Arm lymphedema

If part of your treatment included the removal of lymph nodes under the arm (axillary dissection) you are at risk of developing lymphedema, which can result in swelling of the tissue in the arm(s). The affected arm(s) may also feel tight and heavy, and there may be some pain or discomfort. Lymphedema can put you at risk of an infection. Depending on whether radiation therapy was part of your treatment, the risk of lymphedema is estimated to be from 17% to 41%.

The following are some general tips from the National Cancer Institute to help you avoid lymphedema:

1. Keep the arm or leg raised above the level of the heart, when possible. Avoid making rapid circles with the arm or leg to keep blood from collecting in the lower part of the limb.
2. Clean the skin of the arm or leg daily and moisten with lotion.
3. Avoid injury and infection of the arm or leg.
• Arms:
• Use an electric razor for shaving.
• Wear gardening and cooking gloves.
• Use thimbles for sewing.
• Take care of fingernails; do not cut cuticles.
• Legs:
• Keep the feet covered when outdoors.
• Keep the feet clean and dry; wear cotton socks.
• Cut toenails straight across; see a podiatrist as needed to prevent ingrown nails and infections.
• Either arms or legs:
• Suntan gradually; use sunscreen.
• Clean cuts with soap and water, then use antibacterial ointment.
• Use gauze wrapping instead of tape; do not wrap so tight that circulation is cut off.
• 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 or 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, and fever. Call the doctor immediately if any of these signs appear.
6. Do prescribed exercises regularly as instructed by the doctor or therapist.
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 at regular intervals as suggested by the doctor or therapist.
• Measure the arm or leg at the same two places each time.
• Tell the doctor if the limb suddenly gets larger.
9. The ability to feel sensations such as touch, temperature, or pain in the affected arm or leg may be lessened. Use the unaffected limb to test temperatures for bath water or cooking.

Treatment

The National Cancer Institute also explains how lymphedema is treated:

Lymphedema is treated by physical methods and with medication. Physical methods include:

• supporting the arm or leg in a raised position
• manual lymphatic drainage (a specialized form of very light massage that helps to move fluid from the end of the limb toward the trunk of the body)
• wearing custom-fitted clothes that apply controlled pressure around the affected limb
• cleaning the skin carefully to prevent infection

Lymphedema may be treated by combining several therapies. This is known as complex physical therapy (complex decongestive therapy), which consists of manual lymphedema treatment, compression wrapping, individualized exercises, and skin care followed by a maintenance program. Complex physical therapy must be performed by a professional trained in the techniques.

Surgery for treating lymphedema usually results in complications and is seldom recommended for cancer patients.