preventing lymphedema

Overview

Lymphedema is swelling that happens when lymph fluid builds up in part of your body. It can happen after cancer treatment when lymph nodes are removed or damaged. Lymph nodes are small glands that help fight infection and drain fluid from your tissues.

Lymphedema is fairly common among cancer survivors. It is more likely after treatments for breast, gynecologic, prostate, or skin cancers, but it can happen after any treatment that affects lymph nodes.

It most often affects people who have had lymph nodes removed or treated with radiation. It can also affect people who had surgery in their armpit, groin, neck, or abdomen. Being overweight or having an infection in the treated area can increase your risk.

Symptoms

Common symptoms

• A feeling of heaviness, achiness, or tightness in an arm or leg
• Visible swelling that may come and go
• Leathery or hard feeling skin
• Rings, shoes, or sleeves feeling tighter than before
• A noticeable difference in the size of one arm or leg compared to the other

Symptoms in children

• Lymphedema in children may look like one leg or arm growing or swelling faster than the other.
• Children may complain of clothes or shoes feeling too tight.
• They might have less energy or feel uncomfortable during physical activity.

Symptoms in older adults

• Older adults may notice more pronounced swelling because of weaker circulation and less muscle tone.
• Skin may become drier and more fragile, raising the risk of cuts that can lead to infection.
• Daily activities like dressing or walking may become harder as swelling progresses.

Causes

Main causes

• Cancer surgery that removes lymph nodes
• Radiation therapy that damages lymph vessels or nodes
• Scarring from surgery or radiation that blocks normal lymph flow

Risk factors

• Having many lymph nodes removed
• Being treated for breast, gynecologic, head and neck, or melanoma cancers
• Having radiation to the area where lymph nodes are located
• Being overweight or having obesity
• Having an infection in the affected area
• Not moving the affected area, which slows lymph flow

When to see a doctor

See a doctor urgently if:

• If you have new swelling that is very painful, red, or hot, contact your cancer care team right away. This could be an infection.
• If you have a fever with swelling, seek medical care the same day.

Book a routine appointment if:

• Tell your healthcare provider about any new or worsening swelling, even if it is mild.
• If you have had lymph nodes removed, ask your care team when to begin regular limb measurements and skin checks.

Diagnosis

A doctor or a lymphedema specialist will examine you, ask about your cancer treatment, and measure the affected limb. They may also look at your skin and check how your blood is moving.

Tests that may be done

• Limb circumference measurements (using a tape measure at regular points)
• Bioimpedance spectroscopy, a simple test that checks how much fluid is in your arm or leg
• Imaging tests, such as ultrasound or lymphoscintigraphy, to see the lymph vessels

What to expect at your appointment

The process is usually painless and is done in a clinic. The doctor will explain the results and, if you have lymphedema, work with you to create a care plan. You may be referred to a physiotherapist or occupational therapist who specializes in lymphedema.

Treatment

Lymphedema cannot be cured, but it can be treated and managed. With the right care, most people can keep swelling under control and live normally. The goal is to reduce fluid build-up and prevent complications.

Self-care at home

• Protect your skin: keep it clean and moisturized, and use insect repellent to avoid bites.
• Avoid tight jewellery, socks, or blood pressure cuffs on the affected limb unless your care team says they are safe.
• Exercise gently, as movement helps pump lymph fluid. Ask your therapist for safe exercises.
• Elevate the affected arm or leg when resting.
• Do not ignore new cuts, scratches, or bug bites; clean them right away and watch for signs of infection.

Medical treatments

Treatment usually includes manual lymphatic drainage (a gentle massage that helps move fluid), compression bandages or garments, decongestive exercises, and sometimes pneumatic pumps that gently squeeze the limb. A specialist will tailor the treatment to you.

When is surgery considered?

Surgery is rarely needed for lymphedema, but in some advanced cases it may be an option. This is usually only after other treatments have been fully tried. Discuss the risks and benefits with your specialist.

Living with this condition

Day-to-day, you can do much to protect your affected limb. Keep your skin healthy, stay active, and watch for early signs of swelling. If you use a compression garment, put it on in the morning and wear it as directed. Learn to listen to your body and rest when you feel heaviness.

Lifestyle tips

• Keep a healthy weight, as extra fat can slow lymph flow.
• Stay physically active with low-impact activities like walking, swimming, or gentle yoga.
• Avoid extreme heat, such as hot tubs, saunas, or very hot showers, which can increase swelling.
• Do not cross your legs or hold your arm in a bent position for too long.

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and protein can help keep your tissues healthy. Gentle exercise that moves the affected limb is helpful. Start slowly and increase gradually. Your care team can suggest a plan that fits your situation.

Mental health and emotional wellbeing

Living with lymphedema can be stressful and may affect your body image or mood. It is normal to feel frustrated, anxious, or down at times. Talk to your care team about these feelings. They can offer support or connect you with counselling.

Prevention

You cannot always prevent lymphedema after cancer treatment, but you can reduce your risk. This includes protecting your skin, moving regularly, and noticing early changes. If you have had lymph node surgery, your care team may start measuring your limbs from the beginning so any swelling is caught early.

Vaccines

Staying up to date with vaccines that prevent infections, like the flu vaccine and pneumonia vaccine, may help reduce your risk of skin infections that can trigger lymphedema. Ask your healthcare provider which vaccines are right for you.

Screening programmes

Regular check-ups with your cancer care team are important. They may measure your limbs and look at your skin. This is a type of screening that can detect lymphedema early, when it is easiest to manage.

Complications

If left untreated

• Skin infections, such as cellulitis, that can spread and become serious
• Hardening and scarring of the skin and deeper tissues
• Difficulty moving the affected limb
• Persistent pain and discomfort
• Rarely, a serious infection called sepsis, which is a medical emergency

Long-term outlook

With early care and consistent management, you can often keep swelling under control and avoid serious complications. Many people lead full, active lives with lymphedema. Recovery is a process, and your care team is there to help you every step of the way.

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