Breast Cancer And Lymphedema: What You Need To KnowKatie Taylor
You’ve struggled through breast cancer or another form of cancer. You’ve endured chemotherapy, radiation, and surgery. There have been tears and sleepless nights. But finally, finally, there seems to be an end in sight. So what’s with the unexplained, and very unwelcome, swelling in your limbs? Haven’t you been through enough already?
The unfortunate truth is that cancer patients have a high risk of developing lymphedema, a swelling in parts of your body that results from a damaged lymphatic system. Over time, the swollen area may become inflamed and the skin hard. Mobility in nearby joints may be reduced, and lymphedema can put you at risk for other complications.
Lymphedema is a risk for patients undergoing surgery or radiation for many types of cancer, but it is most often related to breast cancer, prostate cancer, pelvic area cancers, melanoma, head and neck cancers, and lymphoma. It most commonly affects the arms or legs, but it’s not limited to the limbs. After breast cancer treatment, lymphedema may affect the breast, chest, underarm area, and/or the arm or arms closest to the surgery area.
What’s My Risk?
If you have or have had breast cancer, your risk for lymphedema varies based partially on the type of surgery you undergo. After a lumpectomy, lymphedema risk is estimated at 0% to 3%, whereas the risk may be as high as 65% to 70% after a radial mastectomy. An article in American Journal of Clinical Oncology estimates that about 15% to 46% of breast cancer patients will experience lymphedema. Other sources estimate that up to 50% of breast cancer patients (and 100% of head and neck cancer patients) will experience post-treatment lymphedema.
The exact level of risk is debated, but we can all agree that the risk is disturbingly high.
What Is Lymphedema?
The lymphatic system is a network of nodes and lymph vessels running through your body, not unlike the circulatory system. Lymph is the fluid that travels through the system removing waste and toxins from the body’s tissues. The fluid contains proteins, salts, water, and white blood cells that help fight infection.
Lymph fluid travels through the lymph nodes where it is filtered before eventually making it back into the blood stream. There are hundreds of lymph nodes in the human body. Some are deep inside the body near the lungs and heart, and some are closer to the surface, such as those under the arm, groin, and jaw.
When the lymph system is prevented from moving fluid, that fluid builds up and causes the affected part of the body to swell. That swelling is called lymphedema, and there are two general categories of the affliction.
Primary lymphedema is rare. It is an inherited condition not caused by surgery or other cancer treatments. A few rare diseases cause people to be born with abnormalities in their lymphatic systems, and these diseases usually cause swelling in the lower extremities, but they may cause swelling in other areas as well.
Secondary lymphedema is caused by damage to the lymphatic system because of surgery, trauma, radiation, or infection. In the case of cancer surgery, damage is caused because lymph nodes and vessels near a cancerous tumor may need to be removed. This of course limits the lymphatic system’s ability to transport lymph fluid through that part of the body, and swelling may occur after fluid starts to back up. Radiation treatment can scar and inflame lymph nodes and vessels, and infection can restrict the flow of lymph fluid. Cancer itself may block lymph vessels.
Temporary vs. Chronic Lymphedema
Lymphedema may occur shortly after surgery, be mild, and go away in about a month. This is temporary lymphedema, and usually starts a month or two after surgery. Temporary lymphedema can be treated, and you should tell your doctor right away if you experience any symptoms as the efficacy of treatment is linked to how soon treatment is started.
Chronic lymphedema develops slowly and will show up months or even years after cancer treatment is completed. Symptoms range in severity and often are not noticeable at first. There is not a cure for chronic lymphedema, but early detection and intervention increase the success of treatment.