Cancers and their treatments can sometimes cause swelling in the tissues under the skin. It can affect an arm, leg or other part of the body. This is called lymphoedema. It may develop months or years after cancer treatment.
If lymphoedema is picked up early, then treatment can help prevent it developing further, and keep the symptoms well controlled.
Some cancer treatments involve surgery or radiotherapy to lymph nodes. There is a chance you may develop lymphoedema if your lymph nodes have been removed or damaged. Occasionally, cancer itself can cause the damage.
Symptoms to look out for include body swelling, usually an arm or leg, but it can affect other areas. You may find it uncomfortable - the area can feel heavy and restrict your movement. It may also affect how you feel about yourself - as it can be a visual reminder of what you’ve been through.
The information on this page will help you to find out more about cancer related lymphoedema, its prevention and management.
Lymphoedema and cancer
If you have cancer which needs treatment involving the lymph nodes, then swelling of the tissue under your skin can sometimes develop. Known as ‘lymphoedema’, it most commonly affects an arm or leg, but sometimes other areas of the body can develop it too. It is a side effect which can occur weeks, months or sometimes years after treatment, so it is helpful to know what to look out for.
We all have a lymphatic system, (which is a series of very small drainage channels and lymph glands), throughout our body. It helps keep us healthy by draining away waste products, bacteria and excess fluid, and protects us from infection. When the channels get blocked, then swelling can occur.
Lymphoedema is long term swelling of the body’s tissues, so shouldn’t be confused with temporary swelling that can happen in the first few days post surgery. People with certain types of cancer are more at risk of developing lymphoedema. These include breast, gynaecological, pelvic, head and neck surgery and radiotherapy - particularly if lymph nodes have been removed or damaged. Sometimes the cancer itself can block lymphatic drainage.
Symptoms of lymphoedema include swelling, heaviness and aching of the affected area. For example, someone who has has lymph glands removed from their axilla (armpit), may experience swelling of the fingers, hand and/or arm.
Lymphoedema can also have an emotional impact - as it can feel a visual reminder of your cancer, and what you’ve been through.
First of all, there are a number of things you can do to help reduce your risk of developing lymphoedema. These include:-
- Good skin care - washing and drying carefully, and using a non-perfumed moisturiser. Rather than shaving the area, use a hair removal cream, to help prevent skin nicks. Avoid extremes of temperature for any length of time.
- Protect your skin - Wear a high factor sun tan lotion or preferably cover up the area when out in the sun. The skin is sensitive, and can easily burn. If your arm is the potential area of concern, wear gardening gloves whilst tending your plants, and use an oven glove to protect your hand from a burn. Insect repellent can help prevent bites - and watch out for pet’s teeth and claws.
- Maintaining a healthy weight - Easier said than done sometimes, but being overweight can be a risk factor for lymphoedema.
- Avoid blood tests, injections and tight blood pressure cuffs on the affected limb. This isn’t always possible. If you advise health care professionals that you have had lymph node surgery, so have to be cautious, they’ll generally do their best to find an alternative site. The aim is to prevent any breaks or damage to the skin that may lead to an infection.
- Exercise - Keeping yourself moving and gentle exercise, helps keep the circulation active, including the lymphatic system.
- Look out for signs of local infection - if you notice you have a cut ,scratch or insect bite then wash it well, and apply antiseptic cream. If you see any redness, heat, swelling or pain then let your doctor know, as you may need antibiotics.
For some people lymphoedema still develops. For example, you may notice swelling, heaviness or aching in a limb or in an area where you have had cancer treatment. If you think you may be have symptoms, do contact your GP, or healthcare team - as early diagnosis can help it developing further. You are likely to be referred to a specialist lymphoedema clinic for treatment.
For early lymphoedema, the aim of treatment is to reduce the swelling, help prevent infection, and encourage healthy eating and exercise. You’ll be given a series of exercises to help with movement and to ease symptoms.
The specialist nurse will teach you gentle massage/manual drainage to help reduce the swelling. You may be fitted with a ‘compression’ garment, such as a sleeve, glove or stocking, depending which area is affected. This helps reduce the swelling and encourage drainage.
For more severe lymphoedema you may have a more intensive treatment programme, involving use of lymphatic drainage, compression bandaging, physiotherapy, and skin care.
Coping with the feelings around lymphoedema can be hard. It’s a daily reminder of your cancer and its treatment, and you may feel self conscious wearing the compression garments, or that your limb is swollen.
Talking about your feelings can help you feel less alone - knowing that others are going through the same experience. Joining a support group, and/or visiting your local Maggie’s Centre can help you address the feelings you may be experiencing. You can also learn about exercise, relaxation, stress management and healthy eating - so that you are able to help control the physical and emotional impact of lymphoedema.
When to seek further help
If you develop signs of infection in that area, including heat, warmth, redness swelling, or have a raised temperature, let your GP, specialist nurse or hospital team know. You may need antibiotics.
Living with lymphoedema, can sometimes trigger feelings of depression and low self esteem. If this is happening, tell your doctor about how you feel - they understand the emotions you’re experiencing, and can refer you on for further support.