LYMPHEDEMA 101: FREQUENTLY ASKED QUESTIONS
Who is at risk of secondary lymphedema related to breast cancer and why?
Anyone treated for breast cancer may be at risk of developing secondary lymphedema. Breast cancer surgery, radiation therapy and other treatments are required to remove or destroy lymph tissue or nodes that may be cancerous. When lymph tissue or nodes are removed or damaged, the lymphatic system is often unable to work as well as it did prior to the treatment. Lymph fluid may be unable to drain effectively from the affected area. If the excess fluid builds up it can lead to a condition known as secondary lymphedema.
What can I do to reduce the risk of secondary lymphedema?
There are several proactive strategies that breast cancer patients and survivors can adopt to reduce the risk of secondary lymphedema:
- It is recommended that you have an assessment with a certified lymphedema physiotherapist. A “baseline” of your arm circumference and upper body range of motion measurements will be taken. These will be used for comparison during and following your treatment, and will allow a physiotherapist to monitor you for secondary lymphedema and help you regain full and proper shoulder movement.
- Take care of your skin.
- Avoid injections, blood work or blood pressure monitoring on your affected side (the side you were operated on). Ask for your unaffected side to be used. If you have had bilateral surgery (both sides), consult your medical team to arrange for use of a lower limb instead.
- Maintain a healthy body weight. Commit to losing weight if your BMI (Body Mass Index) is high. A high BMI is 25+ in people under 60 years and 27+ in people over 60.
- Exercise on a regular basis at a moderate pace, ideally for 30 minutes every day.
- Learn more about secondary lymphedema, so you know how to look out for its early signs and symptoms.
What are the early signs of secondary lymphedema?
The early signs of lymphedema may be very subtle (i.e. tightness of the skin, a sensation of fullness, heaviness, aching or numbness on the treated side, or the feeling of tightness of jewellery or clothing when you have not gained weight. There may also be the less subtle sign of swelling in the fingers, hand, arm, trunk, chest area, neck, or another part of the body. Infection can be serious as it can cause lymphedema. If you notice skin redness, itchiness, swelling or heat in the affected area, call your doctor right away.
If you think you may be showing early signs of lymphedema, see a doctor for advice or a health professional trained and knowledgeable in lymphedema secondary to breast cancer for an assessment. Early detection and diagnosis is the key to effective treatment.
What treatment is effective for secondary lymphedema?
With early detection and effective treatment, secondary lymphedema can be reversed or, in the later stages, stabilized and maintained.
Following a diagnosis of secondary lymphedema, effective treatment combines: education on skin care practices; a specialized form of massage called Manual Lymphatic Drainage; compression therapy; and prescribed exercise. This combined therapy approach is called Complex or Complete Decongestive (Physio)Therapy. It is practised by certified lymphedema physiotherapists and therapists.
Infection is a potential complication of secondary lymphedema that can lead to a worsening of the condition. If you notice skin redness, itchiness, swelling or heat in the affected area, call your doctor right away.
Why is exercise an important part of secondary lymphedema risk reduction and treatment?
To reduce the risk or treat secondary lymphedema, requires a delicate balance between stimulating the flow of lymph fluid and not overloading the body with excess lymph. Regular moderate exercise and deep breathing help to stimulate lymph flow without overloading the lymphatic system. Exercise also reduces the risk of cancer recurrence, while it improves flexibility, well-being and overall quality of life.