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Addressing Lymphedema

May 14, 2009
by Vicki Tashman

In a three part series of short articles, the following information about lymphedema will be examined.


This first article will define lymphedema, the risk factors and provide some helpful suggestions for self-education and care.


Article II will discuss assessment and treatment options for lymphedema.


Article III will discuss Axillary Web Syndrome and its presence with or without lymphedema. This condition may appear following axillary node dissection.

What is Lymphedema?


Lymphedema is a swelling of a body part, most frequently the extremities.  It is the result of the abnormal accumulation of protein rich edema fluid in the affected area.

What causes lymphedema?

Secondary lymphedema, or acquired lymphedema, can develop as a result of surgery, radiation, infection or trauma.  Specific surgeries, such as surgery for melanoma, breast, gynecological, head and neck, prostate or testicular, bladder or colon cancer, all of may require removal of lymph nodes, and  put patients at risk of developing secondary lymphedema. If lymph nodes are removed, there is an increased risk of developing lymphedema.  Currently, with the technique of Sentinel Node Dissection, fewer nodes are removed and there appears to be decreased incidence of lymphedema. The reported incidence after surgery is around 5% increasing to 30% with the administration of radiation therapy (1, 2).


Lymphedema can occur immediately, postoperatively, within several months, or after several years.  With proper education, treatment and care, lymphedema can be kept well under control.


Symptoms of Lymphedema


In post breast cancer, lymphedema can develop on the affected arm.  Signs or symptoms of lymphedema to watch out for include: a full sensation in the limb, skin feeling tight, decreased flexibility in the hand, wrist and ring/wristwatch/bracelet tightness.  If you notice persistent swelling, it is very important that you seek immediate medical advice, as early diagnosis and treatment improves both the prognosis and the condition.



Post Surgical Recommendations


1. Absolutely do not ignore any slight increase of swelling in the arm,   hand, fingers, neck or chest wall.

2.     Never allow an injection, IV or a blood drawing in the affected arm(s)

3.     Have blood pressure checked in the unaffected arm.

4.     Keep the at-risk arm, very clean. Use lotion after bathing. When drying it, be gentle, but thorough. Make sure it is dry in any creases and between fingers

5.     Avoid vigorous, repetitive movements against resistance with the affected arm (scrubbing, pushing, and pulling).

6.     Do not wear tight jewelry or elastic bands around affected fingers or arm(s).
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