Cancer Treatment & Lymphoedema

Today I am very pleased to have a special post all about lymphoedema here on Happy Magazine. It has been contributed by the team at Lymphoedema Ireland, a patient support body for people affected by lymphoedema. If you have wondered what lymphoedema is, who is at risk and what the signs and symptoms are, this post is for you.

Cancer Treatment & Lymphoedema

If you have had lymph nodes biopsied or removed, radiotherapy, or some types of chemotherapy, you are at risk of lymphoedema near the affected area. For example, if you had breast cancer, you may develop it in your arm, breast or trunk. If you had a gynaecological or prostate cancer, you may get lymphoedema in the leg(s).  

Lymphoedema is a chronic (long-term) condition that causes swelling in the body’s tissue. This can lead to pain and a loss of mobility. It usually affects the arms or legs, although in some cases there may be swelling in the chest, head or genitals. People can be born with lymphoedema, but it can also be caused by cancer treatment and a percentage of people will go on to develop it.

There is no cure for lymphoedema, but it is possible to control the symptoms using a combination of techniques including compression, Manual Lymph Drainage (MLD), deep breathing and a healthy lifestyle. The earlier it is caught, the better the outcome.  

It is estimated that over 15,000 people in Ireland are living with lymphoedema. Unfortunately, there is still a major lack of medical knowledge and expertise about it (just 15 minutes is spent on it in a medical degree). But you can help yourself by reducing the risk with your lifestyle and being aware of the early signs.

Note that lymphoedema can develop years after cancer treatment.  

Complications of lymphoedema

Infections

People with lymphoedema are more susceptible to cellulitis. Bacteria love the protein-rich fluid that builds up with lymphoedema, so a small cut or a sting which would normally be no trouble can quickly become quite serious. A bout of cellulitis can bring on lymphoedema.

Psychological

It can be very distressing to survive cancer only to be then faced with a lifelong, progressive condition. People may suffer from issues related to body image.

Finance

Manual Lymph Drainage and compression garments are costly and there is poor health insurance coverage. You may need to have clothes altered or buy extra wide shoes. There are currently few services available from the HSE for medical card holders, so patients are often forced to pay for private treatment if they can afford it – or go without.  

How to help yourself

1. Educate yourself about lymphoedema and watch out for early signs – see below
2. If you think you are developing it, ask your cancer care team for a referral to a lymphoedema clinic as soon as possible
3. Reduce your risk with good skin care, weight management and exercise

Skin care

Avoid damage from bites, burns, and cuts. If you get a cut, clean and cover it immediately (consider keeping some antiseptic wipes and plasters in your purse or wallet). Moisturise with a perfume-free body lotion to keep the skin in good condition.

Weight management

Try to keep to a healthy weight. People who have a body mass index (BMI) of 30+ are at increased risk of developing lymphoedema.

Exercise

Regular exercise will help to keep your muscles toned and your lymph flowing. Be careful of overdoing it. It’s more important to be regular and frequent in your exercise than intensive. Having said that, you can build up the level of intensity if you do it gradually. Start any new exercise gently and build up slowly. Be patient and pay attention to any changes in your body. You are the best expert in your own body.

Early signs of lymphoedema

• Swelling in part of your body. At first this may come and go and it will often be worse at the end of the day, and then go down overnight.
• A feeling of heaviness, tightness, soreness or stiffness in the affected area.
• Skin changes over time. For example, your skin may feel tight, shiny and taut.
• Clothing or jewellery feeling tighter than usual.

Some common fallacies relating to cancer and lymphoedema

Fallacy		Truth
I didn’t have lymph nodes removed so I won’t get lymphoedema	FALSE	Lymphoedema can occur where radiation and in some cases, chemotherapy have damaged the lymph nodes
I had a Sentinel Node Biopsy which was clear so no more nodes were taken	FALSE	While the chances of getting lymphoedema may be reduced, it is still possible
I am five years post treatment and so unlikely to get lymphoedema	FALSE	Lymphoedema can occur 15+ years post treatment and so all risk reduction precautions need to be adhered to.

Take action – Quickly

If you think you are getting lymphoedema, take action. Go to your GP. Get a referral from your oncology team to a lymphoedema service – if there is one. Note that Ireland’s lymphoedema patients are not currently well-served by the public health system. Find out if your local cancer support centre has a lymphoedema service. Or find a private therapist at MLD Ireland. If you are getting lymphoedema, get treatment as soon as possible as this will minimise future complications.

Useful resources

• Lymphoedema Ireland – the patient support body
  • Web: www.lymphireland.com
  • Facebook: www.facebook.com/LymphIreland
• MLD Ireland – for a list of Manual Lymph Drainage Therapists – www.mldireland.com

With special thanks to Lymphoedema Ireland for this post.