Lymphedema is swelling generally in the arms or legs due to a blockage in your lymphatic system. It’s estimated that about one third of women who undergo axillary lymph node dissection during breast cancer treatment will develop lymphedema. Identifying and treating lymphedema early helps ensure faster and better outcomes, but even treatment later on, during the chronic stages of the disease, can still help.
The lymphatic system collects lymph (excess fluid, proteins, and other substances) from the body tissues and carries them back to the bloodstream. Lymph is moved slowly through lymphatic vessels and is passed through the lymph nodes. Swelling (“edema”) may occur when the lymph increases in the body tissues. Lymphedema occurs when the normal drainage of fluid is disrupted by a blockage or a cut in the lymph nodes in the groin area or the armpit. Lymphedema can be a hereditary condition, but it’s most commonly the result of blockages caused by infection, cancer, and scar tissue from radiation therapy or the surgical removal of lymph nodes.
In the early stages of lymphedema, when the swelling is mild, it can often be managed by compression garments, exercise, and elevation of the affected limb to encourage lymph flow. For more severe swelling, the physical therapist may use a treatment called “complete decongestive therapy.” The initial step often includes manual lymphatic drainage, which feels like a light form of massage and helps improve the flow of lymph from your arm or leg. This is followed by compression bandaging that helps to reduce the swelling. Your therapist will carefully monitor the size of the limb throughout your treatment sessions.
Once the limb has decreased to the desired size, your physical therapist will help you begin to take over your own care by developing a safe and sensible exercise program that will increase your physical fitness without unnecessarily straining your affected arm or leg, updating your compression garments to ensure proper fitting, working with you to find the type of garment that best meets your needs, and educating you about proper diet to decrease fluid buildup in your tissues and skin care to reduce the risk of infection.