Lymphedema is an unusual buildup of fluid that causes swelling, typically in the arms or legs. The condition develops when lymph vessels or lymph nodes within the lymphatic system, which extends throughout the body, are damaged or removed.
The swelling is caused by the disruption of the flow of normal lymph fluid within the lymph system, which is part of the immune system. Swelling may occur initially after a traumatic event, such as a cut or sports injury, following an infection or as a side effect of cancer treatment.
The most common cause of lymphedema is cancer treatment. It can occur when breast, gynecologic or other surgery includes removal of lymph nodes or radiation therapy.
Signs and symptoms
The earliest sign of lymphedema is a dull, heavy ache in the back of the arm from which lymph nodes were removed that lasts more than a day or two. The ache is uncomfortable but not painful. These signs and symptoms don't always mean lymphedema and could be a result of treatment or healing but should always be checked out. Other later symptoms of lymphedema may include:
- Gradual increase in swelling, although it may first appear suddenly
- Bra, clothing or jewelry don't fit as normal
- Aching or pain in the arm
- Feeling of heaviness, fullness or tightness in the arm, chest or armpit area
- Trouble bending or moving a joint, such as the fingers, wrist, elbow or shoulder
- Weakness and easy tiring of the arm
- Swelling in the hand
- Thickening of or changes in the skin
If cellulitis, or infection, occurs, it will appear red, hot, painful and swollen. An arm with lymphedema is at a higher risk for infection than an unaffected arm. If you notice any of these symptoms, have any concerns or you're not already seeing a lymphedema specialist, then you should notify your cancer surgeon right away. If infection symptoms occur, this is serious and may require a trip to the emergency room.
Preventing and treating lymphedema
Patients at risk for development of lymphedema can have onsets related to injury of the arm. Patients should avoid any blood pressure cuffs, blood draws or IV needles, tattoos, cuts or scrapes to prevent onset or exacerbate lymphedema.
Compression sleeves and massage therapy are the most common forms of prevention and treatment for lymphedema. It is important to be measured and fitted for sleeves to ensure they are the correct size. Being active and maintaining activity is also a crucial component of prevention. Yoga, Pilates and lifting light weights (with your doctor's approval) have all been shown to reduce the risk of onset lymphedema.
A combination of lymph node removal and radiation puts patients at the highest risk of developing lymphedema. Who gets lymphedema and why continues to be poorly understood. There is ongoing research to try to understand the process better and how to best prevent it. Since there is no way to predict who will be affected by lymphedema, our prevention clinics monitor and assess the journey of all patients.
For patients who are showing early signs, we see them more frequently to ensure our interventions are working and they are not developing irreversible lymphedema. If caught early, lymphedema can be reversed in many cases.
It is a myth that only overweight patients are at risk for development of lymphedema. Being overweight is one factor, but there are many others, and BMI (weight to height ratio) is only one of those factors. Women with many different variables (chemotherapy, radiation, low BMI, high BMI, few lymph nodes removed to all lymph nodes removed) can develop lymphedema.
Why choose The University of Kansas Health System
The University of Kansas Health System offers the region's only surgical lymphedema treatment program. Our team of board-certified, fellowship-trained plastic surgeons is dedicated to supporting your care and meeting your needs.