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Side EffectsLymphedema

Last update: 03/12/2013

Lymphedema | Open Studies - ClinicalTrials.gov

Lymphedema is an accumulation of lymph 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.

Lymphedema may also occur as a result of tumors blocking the flow of lymphatic fluids.  In such cases the condition can improve or resolve completely with treatment of the lymphoma.

"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

Signs and symptoms:
PDQ Cancer.gov

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Swelling of an arm or leg, which may include fingers and toes

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A full or heavy feeling in an arm or leg

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A tight feeling in the skin

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Trouble moving a joint in the arm or leg

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Thickening of the skin, with or without skin changes such as blisters or warts

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A feeling of tightness when wearing clothing, shoes, bracelets, watches, or rings

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Itching of the legs or toes

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A burning feeling in the legs

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Trouble sleeping

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Loss of hair (in the affected limb)

 

Risk Factors

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Lymphoma can cause lymphedema

Advanced cancer causing bulky lymphadenopathy of the anterior cervical, thoracic,
axillary, pelvic, or abdominal nodes.  cancer.gov
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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.  

The extent of axillary dissection also increases the risk of lymphedema.  cancer.gov
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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 
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Radiation therapy of axillary, inguinal, or pelvic regions, or supraclavicular (mantle field) radiation.
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Scarring of the left or right subclavian lymphatic ducts and veins by either
surgical or radiation procedures.  cancer.gov
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Intrapelvic or intra-abdominal tumors that involve or directly compress lymphatic vessels
and/or the cisterna chyli and thoracic duct.  cancer.gov
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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 

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HIGHLY RECOMMENDED:

Lymphedema (PDQ) Patient Version Last Modified: 08/19/2011  Cancer.gov

Signs and Symptoms | Tips to Prevent | Treatment of lymphedema | Exercise | Skin care | Compression device | Weight loss | Laser therapy | Drug therapy | Massage therapy
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Lymphedema PDQ  cancer.gov 
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The Lymphedema Program  Cancer Supportive Care 
(John P. Cooke, MD, PhD and Gary Abrams, MD) Comprehensive site
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Treatment for Lymphedema  Cancer Supportive Care

 

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Related Information and News

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The Lymphatic System PAL
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 Lymphoscintigraphy  a diagnostic test for lymphedema.
 
Disclaimer:  The information 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. 
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