“I fought breast cancer; I’m a fighter! I am cancer free, so what is this lymphedema after breast cancer business? Why was I never told that I could end up with a chronic disease as a complication of my cancer treatments? This lymphedema sucks!” While working in a durable medical supply store that catered to breast cancer patients seeking bras and prostheses, this or a similar sentiment was often heard.
Lymphedema does suck, yet there are ways of reducing your risk of lymphedema after breast cancer. It was heartbreaking and frustrating to hear these women’s sentiments. Going through cancer treatment and receiving a lymphedema diagnosis can be devastating. But were they told and didn’t remember? Had they never been told, and their doctors just hoped for the best? Were their doctors unaware, or did they not want to deal with it?
Dr. Marisa Weiss, chief medical officer of breastcancer.org, says, “I can say from experience that the time right after diagnosis, when you are considering options and planning treatment, is a blur. Feeling anxious and overwhelmed makes it hard to listen, understand, and decide. So even if lymphedema gets mentioned during this time, you may not remember it. Or it may not come up because the focus is on getting you well. So if lymphedema does develop later on, it can feel like yet another insult to the body, one that many women weren’t fully prepared for. The good news is that women can learn to manage it and lead everyday lives. “
WHAT IS LYMPHEDEMA?
Lymphedema is a problem that may occur after surgery when lymph nodes are removed. It can also be caused by radiation therapy, damaging lymph nodes. It is an accumulation of lymph fluid that causes abnormal swelling, usually in the area of the arm after breast surgery. However, it can also develop in the hand, breast, torso, or lower body. Lymphedema doesn’t always appear right away. Instead, it usually develops gradually and can occur during the months or even years that follow breast surgery.
WHAT ARE MY CHANCES OF GETTING LYMPHEDEMA AFTER CANCER?
There is no way to know for sure what your chances are of developing lymphedema. However, the good news is they are continually developing new and better surgical treatments. Therefore, the cases of lymphedema today are significantly reduced. Most people do not get lymphedema since modern surgery removes fewer axillary lymph nodes than before. The more nodes removed, the greater the risk. Axillary node dissection removes more lymph nodes and gives you a 15% to 25% chance of developing lymphedema. Sentinel lymph node biopsy removes only a few lymph nodes to check for cancer and gives you less than a 5% chance of developing lymphedema. When lymph nodes are removed, the lymph system is compromised, and you will always be at higher risk for lymphedema.
SIGNS AND SYMPTOMS OF LYMPHEDEMA
The main symptom of lymphedema after breast cancer is swelling in the arm on the affected side. The amount of swelling can vary. A feeling of fullness, heaviness, or tightness in the arm, armpit, or chest may also occur. Clothing feeling tight or jewelry that doesn’t fit may also indicate the development of lymphedema. Do you have trouble bending or moving your joints? Does your arm feel weak or heavy? Do you have aching or pain in your arm that was not there before? All are signs to look for when you are at risk for lymphedema. You should seek medical attention immediately if you notice any of these conditions. The sooner lymphedema is diagnosed and treated, the easier it is to manage.
TREATMENT OF LYMPHEDEMA
Lymphedema treatment is typically broken down into four components: manual lymphatic drainage, skin and nail care, compression, and exercise. Manual lymphatic drainage is a gentle massage that helps redirect lymph fluid to move it out of the affected area. Skin care includes keeping skin clean and moisturized, along with protecting the skin from injury and infection. Compression helps prevent more fluid build-up, including multi-layer bandaging and compression garments. Finally, exercises help to stimulate your lymph vessels and move lymph fluid out of the body. Your therapist may incorporate Kinesio tape, aquatic therapy, and pneumatic pumps.
REDUCING YOUR RISK OF LYMPHEDEMA AFTER BREAST CANCER
Although there is no proven way to prevent lymphedema, there are some things you can do to reduce your risk after breast cancer. First, it’s essential to be aware of the risk and seeks care if you notice any signs or symptoms. Maintain a healthy body weight and eat a low-sodium diet. Finally, reduce the risk of infection or injury that can trigger lymphedema. Here are some suggestions to help prevent injuries and illnesses:
- Wear gloves when doing work around the yard or in the house.
- Keep skin clean and well moisturized.
- Be very careful with shaving. Be sure to use a clean, sharp razor. If the area is swollen, it may be better to avoid shaving.
- Avoid sunburn and excessive heat from saunas or hot baths.
- Use insect repellent when outdoors.
- Treat infections of the at-risk arm and hand immediately.
- Do not use the at-risk arm when blood draws, getting injections, or taking blood pressure if possible.
- Don’t cut nail cuticles. Instead, gently push back when they are soft.
- Wear compression sleeves and gloves on long airplane flights.
- Try to avoid bruises and scratches to the at-risk arm.
- Do not wear clothing that is tight or restrictive.
- Carry handbags or heavy packages with the unaffected arm.
- Avoid vigorous, repetitive movements against resistance, such as scrubbing, pulling, or pushing with the affected arm.
- Seek medical attention immediately if you see signs of infection, such as redness, pain, heat, increased swelling, or fever.
KNOWLEDGE IS POWER
Talk with your healthcare provider about ways to help prevent lymphedema. Make these precautions a part of your life. Compare your hands and arms regularly. Learn what is normal for you so that you can seek medical help if you see changes as soon as possible. There is no way to know whether or not you will develop lymphedema after breast cancer, but early detection is critical to treating and managing lymphedema. Be aware knowledge is power.
Disclaimer – This blog is for general information purposes only. Furthermore, the information contained in this blog is not a substitute for medical advice – always consult a licensed healthcare professional for advice on your specific condition.