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Lymphedema in the arm or leg

Lymphedema (lim-fuh-dee-muh) is a build-up of lymph fluid in your tissues. This build-up causes swelling (“edema”) in your arm or leg.

Lymphedema in arm or leg - patient handout

Your lymphatic system collects extra fluid from your body tissues. The lymphatic system carries the fluid back to the bloodstream, through your vessels and lymph nodes. The lymph nodes filter lymph fluid and help fight infections. If your lymph nodes are damaged or removed, lymph fluid builds up and causes lymphedema.


The lymphatic system 

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Your lymph nodes can be damaged by
  • cancer
  • cancer treatments such as radiation therapy
  • surgery (lymph nodes may be removed)
  • infection
  • inflammation (your body’s immune system response).
Breast cancer treatment is the most common cause of lymphedema. Most people with breast cancer do not get lymphedema.

Lymphoma, melanoma, uterine, prostate, vulvar or ovarian cancers and treatments are also associated with arm or leg lymphedema.

Your chance of getting lymphedema will also go up if you have
  • more than one treatment in the same area (for example, surgery and radiation).
  • extra body weight.
  • repeated infections in the same arm or leg.

Signs of lymphedema

  • Your sleeve, wristwatch, rings or socks leave marks in your skin.
  • Your arm, leg or pelvis feels full, puffy or heavy.
  • You have swelling in your arm or leg, including your fingers or toes.
  • It is hard to move the joints in your arms or legs.
  • Your skin is tight, warm, shiny, and thick or the texture has changed.
Lymphedema usually starts in your underarm, pelvis or groin (the area where your upper leg meets your pelvis). Lymph fluid then builds up in your chest, pelvis, arm or leg.

Lymphedema does not spread. If you get lymphedema, it will be in areas of your body where you have damaged lymph nodes. If you have damaged lymph nodes, you will always have a risk of getting lymphedema.
We cannot cure lymphedema. You will need to learn how to manage it.

If your lymphedema gets worse, you may have trouble doing everyday things such as getting dressed, walking or doing chores.
Talk to your health care team if you notice any signs of lymphedema or if you lymphedema gets worse. Lymphedema is easiest to treat when it is mild.

Your health care team will examine you to see how bad your lymphedema is. They will work with you to choose the best treatment.
Your health care team will give you instructions on how to care for your arm or leg. It is very important you follow these instructions.

By managing your lymphedema, you can
  • lower swelling
  • improve movement
  • lessen pain
  • prevent infection
  • stop your lymphedema from getting worse.

Here are some tips to help you manage your lymphedema

Skin Care
You should try to take very good care of your skin. This will help
  • prevent infections
  • improve or maintain your skin texture
  • help keep your lymphedema from getting worse.
Skin care tips for the arm or leg that has, or is at risk for, lymphedema:
  • Try not to get needles (injections or shots) or blood pressure measurements, especially if there is swelling.
  • Treat cuts or burns quickly. Keep the area clean, use an anti-bacterial ointment and cover with a bandage.
  • If you notice redness, warmth and pain in your skin, you may be getting an infection. Talk to your health care team right away.
  • Keep your skin clean and moisturized.
  • In the sun, wear sunscreen and long sleeves or pants.
  • Wear loose fitting jewelry and clothing without tight cuffs or waistbands.
  • Do not carry a heavy bag on the arm with lymphedema.
  • Do not use extreme heat or cold, such as ice packs and hot packs. Check with your health care team before using saunas, steam baths and hot tubs.
  • Wear gloves when gardening or cooking so you do not get cuts or bug bites.
  • Do not wax. Use an electric shaver, as this is unlikely to cut your skin. If you do use a razor, use clean, sharp blades with soap or shaving cream.
Compression Garments
These are sleeves, stockings or gauntlets (gloves). They are made of elasticized fabric that put pressure on your arm or leg. This pressure helps drain lymph fluid and stop it from building up.

  • You may need to wear these garments all day.
  • To get a compression garment, a certified fitter needs to measure you. You can find fitters at medical supply shops or pharmacies.
  • Check the B.C. Lymphedema Association website for a list of shops or ask your health care team (www.bclymph.org).
  • If you get a prescription for the compression garment, Pharmacare (MSP) will cover it. Pharmacare pays for two garments each year for each arm or leg that has lymphedema. You will need to pay a deductible (a certain amount of money).
Exercise
  • Increases muscle tone
  • May help move lymph fluid out of your arm or leg
  • Helps reduce swelling
  • Helps keep a healthy body weight.
Exercise tips
  • Talk to your health care team before starting an exercise.
  • Pick exercise you enjoy.
  • When you rest after exercise, raise your swollen arm or leg to help drain the excess fluid.
Certified Lymphedema Therapists
  • Specially trained Physiotherapists and Massage Therapists who can help you manage lymphedema. They use compression bandages, a type of massage called manual lymphatic drainage, exercise, and skin care.
  • You can get a list of certified therapists from the B.C. Lymphedema Association website (www.bclymph.org).
  • Your health insurance may cover the cost of the appointments.
Counselling
Lymphedema can be very hard to deal with. You may feel differently about yourself. Your mood and emotions may change.

  • B.C. Lymphedema Association (www.bclymph.org) has support groups.
  • You can find online support through the Canadian Cancer Society at www.cancerconnection.ca
  • Call your local BC Cancer Patient & Family Counselling program if you want to talk to a counsellor.
 

Revised September 2019

SOURCE: Lymphedema in the arm or leg ( )
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