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The National Lymphedema Network defines lymphedema as an abnormal collection of high-protein fluid just beneath the skin. This swelling, or edema, occurs most commonly in the arm or leg, but it also may occur in other parts of the body, including the breast or trunk, head and neck, or genitals. It results from a blockage in the lymphatic system, which is part of the immune system. This may cause persistent swelling of the affected body part.
Individuals with a cancer diagnosis may be at risk for lymphedema. It is most commonly caused by the removal of or damage to the lymph nodes as part of cancer treatment. Lymph nodes may be removed to check for the spread of cancer. Radiation therapy can cause fibrosis, which is an inflammatory reaction resulting in scar tissue in the affected area. Fibrosis impedes the elimination of excess fluid from the area. Cancer cells can cause blockage of the lymphatic system which can result in lymphedema as well.
Lymphedema is most often reported in the upper extremities of women with breast cancer associated with the removal of lymph nodes and fibrosis after radiation therapy. Lower extremity lymphedema may occur for those who have had lymph nodes removed in the groin related to cancers involving the pelvis, such as endometrial cancer. Individuals who have been treated with surgery and radiation for head and neck cancers are also at risk for facial lymphedema.
The key to lymphedema is prevention! Education on proper skin care and the role of exercise are important measures that may decrease the risk of it ever occurring. Lymphedema generally presents within five years after treatment, although the risk never entirely goes away. It may start out as a heaviness or tightness with or without visible swelling. This swelling may progress and alter function by decreasing range of motion and limiting the ability to maintain normal activities of daily living. Prevention is important, but if lymphedema develops, treatment becomes critical to control it and maximize quality of life.
A referral to a lymphedema therapist is appropriate if signs and symptoms of lymphedema are noted. The therapist can evaluate and treat for lymphedema. Complete Decongestive Therapy (CDT) is the main treatment for lymphedema and is considered the “gold standard” of treatment. Components of CDT include manual lymphatic drainage, compression bandaging, exercise, skin care, and education in self-management. There is no cure, but early intervention can decrease swelling, improve skin condition, decrease risk of infection, and improve overall quality of life. Classes are offered in our community so those at risk for lymphedema can be informed about prevention and treatment.
The Community Cancer Center has clinics intended for one-time attendance for those who are at risk for lymphedema. They are held the first and third Monday of each month at the Community Cancer Center, 407 East Vernon Avenue, Normal, Illinois. A lymphedema therapist from Advocate BroMenn or OSF St. Joseph is present to provide education and screening. For additional information or to register for the clinic, please call 309-451-2257.
The Community Cancer Center offers a variety of free, supportive, and educational programs to help patient and families cope with cancer and its effects. For more information, go to www.cancercenter.org