How Do I Prevent and Manage Lymphedema?

Lymphedema is swelling in the arms, legs, hands or feet. In breast cancer patients, it is often seen immediately after surgery to remove lymph nodes and gradually recedes.

It can also reappear months or even years after treatment ends when lymph nodes and the vessels that support them are removed or damaged during surgery or radiation. Such swelling that occurs long after treatment is called chronic lymphedema.

The name comes from lymph, which is a clear, colorless fluid that contains a few blood cells, and edema, which is the buildup of excess fluid in the fatty tissues just under the skin. In people with advanced breast cancer, lymphedema most often occurs in the arm, hand, breast, or torso.

It’s important to address lymphedema quickly because early treatment avoids permanent damage to your skin and helps prevent infections and sores from developing in the affected areas.

Lymphedema can greatly impact your quality of life and make you more vulnerable to infection so the faster you get it under control, the better.

Lymphedema is a chronic condition that has no cure, but the good news is that it can be managed and sometimes prevented.

Signs of lymphedema

Lymphedema usually develops slowly, and its symptoms can be vague before any visible puffiness or swelling occurs. Some people report an unusual tingling or numbness that comes and goes or a bra or jewelry that feels unusually tight. Other common symptoms include skin changes, achiness, feelings of weakness, fullness, tightness or heaviness, and trouble bending the affected area. Lymphedema does not get better without treatment.

Ways to prevent lymphedema

Science can’t yet explain why some women develop lymphedema and others don’t. However, doctors do know that exercise, weight management, and good skincare seem to reduce the chances of developing lymphedema.

Exercise helps because it encourages the lymph system to drain. It’s a good idea to get your doctor’s advice about an exercise regimen because you don’t want to overdo it. There are also special exercises and movements your medical team can recommend helping reduce lymphedema should it appear.

Good skincare means you should use a gentle soap and moisturizer to prevent skin from cracking, keep the skin clean and dry, and use an antibiotic ointment on any insect bites, cuts or scrapes immediately.

It’s also important to maintain a healthy weight because obese patients are more likely to develop lymphedema and obesity makes it harder to treat.

Newer types of lymph node surgery have helped decrease the risk of lymphedema. But many of those with advanced breast cancer still develop lymphedema.

Treatments for lymphedema

If you haven’t been able to prevent lymphedema, there are still several actions you can take to reduce the swelling, discomfort, and risk of infection.

Common interventions include:

• Exercise, which helps get the fluid moving and draining.
• Compression sleeves, gloves or socks which both help fluid move and prevent fluid buildup.
• Diet, such as decreasing salt and avoiding processed meats, can reduce fluid retention.
• Elevation, or keeping the part of the body raised above the heart, let gravity help drain the fluid.
• Massage therapy by someone trained in lymphedema management can get fluid moving. This is also known as manual lymph drainage.
• Infection and injury prevention such as avoiding manicures, blood pressure checks, blood draws or injections on the affected arm or hand. This includes putting pressure on the area by carrying a heavy handbag or putting pressure on the arm during exercise.

Because the risk of infection is high, you shouldn’t try to manage lymphedema on your own. Get advice from your medical team, and if necessary, consult a lymphedema specialist.