Understanding & Managing Lymphedema
- New research suggests that about one-third of female cancer survivors develop leg swelling, known as lower extremity lymphedema, after their recovery.
- Lymphedema is a condition in which extra lymph fluid builds up in tissues and causes swelling, usually in the arm and hand. However, with lower extremity lymphedema, the swelling occurs in the legs.
- While there's no cure for lymphedema, there are a number of ways to manage the symptoms, including both surgical and non-surgical options. But the treatment depends on the stage of lymphedema.
Lower extremity lymphedema commonly occurs in women after they've completed treatment for cancers of the ovaries, uterus and colon and rectum, according to the research published by JAMA Network Open.
Read MoreStudy Details
For this study, 900 women, mostly in their 70s and 80s, diagnosed with ovarian, endometrial (uterus) or colon cancer were assessed.
Of those 900 women, 292 of them, or 32%, reported that they had experienced lower extremity lymphedema. About 37% of those women were ovarian cancer survivors, 33% were endometrial cancer survivors and 31% were colon cancer survivors.
Paskett also said that some of these women still had lymphedema up to eight years after finishing cancer treatment.
In addition to reporting experiences with lower extremity lymphedema, the women assessed in this study were also twice as likely to say they need assistance with daily activities.
Understanding Lymphedema
Lymphedema is a condition in which extra lymph fluid builds up in tissues and causes swelling, usually in the arm and hand.
However, with lower extremity lymphedema, the swelling occurs in the legs. Lymphedema in the arms and hands is a common side effect of breast cancer surgery and radiation treatment.
Lymphedema can happen shortly after treatment or even years later.
SurvivorNet experts say it is critical that you monitor for swelling since detecting lymphedema early is key. While this condition is uncomfortable and can be painful, there are a number of ways to manage it, as there's no cure.
Managing the Pain & Swelling
While there's no cure for lymphedema, there are a number of ways to manage the symptoms, Dr. Dung Nguyen, a clinical associate professor at Stanford Medicine in the division of plastic and reconstructive surgery, previously told SurvivorNet. (As previously mentioned, lymphedema is primarily a side effect of breast cancer treatment, and we spoke with Dr. Nguyen about lymphedema in breast cancer patients specifically.)
Understanding and Treating Lymphedema
"We have surgical options as well as non-surgical options that help to control the progression of the disease," she said.
Stage 0
When a patient presents with stage 0 lymphedema, typically doctors will start with conservative therapy, which includes physiotherapy (treatment to restore, maintain and make the most of a patient's mobility, function and well-being) and compression garments.
Stage 1
Patients who present with stage 1 lymphedema are surgical candidates, she said. The most common form of surgery that offers effective results is lymphovenous bypass, which is a procedure that involves identifying obstructed lymphatics in the patient's extremity and then bypassing it to a working superficial vein.
Stage 2
Typically, Dr. Nguyen said, when a patient presents with stage 2 lymphedema, "this is (a) more advanced disease where they tend to have recurrent infections."
"In this group of patients, vascularized lymph node transfer is the option of choice," she said. "That is because with lymph node transfer, the lymph nodes themselves will bring lymphatic tissue to the extremity and help fight infection."
The risks and the rate of infection significantly decreases with lymph node transfer, she said.
Stage 3
In patients who present with severe lymphedema, the first approach is to debulk the dense fiber fatty tissue that's built up.
"We do this using a technique called dry liposuction," Dr. Nguyen said. This technique is done by extracting the tissue from the extremity using a suction device.
"Once the patient has recovered from the surgery and this typically takes a good year to year and a half then that patient can become a candidate for procedures like lymph node transfer or the lymphovenous bypass procedure to help re-establish the lymphatic drainage system in the extremity," Dr. Nguyen explained.
Contributing: SurvivorNet staff reports
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