Ask Question
Sign Guest book

 
About Lymphoma
| Advocacy & Art | CAM & Life Style | Clinical trials | Doctors & Centers  | Guidelines  at  Diagnosis | How  to   Help  | Research | Side Effects  | Support | Symptoms  | Tests | Treatments


WebCasts

Lymphedema

  

Side Effects > Lymphedema

Last update: 04/14/2008

Lymphedema is an accumulation of lymphatic fluid that causes swelling, usually, but not exclusively in the limbs. 
 
It's a side effect associated with surgical removal of lymph nodes, or after radiation therapy to lymph nodes. It may also occur as a result of tumors blocking the flow of lymphatic fluids. 

"Lymphedema is categorized as either primary or secondary.
 
Primary lymphedema is caused by congenital absence or abnormalities of lymphatic tissue and is relatively rare. 
  
Secondary lymphedema is generally caused by obstruction or interruption of the lymphatic system, which usually occurs at proximal limb segments (i.e., lymph nodes) due to infection, malignancy, or scar tissue (see table below).[1
 
The pelvic and inguinal groups of nodes in the lower extremities and the axillary nodes of the upper extremities are the primary sites of obstruction."  ~ cancer.gov

Risk Factor
Radiation therapy to the axilla following axillary node dissection increases the incidence of lymphedema. 

Approximately 41% (range, 21%-51%) of patients who underwent axillary radiation and surgery, 
compared with 17% (range, 6%-39%) of those receiving axillary surgery without radiation.[6] 
The extent of axillary dissection also increases the risk of lymphedema. 
cancer.gov
Nodal dissection of axillary, inguinal, or pelvic regions.  

"Arm edema occurs in 20 to 30 per cent of patients who undergo axillary lymph node dissection ... " 
ncbi.nlm.nih.gov 
Radiation therapy of axillary, inguinal, or pelvic regions, or supraclavicular (mantle field) radiation.
Scarring of the left or right subclavian lymphatic ducts and veins by either surgical or radiation procedures.
 cancer.gov
Advanced cancer causing bulky lymphadenopathy of the anterior cervical, thoracic, axillary, pelvic, or 
abdominal nodes.  cancer.gov
Intrapelvic or intra-abdominal tumors that involve or directly compress lymphatic vessels and/or the 
cisterna chyli and thoracic duct.  cancer.gov
Poor nutritional status and obesity, that may lead to delayed wound healing, which in turn is an 
important risk factor for the development of lymphedema.[9-11]  cancer.gov

Recommended resources 

Lymphedema PDQ  cancer.gov 
The Lymphedema Program  Cancer Supportive Care 
(John P. Cooke, MD, PhD and Gary Abrams, MD) Comprehensive site
Treatment for Lymphedema  Cancer Supportive Care
Resources & Research News

Also see Lymphoscintigraphy a diagnostic test for lymphedema.

Return to top

 

The Lymphatic System  PAL
Despite the risk, oncologists admit they know little about lymphedema
Lymphedema treatment does not increase the risk of metastatic disease, experts say.  http://www.hemonctoday.com/200402/frameset.asp?article=despite.asp (free login req.) 
Education and guidance  National Lymphedema Network
 
Disclaimer:  The information presented on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
Patients Against Lymphoma, Copyright © 2004,  All Rights Reserved.