorter regimen of the same medication. (After which he was in remission. Always a good result!) He developed swelling in his hands which is ongoing but not unbearable.
In extreme cases, lymphedema can be life-threatening. But don’t let that frighten you! For the large majority of us, symptoms will never even approach that level.
Can anything be done to prevent cancer-related lymphedema? I don’t think so. Who can control where and when their cancer will arise? Who can decide what side effects they’ll experience from a particular treatment? If someone can, I’ll be first in line to take classes from them. There are things we can do, however, to help alleviate symptoms and lessen their occurrence. I’ve listed just a few below.
If you’re experiencing edema, you should report it to your doctors and have a discussion about what they recommend. Your doctors need to know about your symptoms, and they’re in the best position to make an informed suggestion. In addition, a physical or occupational therapist may be able to steer you toward remediation measures.
- Exercise/Movement – Engage in light exercise of the affected area to encourage lymph drainage. Be sure to discuss exercise plans with your doctors.
- Compression – Compress affected areas through wrapping, wearing compression garments, or using a pneumatic compression device.
- Unrestrictive Clothing – Aside from compression garments used to reduce swelling and support swollen areas, wear unrestrictive clothing to lessen the likelihood of a blockage in the lymphatic system. Avoid clothing with tight cuffs and waistbands, etc. that could hamper lymph flow.
- Massage – Specialized manual manipulation can be used to help lymph flow.
- Elevation – When possible, elevate the affected limb to encourage lymph drainage.
- Dietary Changes – Follow a healthy, well-balanced, low-sodium diet.
- Surgical Intervention – Surgery is used only for very advanced stage symptoms
- Medication – At present, there is no FDA-approved medication for treatment of lymphedema.
Are you suffering from cancer-related lymphedema? What are your symptoms? Have you found anything helpful? I’d love to hear your experience.