Lymphedema is swelling anywhere in the body–but most commonly (and most obviously) in the limbs–due to of a “backlog” of fluid in the lymphatic vessels. It has numerous possible causes, but lymphedema risk goes up significantly with many types of cancer treatment. One study found that “treatment combinations involving axillary lymph node dissection (ALND) or chemotherapy resulted in approximately 4–5 fold increases in hazard ratios for lymphedema.” (PubMed)
What are the Symptoms of Lymphedema?
Lymphedema primarily presents as swelling in the tissues after some kind of local trauma. Other symptoms can include:
- Aching or heaviness in the arm or leg
- Rings, shoes, or clothing seems tight in the affected limb/area
- Redness in the limb/affected area
- Feeling of weakness in the arm or leg
- Restricted range of motion
- Recurring infections (because the lymph functions both to remove wastes/toxins from the tissues, and also to return vital proteins and nutrients from the tissues to the bloodstream)
- Hardening and thickening of the skin (fibrosis)
If you have undergone surgery as cancer treatment, the lymphatic network in that area has been damaged and will have increased risk of lymphedema–even years into the future. Chemotherapy will not damage lymphatic vessels in the same way, but the toxic burden it creates will be a significant added stress on the lymphatic system and the body’s other detox pathways. So basically: get some baseline measurements now (see below) and then keep an eye out for lymphedema symptoms.
What Are the Early Warning Signs of Lymphedema?
There are quite a few early warning signs that could signal lymphedema risk, and many of them could signal other conditions. So pay attention to your own body, but also know when to get a professional assessment. Any of the following could be cause for concern:
- Tingling feelings
- Heavy achy feelings
- Noticeable swelling (especially on one side vs. the other)
- A lack of flexibility in your hand, wrist, fingers or ankle (for lower or upper extremity).
- Skin that holds a dent if you press it with a finger (“pitting edema”)
- Skin that feels stretched or tight
- “Stemmer’s” sign – you are unable to pinch the skin at the base of the second toe (for lower-leg swelling).
The sooner these warning signs are correctly diagnosed and addressed, the lower your risk of developing chronic lymphedema. Early identification and treatment will lead to improved outcomes and management of your condition.
Why Do I Need a Baseline?
Lymphedema is typically (and perhaps most easily) diagnosed by careful measurements of the circumference of your limbs. A small change in circumference –which is hard to see, but easy to measure–can signal lymphedema, especially if one limb is larger than the other. But this kind of simple, non-invasive test works far better if there are good measurements from before your cancer treatment and before the onset of any lymphedema symptoms. (If both sides swell equally, it could be mistaken for a slight weight gain, for instance.) Diagnosis & treatment is certainly possible without such a baseline… it’s just not as easy.
As an added consideration, the comprehensive baselines we perform at ORW will allow for early detection of a host of potential post-cancer-treatment risks and symptoms–not just lymphedema. See this blog post for more.
What Do I Do if I Have Early Signs of Lymphedema?
To begin with: congratulate yourself that you have identified the early signs! Like most conditions, lymphedema risk is simplest to address while it’s a risk–before the symptoms get severe.
Secondly: schedule an appointment with us for a full evaluation. Our Certified Lymphedema Therapists (CLTs) will assess your risk factors and put together a tailored program for your onco-history and current condition.
But don’t leave it all up to us! Do what you can to reduce risk: improve your diet and begin some lymphedema-specific at-home exercises, such as these–along with some general whole-body yoga or similar gentle exercises, to keep lymph moving through the body. (Don’t be sedentary!) Avoid coffee and alcohol and prefer herbal teas: many herbs, such as dandelion root, are believed to be beneficial for improving lymphatic flow (also cilantro, parsley, ginger, cinnamon, and many others).