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Lymphedema

Lymphedema is the build-up of fluids in your body. It can cause an arm, leg, or other area of your body to swell and become painful. The disorder is usually lifelong.

What to expect

Lymphedema may start 6 to 8 weeks after surgery or after radiation treatment for cancer.

It can also start very slowly after your cancer treatment is over. You may not notice symptoms for 18 to 24 months after treatment. Sometimes it can take years to develop.

Even a small infection or injury can cause lymphedema to start.

Ways to help relieve swelling

Use your arm that has lymphedema for everyday activities, such as combing your hair, bathing, dressing, and eating. Rest this arm above the level of your heart 2 or 3 times a day while you are lying down.

  • Stay lying down for 45 minutes.
  • Rest your arm on pillows to keep it raised.
  • Open and close your hand 15 to 25 times while you are lying down.

Take good care of your skin

Every day, clean the skin of your arm or leg that has lymphedema. Use lotion to keep your skin moist. Check your skin every day for any changes.

Protect your skin from injuries, even small ones.

  • Use only an electric razor for shaving underarms or legs.
  • Wear gardening gloves and cooking gloves.
  • Wear gloves when doing work around the house.
  • Use a thimble when you sew.
  • Be careful in the sun. Use sunscreen with an SPF of 30 or higher.
  • Use insect repellent.
  • Avoid very hot or cold things, such as ice packs or heating pads.
  • Stay out of hot tubs and saunas.
  • Have blood draws, intravenous therapy (IVs), and shots in the non-effected arm or in another part of your body.
  • Do not wear tight clothing or wrap anything tight on your arm or leg that has lymphedema.

Take care of your feet.

  • Cut your toenails straight across. If needed, see a podiatrist to prevent ingrown nails and infections.
  • Keep your feet covered when you are outdoors. Do not walk barefoot.
  • Keep your feet clean and dry. Wear cotton socks.

Do not put too much pressure on your arm or leg with lymphedema.

  • Do not sit in the same position for more than 30 minutes.
  • Do not cross your legs while sitting.
  • Wear loose jewelry. Wear clothes that do not have tight waistbands or cuffs.
  • Where a bra that is supportive, but not too tight.
  • If you carry a handbag, carry it with the unaffected arm.
  • Do not use elastic support bandages or stockings with tight bands.

Taking care of cuts and scratches.

  • Wash wounds gently with soap and water.
  • Apply an antibiotic cream or ointment to the area.
  • Cover wounds with dry gauze or bandages, but do not wrap them tightly.
  • Call your doctor right away if you have an infection. Signs of infection include rash, red blotches, swelling, heat, pain, or fever.

Taking care of burns.

  • Place a cold pack or run cold water on a burn for 15 minutes. Then wash gently with soap and water.
  • Put a clean, dry bandage over the burn.
  • Call your doctor right away if you have an infection.

Living with lymphedema can be hard. Ask your doctor about visiting a physical therapist who can teach you about:

  • Ways to prevent lymphedema
  • How diet and exercise affect lymphedema
  • How to use massage techniques to decrease lymphedema

Wear your compression sleeve during the day. Remove it at night. Make sure you get the right size.

Wear a compression sleeve when traveling by air. If possible, keep your arm above the level of your heart during long flights.

When to call the doctor

Call your doctor if you have any of these symptoms:

  • New rashes or skin breaks that do not heal
  • Feelings of tightness in your arm or leg
  • Rings or shoes that become tighter
  • Weakness in your arm or leg
  • Pain, aching, or heaviness in the arm or leg
  • Swelling that lasts longer than 1 to 2 weeks
  • Redness, swelling, or other signs of infection
  • Fever over 100.5 °F

References

Gamble GL. Lymphedema: Nonoperative treatment. In: Cronenwett JL and Johnston W., eds. Rutherford's Vascular Surgery. 7th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 66.

Korpani MI, Crevenna R, Fialka-Moser V. Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients. Am J Phys Med Rehabil. 2011;90(5 Suppl 1):S69-S75.

National Cancer Institute: Lymphedema (PDQ®). Bethesda, MD: National Cancer Institute. Updated March 18, 2014. http://cancer.gov/cancertopics/pdq/supportivecare/lymphedema/HealthProfessional. Accessed May 7, 2014.

Towers A. Lymphedema. In: Walsh D, Caraceni AT, Fainsinger R, et al, eds. Palliative Medicine. 1st ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 87.

Updated: 5/7/2014

Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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