More often than anyone would like, the effects of cancer can last beyond even life-saving surgical treatment. In a significant number of patients who have had cancerous lymph nodes removed, a side effect called lymphedema persists long after the cancer has been removed.
Lymphedema is a result of the accumulation of lymph fluids retained in tissues, brought on by blockages in the lymphatic system. It leads to painful and sometimes persistent swelling in the arms, legs, hands, or feet. Lymph nodes, located throughout the body, collect fluid from tiny vessels throughout the body. The nodes act as an important part of your immune system. When cancer is removed surgically, adjacent lymph nodes are commonly removed to determine the spread of the disease and whether chemotherapy or radiation treatment is needed. If too many lymph fluid channels are removed or damaged, the fluid becomes trapped, leading to the development of lymphedema.
Not only can the condition be painful, it can be debilitating.
An estimated 3 to 5 million Americans – and a staggering 140 to 200 million people worldwide – suffer from it. Millions of women who have overcome breast cancer are among its most common victims. Up to 40 percent of women who undergo surgery, radiation, and chemotherapy for breast cancer will develop lymphedema as a side effect.
Diagnosis
Symptoms of lymphedema are fairly forthright. If swelling and pain are present after lumpectomy, it’s pretty much a no-brainer. Other symptoms are more subtle: a heavy feeling in a leg or arm, trouble moving a limb, or itching in fingers or toes due to increased internal pressure. Thickening of skin, particularly in the legs, or trouble sleeping because of swelling discomfort are also clues to its presence.
Once you and your doctor suspect lymphedema, it can be confirmed by a test called lymphoscintigraphy in which a radioactive substance is injected into the lymphatic system and tracked using scanning equipment. The disease can also be seen on a magnetic resonance imaging (MRI) scan.
Treatment
Depending on how severe the condition is, treatment can be as low-tech as compression wraps.
More complex therapies can include specialized massages to stimulate the pumping acting of your lymphatic system or something called Le duc therapy, which is a combination of manual lymph drainage and compression wraps that can ultimately kickstart your remaining lymphatic system.
Surgical treatment is reserved for the most advanced cases. A common procedure transplant healthy nodes to damaged areas. A newer procedure employs microsurgical processes to create shunts in damaged areas. The shunts between the nodes and small, nearby blood vessels allow lymph fluids to drain into the bloodstream and surrounding tissues, alleviating swelling.
The procedure, being pioneered at Ohio State University Comprehensive Cancer Care Center and several other hospitals around the country, is showing the most promise for a cure. According to OSU, the technique is reducing the occurrence of lymphedema by up to 90 percent.
