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Arm and Leg Swelling After Cancer

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Arm and Leg Swelling After Cancer

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LYMPHEDEMA AND CANCER

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Home page: Lymphedema People

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Arm and Leg Swelling After Cancer

With the advent of better and more effective cancer treatments, the survival rate for all cancers has risen dramatically.  With this progress, a new and often misunderstood and misdiagnosed complication has arisen.

Many cancer survivors , having overcome cancer, find themselves with sudden and often unexplained swelling, usually of the arms or of the legs.

This swelling occurs because of one of several factors.

First, the swelling begins after lymph nodes have been removed for cancer biopsies. 

Second, the swelling may start as a result of radiation damage to either the lymph nodes and/or the lymph system.

Due to either the removal of lymph nodes or damage to the lymph system, your body is no longer able to rid itself of excess fluids.  The fluids collect in the limbs effected and swelling beings.

This swelling is called lymphedema. The swelling that occurs is permanent, and while it is not curable it is treatable.

Permanent Leg or Arm Swelling

****In the situation of any permanent leg swelling whether the cause is known or unknown, the diagnoses of lymphedema must be considered****

There are several groups of people who experience leg or arm swelling from known causes, but it doesn't go away or unknown causes where the swelling can actually get worse as time goes by.

Group One

This group includes those who have had the injuries, infections, insect bites, trauma to the leg, surgeries or reaction to a medication. When this swelling does not go away, and becomes permanent it is called secondary lymphedema.

Group Two

Another extremely large group that experiences permanent leg or arm swelling are cancer patients, people who are morbidly obese, or those with the condition called lepedema.  What causes the swelling to remain permanent is that the lymph system has been so damaged that it can no longer operate normally in removing the body's waste fluid.

In cancer patients this  is the result of either removal of the lymph nodes for cancer biopsy, radiation damage to the lymph system, or damage from tumor/cancer surgeries.

This is also referred to as secondary lymphedema.

Group Three

Group three consists of people who have leg or arm  swelling from seemingly unknown reasons.  There may be no injury, no cancer, no trauma, but for some reason the leg simply is swollen all the time.

The swelling may start at birth, it may begin at puberty, or may begin in the 3rd, 4th or even 5th decade of life or sometimes later.

This type of leg or arm  swelling is called primary lymphedema.  It can be caused by a genetic defect, malformation or damage to the lymph system while in the womb or at birth or be part of another birth condition that also effects the lymph system.

This is an extremely serious medical condition that must be diagnosed early, and treated quickly so as to avoid painful, debilitating and even life threatening complications.  Treatment should NOT include the use of diuretics.

What is Lymphedema?

Lymphedema is defined simply as an accumulation of excessive protein rich fluid in the tissues of the leg.  The accumulation of fluid causes the permanent swelling caused by a defective lymph system.

A conservative estimate is that there may be 1-2 million people in the United States with some form of primary lymphedema and two to three million with secondary lymphedema.

What are the symptoms of Lymphedema?

If you are an at risk person for arm lymphedema there are early warning signs you should be aware of.  If you experience any or several of these symptoms, you should immediately make your physician aware of them.

1.)  Unexplained aching, hurting or pain in the arm

2.)  Experiencing "fleeting lymphedema."  This is where the limb may swell, even slightly, then return to normal.  This may be a precursor to full blown arm lymphedema.

3.)  Localized swelling of any area.  Sometimes lymphedema may start as swelling in one area, for example the hand, or between the elbow and hand.  This is an indication of early lymphatic malfunction.

4.)  Any arm inflammation, redness or infection.

5.)  You may experience a feeling of tightness, heaviness or weakness of the arm.

How is Lymphedema Treated?

The preferred treatment today is decongestive therapy. The forms of therapy are complete decongestive therapy (CDT) or manual decongestive therapy (MDT), there are variances, but most involve these two type of treatment.

It is a form of massage therapy where the leg is very gently massaged to actually move the fluid out of the leg and into an area where the lymph system still functions normally.

With these massage treatments, swelling is reduced and then the patient is fitted with a pre-measured custom pressure garment to keep the swelling down and/or is taught to use compression wraps to maintain the leg size.

What are some of the complications of lymphedema?

1. Infections such as cellulitis, lymphangitis, erysipelas. This is due not only to the large accumulation of fluid, but it is well documented that lymphodemous limbs are localized immuno-deficient.

2. Draining wounds that leak lymphorrea which is very caustic to surrounding skin tissue and acts as a port of entry for infections.

3. Increased pain as a result of the compression of nerves usually caused by the development of fibrosis and increased build up of fluids.

4. Loss of Function due to the swelling and limb changes.

5. Depression - Psychological coping as a result of the disfigurement and debilitating effect of lymphedema.

6. Deep venous thrombosis again as a result of the pressure of the swelling and fibrosis against the vascular system. Also, can happen as a result of cellulitis, lymphangitis and infections.

7. Sepsis, Gangrene are possibilities as a result of the infections.

8. Possible amputation of the limb.

9. Pleural effusions may result if the lymphatics in the abdomen or chest are to overwhelmed to clear the lung cavity of fluids.

10. Skin complications such as splitting, plaques, susceptibility to fungus and bacterial infections.

11. Chronic localized inflammations.

Can lymphedema be cured?

No, at the present time there is no cure for lymphedema. But it can be treated and managed and most of the complications can be avoided.  Life with lymphedema can still be active and full, with proper treatment, patient education, and patient life style adaptation.

For extensive information on lymphedema, please visit our home page:

Lymphedema People

http://www.lymphedemapeople.com

(c) Copyright 2005 by Pat O'Connor and Lymphedema People. Use of this information for educational purpose is encouraged and permitted.  It  must be available free and without charge and not used for financial renumeration or gain.  Please include an acknowledgement to the author and a link to Lymphedema People.

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Lymphedema

This patient summary is adapted from the summary on lymphedema written by cancer experts for health professionals. This and other credible information about cancer treatment, screening, prevention, supportive care, and ongoing clinical trials, is available from the National Cancer Institute. Lymphedema is a swelling of a part of the body, usually an arm or leg, that is caused by the buildup of lymph. Lymph is a nearly colorless fluid that travels throughout the lymphatic system and carries cells that help fight infection and disease. Lymphedema can be caused by cancer or the treatment of cancer. This brief summary describes lymphedema, its causes and treatment.

OVERVIEW

Lymphedema is the buildup of lymph in the tissues, mainly in the fat just under the skin, and is caused by a problem in the lymphatic system. Lymphedema is an abnormal collection of too much tissue protein, fluid (edema), chronic inflammation, and thickening and scarring of connective tissue.

The lymphatic system is made up of vessels that are similar to blood vessels, but it carries lymph instead of blood. Unlike the blood system, which circulates through every part of the body, the lymphatic system drains lymph away from each part of the body. The lymphatic system collects fluid and protein from body tissues and returns it to the blood stream. Proteins and substances too big to fit into veins are moved through the lymphatic system. Edema may occur when these substances are in excess and the lymphatic system becomes overwhelmed or blocked.

Lymphedema is categorized as either primary or secondary. Primary lymphedema is a rare inherited condition in which lymph nodes and lymph vessels are absent or abnormal. Secondary lymphedema is usually caused when the lymphatic system is blocked or cut and may be caused by infection, cancer, or scar tissue. The most frequently affected lymph nodes are in the pelvis and legs or under the arms.

Acute versus chronic lymphedema There are several types of lymphedema. The first type is acute, temporary, and mild lymphedema that occurs within a few days after surgery that has involved the cutting of lymphatic vessels. It usually gets better within a week after keeping the affected arm or leg raised and by pumping the muscle that is associated with the affected limb (for example, making a fist and releasing it). The second type of lymphedema is acute and painful and occurs 4-6 weeks after surgery. This type of lymphedema is caused by swelling of the lymphatic vessels. It is treated by keeping the affected arm or leg raised and taking anti-inflammatory drugs. The third type of lymphedema is an acute form involving the skin, often occurring after an insect bite or minor injury or burn. It may occur on an arm or leg that is chronically swollen. This third form of edema is treated by keeping the arm or leg raised and by taking antibiotics. The fourth and most common form of lymphedema is slow and painless and usually occurs 18-24 months after surgery to remove a tumor or lymph nodes. If it develops later, it may mean that the tumor is coming back.

Acute lymphedema is a temporary condition that lasts less than 6 months. The skin indents when touched and stays indented, but there is no hardening of the skin. A patient may be more likely to develop lymphedema if he or she has surgical drains that leak protein into the surgical site; inflammation; no movement of the arm or leg; or a temporary lack of lymphatic function in one area of the body.

Chronic lymphedema is the hardest of all types of edema to treat. The damaged lymphatic system of the affected part of the body is not able to handle the increased fluid. This may happen when a tumor recurs or grows in an area of lymph nodes; when infection and/or injury of the lymphatic vessels occurs; when there is lack of movement of the arm or leg; after radiation therapy or surgery; with medical conditions such as diabetes, kidney problems, high blood pressure, congestive heart failure, or liver disease; or when preventive measures have not been taken after surgery. Lymphedema may also occur when cancer or cancer treatment causes loss of appetite, nausea, vomiting, depression, anxiety, or problems with metabolism.

A patient who is developing lymphedema will have soft, pitting edema that is helped by raising the arm or leg and by wearing elastic support garments. Continued problems with the lymphatic system cause fluid to flow back into the tissues, and the condition may become worse. This causes pain, heat, redness, and swelling as the body tries to get rid of the extra fluid. The skin becomes hard, stiff, and non-pitting and is no longer helped by raising the arm or leg or using elastic support.

Patients with lymphedema are more susceptible to infection. No effective treatment is yet available for patients with advanced chronic lymphedema. Edema may reoccur more easily in patients who have had lymphedema.

Risk factors

Factors that can lead to the development of lymphedema include radiation therapy to the area where the lymph nodes were surgically removed, problems after surgery that cause inflammation of the arm or leg, being overweight, the number of lymph nodes removed in surgery, and being elderly.

Patients who are at risk for lymphedema are those with:

- Breast cancer if they have received radiation therapy or had lymph nodes removed. Radiation to the underarm area after the lymph nodes have been removed increases the occurrence of lymphedema.

- Melanoma of the arms or legs if the patient has had lymph nodes removed from the underarm area and/or received radiation therapy.

- Prostate cancer treated by radiation therapy to the whole pelvis or by surgery.

- Cancer of the female reproductive tract that is advanced, treated with surgery to remove the lymph nodes, or treated with radiation therapy.

- Cancer that has spread to the lower abdomen, such as metastatic ovarian, testicular, colorectal, pancreatic, or liver cancer. The pressure from the growing tumor can destroy the lymphatic vessels and block lymphatic drainage.

Diagnosis

Specific criteria for diagnosing lymphedema do not yet exist. About half of patients with mild edema describe their affected arm or leg as feeling heavier or fuller than usual. To evaluate a patient for lymphedema, a history and physical examination of the patient should be completed. The history should include any past surgeries, problems after surgery, and the time between surgery and the onset of symptoms of edema. Any changes in the edema should be determined as well as any history of injury or infection. Knowing the medications a patient is taking is also important for diagnosis.

MANAGEMENT

Prevention Patients at risk for lymphedema should be identified early, monitored, and taught self-care. A patient may be more likely to develop lymphedema if he or she eats an inadequate diet, is overweight, is inactive, or has other medical problems. To detect the condition early, the following should be examined: weight, measurements of the arms and legs; protein levels in the blood; ability to perform activities of daily living; history of edema, previous radiation therapy, or surgery; and other medical illnesses, such as diabetes, high blood pressure, kidney disease, heart disease, or phlebitis (inflammation of the veins).

It is important that the patient know about his or her disease and the risk of developing lymphedema. Poor drainage of the lymphatic system due to surgery to remove the lymph nodes and/or radiation therapy may make the affected arm or leg more susceptible to serious infection. Even a small infection may lead to serious lymphedema.

Patients should understand the dangers of developing lymphedema and should be taught about arm, leg, and skin care after surgery and/or radiation therapy (see Table I below). It is important that this care continues for life, since lymphedema can occur 15 or more years after surgery. Breast cancer patients who follow instructions about skin care and proper exercise after mastectomy are less likely to experience lymphedema.

Lymphatic drainage is improved during exercise, therefore exercise is important in preventing lymphedema. Breast cancer patients should do hand and arm exercises after mastectomy. Patients who have surgery that affects pelvic lymph node drainage should do leg and foot exercises. The doctor determines how soon patients should start exercising after surgery. Physical therapists should develop an individual exercise program for the patient.

Better recovery occurs when lymphedema is discovered early, so patients should be taught to recognize the early signs of edema and to tell the doctor about any of the following symptoms: feelings of tightness in the arm or leg; rings or shoes that don't fit; weakness; pain, aching, or heaviness; redness, swelling, or signs of infection.

Patient Teaching Guide

1. Use an electric razor for shaving
-wear gardening and cooking gloves; use thimbles for sewing
-take care of nails; do not cut cuticles

2. Legs
-keep the feet covered when going in the ocean
-keep the feet clean and dry; wear cotton socks
-cut toenails straight across; see a podiatrist

3. Either arms or legs
-suntan gradually; use sunscreen
-clean cuts with soap and water, then use antibacterial ointment
-use gauze wrapping instead of tape
-talk to the doctor about any rashes
-avoid needle sticks of any type in the affected arm or leg
-avoid extreme hot or cold, such as, ice packs, heating pads
-do not overwork the affected arm or leg

4. Do not put too much pressure on the arm or leg:
-do not cross legs while sitting -wear loose jewelry; wear clothes without tight bands
-carry a handbag on the unaffected arm
-do not use blood pressure cuffs on the affected arm
-do not use elastic bandages or stockings with tight bands
-do not sit in one position for more than 30 minutes

5. Watch for signs of infection, such as redness, pain, heat, swelling, fever. Call the doctor immediately if any of these signs appear.

6. Do exercises regularly to improve drainage.

7. Keep regular follow-up appointments with the doctor.

8. Check all areas of the arms and legs every day for signs of problems:
-measure around the arm or leg periodically or if the limb seems swollen
-use a tape measure at two consistent places on the arm or leg
-tell the doctor if the limb suddenly gets larger

9. The arm or leg may be less sensitive. Use the unaffected limb to test temperatures for bath water or cooking.

10. Eat a well-balanced diet. 

Treatment

Lymphedema is treated by mechanical methods and with medication. Mechanical methods include raising the arm or leg, wearing custom-fitted clothes that apply controlled pressure, cleaning the skin carefully to prevent infection, and controlling body weight. When used, pressure garments should cover the entire area of edema. For example, a stocking that only reaches the knee can become tight and cause problems if there is edema in the thigh. Pumps on the arm and leg that give intermittent pressure are very helpful. The cuff is inflated and deflated according to a controlled time cycle. This increases fluid flow in the veins and lymphatic vessels and keeps fluid from collecting in the arm or leg.

Antibiotics may be used to treat and prevent infections. Other types of drugs such as diuretics or anticoagulants are generally not helpful, and may even worsen the problem.

Finding the exact cause of the swelling and treating it correctly is important. Edema often leads to infection, which then increases protein deposits in the tissues. If an infection is diagnosed, appropriate antibiotics should be given. Blood clots should be ruled out, since massage and therapy to encourage drainage may make the clots more dangerous. If blood clots are found, they should be treated with medication.

Coumarin was once used in some foods and medications in the United States. Coumarin was found to cause liver damage, and its use in foods and drugs in the United States has been banned since the 1950's.

Coumarin has been studied to determine if it is effective in reducing the swelling caused by lymphedema. Research has not shown coumarin to be an effective treatment for lymphedema and has shown that it may cause liver damage. Coumarin is available in some countries, but has not been approved for use in the United States.

Psychosocial considerations

Because lymphedema is disfiguring and sometimes painful and disabling, it can create mental, physical, and sexual problems. Women who develop lymphedema after treatment for breast cancer have more mental, physical, and sexual difficulties than women who do not develop lymphedema. The added stresses associated with lymphedema may interfere with its treatment that is often painful, difficult, and time-consuming.

Coping with lymphedema in the upper body after breast cancer treatment is especially difficult for patients who have little social support. Some patients may react to the problem by withdrawing. It is also difficult for patients with painful lymphedema. Patients with lymphedema may be helped by group and individual counseling that provides information about ways to prevent lymphedema, the role of diet and exercise, advice for picking comfortable and flattering clothes, as well as emotional support.

Other treatment

Surgery for lymphedema usually results in complications and is seldom recommended to the cancer patient.

COMPLICATIONS

A rare but fatal complication of lymphedema is lymphangiosarcoma, a tumor of the lymphatic vessels. The average time between mastectomy and the appearance of lymphangiosarcoma is about 10 years. After a patient develops lymphangiosarcoma, the average survival time is 1.3 years.

The cause of lymphangiosarcoma is not known. It appears as one or more bluish- red bumps on the affected arm or leg. First, one purple-red, slightly raised area in the skin of the arm or leg appears. The patient usually describes it as a bruise. Later, more tumors appear, and the bumps grow. Death usually results from metastases to the lungs.

TO LEARN MORE

For more information, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist is available to answer your questions.

There are many other places to get information about cancer treatment and services. Check the social service office at your hospital for local and national agencies that can help with finances, getting to and from treatment, care at home, and dealing with other problems.

Write to the National Cancer Institute at this address:

National Cancer Institute Building 31, Room 10A24 9000 Rockville Pike Bethesda, MD 20892

http://saints-memorial.org/cancercare/patiented/lymphedema.html

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Cancer Resources and Information:

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Cancer Topics - National Cancer Institute

http://www.nci.nih.gov/cancertopics

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American Cancer Society

http://www.cancer.org/docroot/home/index.asp

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Canadian Cancer Society

http://www.cancer.ca/ccs/internet/niw_splash/0%2C%2C3172%2C00.html

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CancerBACUP - UK / Europe

http://www.cancerbacup.org.uk/Home

-  -  -  -  -  -

The Cancer Council Australia

http://www.cancer.org.au/

-  -  -  -  -  -

ACOR.ORG - Association of Cancer Online Resources

http://www.acor.org/

-  -  -  -  -  -

Your Body After Cancer Treatment

http://www.nci.nih.gov/cancertopics/life-after-treatment/page5

-  -  -  -  -  -

Cancer - Medline Plus Information and Links Page

http://www.nlm.nih.gov/medlineplus/cancer.html

-  -  -  -  -  -

Cancer Information  on the Internet

http://www.hackley.org/medical_services/cancer_center/internet_links.htm

-  -  -  -  -  -

Cancer Resource Center

http://patient.cancerconsultants.com/links.aspx?id=32333

-  -  -  -  -  -

Cancer Lynx

http://www.cancerlynx.com/

-  -  -  -  -  -

The Cancer Information Network

http://www.cancerlinksusa.com/

-  -  -  -  -  -

Cancer Information  & Support International

http://www.cancer-info.com/

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Lymphedema

WHAT IS IT?

Lymphedema is a buildup of a fluid called lymph and protein in the tissues under the skin. Lymph accumulates when there is an obstruction to normal flow causing swelling, usually in an arm or leg. The lymph system is similar to the blood system in its network of vessels that carry lymph fluid throughout the body.

Trauma to lymphatic tissue by surgery or radiotherapy is the main cause of lymphedema in the context of cancer. It can result from surgery and/or radiation therapy during treatment for cancers of the breast, abdomen, melanoma, connective tissues (sarcomas) and the pelvic area, as well as lymphomas, in both men and women. Lymphedema may also be the result of infection, such as dermatophytosis in the foot.

Cancer tumors also can block the lymph vessels, especially in people with prostate cancer or lymphoma.

IF I HAVE CANCER WILL I DEVELOP LYMPHEDEMA?

Not necessarily. The most frequent cases occur in women with breast cancer; 10% to 25% of breast cancer patients will develop lymphedema. While most cases are mild, approximately 400,000 women cope daily with some degree of disfigurement, discomfort, and sometimes disability because of arm and hand swelling.

Because of improvements in radiation and surgical techniques (such as removing smaller samples of lymph nodes), lymphedema is less common today than it use to be. Lymphedema develops in about one in four breast cancer patients who have a mastectomy with lymph-node dissection. The risk doubles for those who also receive radiation treatments to the underarm area.

Radical prostatectomy, a procedure that removes the prostate gland, seminal vesicles and sometimes the nearby pelvic lymph nodes, can lead to lymphedema .One type of Kaposi’s sarcoma is called the lymphadenopathic form that can spread throughout the body and may aggressively involve lymph nodes, viscera, and occasionally the GI tract – resulting in a kind of lymphedema. 

SENTINEL LYMPH NODE BIOPSY

If breast cancer spreads, it first goes to the lymph nodes under the arm. That's why women with breast cancer have these nodes examined. Until recently, surgeons would remove as many lymph nodes as possible, but this greatly increased the risk of lymphedema. More recently, a growing number of physicians have begun focusing on finding the sentinel nodes — the first nodes to receive the drainage from breast tumors and therefore the first to show evidence of cancer’s spread. Experts believe that if a sentinel node is removed and found to be healthy, then the chance of finding cancer in any of the remaining nodes is very small and no other nodes need to be removed. This spares as many as 75% of women who have no evidence of tumor spread to the axillary nodes the risk of complications, especially lymphedema.

WHEN DOES IT DEVELOP?

Lymphedema can appear any time after surgery or radiation treatment including many years later.

When the condition develops very soon after surgery, it is usually mild, and goes away within one to two weeks. It can also develop six to eight weeks after surgery or radiation. Again, this type of lymphedema usually goes away in a few weeks. 

Unfortunately, the more common form of lymphedema in cancer survivors develops slowly over time. It may show up many months or even years after treatment ends and swelling can range from mild to severe. In most cases however, lymphedema appears between six and 12 months after treatment. While people who have many lymph nodes removed and radiation therapy have the highest risk of developing lymphedema, some high-risk patients won’t develop the condition.

WHEN TO CALL A PROFESSIONAL

Patients should contact a physician if they had a mastectomy, lower abdominal surgery or radiation treatments in the past, and the affected limb becomes red, painful or hot, or if it develops open sores or areas of broken skin. Doctors should be consulted especially if there is a fever in addition to swelling.

Diagnostic Tests

Usually, no specific testing is necessary to diagnose lymphedema, but tests may be done such as a blood count that can identify signs of infection. Ultrasound may be ordered to look for blood clots, which can cause swelling. Computed tomography (CT) may be used to find a tumor that could be blocking lymph vessels. In addition, there are more specialized tests that can identify lymph flow and lymph vessel abnormalities. 

Symptoms

The first signs of lymphedema can be a change in a patient’s arms or legs or other affected area such as the groin. Initially, skin will remain soft, but if the problem continues, the limb may become hot and red and the skin hard and stiff. The lymph fluid that collects in the tissues can be very uncomfortable, but pain is not always present. Early symptoms of lymphedema may include: 

In most cases, only one arm or leg is affected. If the leg is involved, swelling usually begins at the foot, then progresses upward toward the ankle, calf and knee.

Severity

The severity is directly related to the extent of surgery and radiation treatment to the lymph nodes. Severity and general risk of developing lymphedema seems to increase with obesity, weight gain and infection in the affected area. 

TREATMENTS

Lymphedema has no cure so treatment focuses on reducing the symptoms. Treatment has varied from virtually no treatment to surgery, but there are various practical methods to deal with the condition, including elevation of the limb (in the first year only), compression garments (no greater than 20-30 mm Hg), certain types of massage and exercises, pneumatic compression devices (controversial), and other types of physical therapy. Experts also recommend keeping the affected limb clean, dry and lubricated.

The National Lymphedema Network (www. Lymphnet.org) encourages massage by an specially certified expert in lymphedema massage.. In many cases, patients can also be trained to massage themselves to improve the flow of lymph fluids. 

Medications

There are no medications to treat lymphedema. Diuretics have been found to be ineffective and may actually exacerbate the condition. Other medicines have been tried, but there is no clear evidence of significant effectiveness with any particular drug. 

MILD LYMPHEDEMA: 

Elevating the arm or leg above the level of the heart(during the first year) and flexing it frequently are basic methods to manage the condition. Since elevation is impractical except for short periods, patients should be fitted with an elastic sleeve, covering the arm or leg. 
A significant reduction in edema (swelling) has been reported after wearing elastic sleeves for 6 consecutive hours per day. Using these garments during exercise, physical activity, and especially air travel is recommended, since air travel seems to exacerbate the condition. 
If the legs are affected, avoid periods of prolonged standing. If working or standing a lot, a doctor may prescribe special graduated compression stockings to wear throughout the day. A doctor may also suggest a protein-rich, low-salt diet for those who are over-weight or obese. 

MODERATE TO SEVERE: 

For people with moderate to severe lymphedema in the legs, doctors prescribe pneumatic compression devices to be used at home to help reduce limb swelling. The “pneumatic stockings” are worn every day for an hour or two to reduce the swelling. Once the swelling has been reduced, a person may still need to wear elastic stockings up to the knee every day from the moment of rising until bedtime. 

For lymphedema in the arm, pneumatic sleeves--like pneumatic stockings--can be used every day to reduce the swelling; elastic sleeves may also be needed.

Others recommend a special type of massage therapy called manual lymph drainage. Antibiotics also may be prescribed to prevent or treat infection in the affected limb. Since skin infections can be more serious in people with lymphedema, a person may need to have antibiotics administered intravenously in the hospital during an infection.

Complex Decongestive Therapy

More serious cases of lymphedema can be treated with Complex Decongestive Therapy by a physical therapist or other health care professional, who has special training. Complex Decongestive Therapy consists of skin care, massage, special bandaging, exercise, and fitting for a compression sleeve. Seeking and getting treatment early should lead to a shorter course of treatment to get the lymphedema under control. While most insurance companies will pay for this treatment, some do not.

Someone certified in the procedure should perform Manual Lymph Drainage (MLD). 
In the case of lymphedema of the arm, the procedure involves a type of massage that moves built up fluid around the blocked vessels and across the chest to the other side of the body where the lymphatic system is still in tact. Usually the healthy area will be “worked” first. After each treatment, the effected area is carefully bandaged with a special layered wrap that looks like an ace bandage but is made of a different fabric. The wrap is important for keeping the effected limb de-congested. An average course is 15 daily treatments of 60 to 90 minutes each. After a MLD course of treatments, the patients will wear a compression garment every day. The patient should be measured for a new compression sleeve every six months or so. Sometimes a yearly MLD treatment course is recommended as a kind of “tune up.”

PREVENTING COMPLICATIONS

Because lymphedema development may occur even after several decades, patients should monitor themselves for signs of lymphedema and report any changes to their physicians. 
Prevention is important and can require daily attention to manage the symptoms of swelling in particular. Arm and hand precautions are based on two key ideas: (1) Do not increase lymph production, which is directly proportional to blood flow, and (2) do not increase blockage to lymph system. Therefore, patients should avoid excessive heat, infections, and overly-strenuous arm exercises which would increase blood flow in the arm and thereby increase lymph production.

MANAGING LYMPHEDEMA

Patients should follow these suggestions to manage their lymphedema: 

It is important to use your affected limb for normal everyday activities, yet overuse can cause lymphedema to occur in some people. Follow these suggestions whenever possible: 

For More Information

American Cancer Society

The American Cancer Society held an international conference on lymphedema in 1998 in New York City. It involved 60 of the world’s leading experts and included a forum of more than 250 breast cancer survivors, leaders of breast cancer advocacy groups, and others. The conference report plus a lymphedema resource guide are available as a book from the ACS at cancer.org. (See below for title.)

National Lymphedema Network

The National Lymphedema Network is a charitable organization with an international scope. Founded in 1988, the Network’s mission is to provide education and guidance to patients and health care professionals. The Network promotes standardizing quality treatment for lymphedema patients. In addition, the organization supports research into the causes and possible alternative treatments for this “often incapacitating, often-neglected condition.”


Sources:

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Lower leg edema

http://www.nlm.nih.gov/medlineplus/ency/imagepages/8857.htm

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Lymphedema ArmLymphedema is swelling,

 

 

 

 

 

http://www.biohorizonmedical.com/aboutlymph/aboutlymph.html

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MEN WITH LYMPHEDEMA

If you are a man with lymphedema; a man with a loved one with lymphedema who you are trying to help and understand come join us and discover what it is to be the master instead of the sufferer of lymphedema.

http://health.groups.yahoo.com/group/menwithlymphedema/

Subscribe: menwithlymphedema-subscribe@yahoogroups.com

Pat O'Connor

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Join us as we work for lymphedema patients everywehere:

Advocates for Lymphedema

Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.

http://health.groups.yahoo.com/group/AdvocatesforLymphedema/

Subscribe: AdvocatesforLymphedema-subscribe@yahoogroups.com

Pat O'Connor

Lymphedema People / Advocates for Lymphedema

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For information about Lymphedema

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema\

For Information about Lymphedema Complications

http://www.lymphedemapeople.com/wiki/doku.php?id=complications_of_lymphedema

For Lymphedema Personal Stories

http://www.lymphedemapeople.com/phpBB2/viewforum.php?f=3

For information about How to Treat a Lymphedema Wound

http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound

For information about Lymphedema Treatment 

http://www.lymphedemapeople.com/wiki/doku.php?id=treatment

For information about Exercises for Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema

For information on Infections Associated with Lymphedema

http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema

For information on Lymphedema in Children

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children

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Lymphedema Glossary

http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing

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Lymphedema People

Support Groups

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Children with Lymphedema

The time has come for families, parents, caregivers to have a support group of their own. Support group for parents, families and caregivers of chilren with lymphedema. Sharing information on coping, diagnosis, treatment and prognosis. Sponsored by Lymphedema People.

http://health.groups.yahoo.com/group/childrenwithlymphedema/

Subscribe: childrenwithlymphedema-subscribe@yahoogroups.com

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Lipedema Lipodema Lipoedema

No matter how you spell it, this is another very little understood and totally frustrating conditions out there. This will be a support group for those suffering with lipedema/lipodema. A place for information, sharing experiences, exploring treatment options and coping.

Come join, be a part of the family!

http://health.groups.yahoo.com/group/lipedema_lipodema_lipoedema/?yguid=209645515

Subscribe: lipedema_lipodema_lipoedema-subscribe@yahoogroups.com

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All About Lymphangiectasia

Support group for parents, patients, children who suffer from all forms of lymphangiectasia. This condition is caused by dilation of the lymphatics. It can affect the intestinal tract, lungs and other critical body areas.

http://health.groups.yahoo.com/group/allaboutlymphangiectasia/

Subscribe: allaboutlymphangiectasia-subscribe@yahoogroups.com

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Lymphatic Disorders Support Group @ Yahoo Groups

While we have a number of support groups for lymphedema... there is nothing out there for other lymphatic disorders. Because we have one of the most comprehensive information sites on all lymphatic disorders, I thought perhaps, it is time that one be offered.

DISCRIPTION

Information and support for rare and unusual disorders affecting the lymph system. Includes lymphangiomas, lymphatic malformations, telangiectasia, hennekam's syndrome, distichiasis, Figueroa
syndrome, ptosis syndrome, plus many more. Extensive database of information available through sister site Lymphedema People.

http://health.groups.yahoo.com/group/lymphaticdisorders/

Subscribe: lymphaticdisorders-subscribe@yahoogroups.com

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Updated Dec. 13, 2011