The Relationship Between Breast Cancer and Lymphedema

When people hear the word breast cancer, a lot of things go through their minds.

Chemotherapy, radiation, lumpectomies, mastectomies. They worry about side effects from medications, such as hair loss, fatigue and nausea. They pray the cancer will go into remission quickly. And they hope they can get back to their normal lives soon.

But one side effect of breast cancer surgery and radiation therapy that is often over looked is lymphedema. This ailment, which is caused by the build-up of lymph fluid in an area of the body, can cause swelling, tightness and changes to the skin and tissues underneath. In more extreme cases, it can be painful.

The problem with lymphedema is that there’s no quick fix. Healthcare professionals usually have to give hands-on care to help ease the swelling. And patients have to actively participate in their treatment to improve lymph flow.

Why does lymphedema happen?

While generally associated with the swelling of legs and feet, breast cancer patients usually experience lymphedema in the arm and hand. But they can also get swelling in the breast, underarm, chest, trunk or back.

Lymph is a clear fluid that moves throughout the body to remove wastes, bacteria and other substances. When it doesn’t circulate and drain correctly, the fluid backs-up, causing lymphedema.

This uncomfortable side effect can occur in breast cancer patients as a result of the removal of lymph nodes or auxiliary nodes to prevent the spread of cancer cells. Breast cancer often spreads first to lymph nodes under the arms because they drain lymph from the breast. Many patients also receive radiation therapy to the chest or underarm to help ensure the eradication of the disease, which can also cause swelling.

While some swelling during breast cancer treatment is normal, prolonged distension of the tissues is not. Surgery and radiation can cut off or damage some of the nodes and vessels that carry lymph through the body. In some people, the remaining pathways become overwhelmed with lymph, causing a build-up of fluid.

It’s unclear when or if lymphedema will strike in breast cancer patients. It can happen days, months or even years after treatment. And it can be temporary or permanent.

Patients should be proactive in their recovery and learn the signs and treatment available to keep lymphedema at bay.

What are the treatment options?

Although there’s no telling when lymphedema may occur, there are things patients can do to reduce their risk of developing the condition and keep it under control if they do. That often involves a lymphedema specialist, someone such as a doctor, nurse, physical therapist, massage therapist or rehabilitation therapist, who has expertise in breast cancer-related lymphedema.

A lymphedema specialist is trained in techniques that can help reduce swelling in an affected area. Specialists, such as physical therapists, will develop a program that includes massage, exercise, skin care and when necessary, compression bandages and fitted sleeves, to help improve lymph circulation.

Under the watchful eye of a physical therapist, patients use sensible exercises soon into their recovery to help improve strength and flexibility as well as avoid weight gain, all of which can help reduce the risk of lymphedema. Monitored exercise will also help patients avoid straining a limb where lymphedema has already occurred and reduce the risk of developing the condition after surgery or an infection.

Another critical step following surgery is good skin care and hygiene. That’s because poor drainage of the lymphatic system could make a patient’s arm or hand more susceptible to infection, which can exacerbate swelling. A lymphedema specialist or physical therapist can provide practical tips for avoiding cuts, abrasions and insect bites on areas where swelling is already a problem.

There’s no question that a breast cancer diagnosis can be overwhelming and scary. And the threat of lymphedema is just one more thing to think about. But don’t let it catch you by surprise. A physical therapist can help you manage your recovery and keep symptoms of swelling under control.

Related blog: Recovering from Breast Cancer Surgery

 

Sources:

http://www.breastcancer.org/treatment/lymphedema

http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=8fadc252-aa62-472d-9f22-977837a30acc#.VjvPKberTcc

http://www.breastcancer.org/treatment/side_effects/lymphedema