Lymph nodes are part of your body’s immune system. The immune system helps your body fight infection and disease by circulating lymph fluid throughout the body. Lymph nodes carry lymph fluid from node to node through this web-like system.

Cancer may affect the lymph nodes, making it necessary to remove those nodes. When lymph nodes are removed, it changes the flow of the lymph fluid.

Lymph fluid may build up in parts of the body where lymph nodes have been removed or damaged. This causes lymphedema, a swelling that can be very painful. It is important to learn if you are likely to suffer from lymphedema, as you can take steps to avoid or lessen its impact.

Who is at risk for lymphedema?

  • Breast cancer patients whose surgery required removal of lymph nodes under the arm
  • Other cancer patients whose treatment also required the removal of lymph nodes under the arm
  • Cancer patients whose surgery required removal of lymph nodes in the neck (head and neck cancers, thyroid cancer)
  • Cancer patients who have had lymph nodes removed from the groin area (testicular cancer)
  • Cancer patients who had radiation treatment that damaged lymph nodes

What are the symptoms of lymphedema?

  • Swelling (pressing the skin with your finger may leave a dent or impression)
  • Pain
  • Numbness
  • Loss of ability to move the affected area
  • Hardened skin
  • Ulcerations/tears in swollen skin

How can I avoid lymphedema or avoid making my lymphedema worse?

  • If you had lymph nodes removed from under your arm, do not have your blood pressure taken from that arm, especially if you have had the symptoms of lymphedema.
  • Similarly, do not have blood drawn or receive shots or IVs in an area where lymph nodes have been removed.
  • Avoid sunburns by staying out of the sun and always wearing at least SPF 30 sunscreen.
  • Use insect repellent when outside to help avoid bites that could lead to infection.
  • Avoid trauma or injury to the area where lymph nodes have been removed.
  • Avoid heavy lifting with the affected arm.
  • No new tattoos in the affected area.
  • Do not wear tight clothing, bands, shoes, or jewelry on the affected area.
  • Wear a compression sleeve or stocking, if ordered by your doctor.
    • The snug way a compression sleeve or stocking fits on your arm or leg helps lymph fluid move though the system instead of getting blocked.
    • Compression sleeves for lymphedema need to fit correctly. An ill-fitting compression sleeve may make lymphedema worse.
    • Your healthcare team can help you find the correct compression sleeve for you.
    • Compression sleeves and stockings are often not covered by health insurance, including Medicare and Medicaid plans.
      • Ask your case manager or representative if lymphedema sleeves and treatments are covered by your plan.
      • Ask your healthcare team about free or reduced-cost resources in your area or at your treatment center.
      • Seek financial assistance.
  • Keep your skin moisturized and healthy to avoid cracks that may lead to infection.
  • Maintain a healthy body weight.
  • Eat a variety of fruits and vegetables.
    • Choose whole grains.
    • Choose lean proteins.
    • Limit sugar and sweets.
    • Drink eight glasses of water a day.
  • Exercise.
    • Ask your healthcare team which exercises are right for you. Some exercises may make lymphedema worse.
    • Talk to your healthcare team before beginning any new exercise program.

How can I manage lymphedema?

  • Tell your healthcare team as soon as you notice the symptoms of lymphedema.
  • If your lymphedema is moderate to severe, you doctor may recommend you to a lymphedema therapist or a physical therapist for complex decongestive therapy (CDT).
    • Complex decongestive therapy involves a few different strategies, as follows:
      • Massage
      • Skin care
      • Special exercises
      • Compression bandages
    • The massage is called manual lymphatic drainage (MLD). This massage style helps move lymph fluid through the system to decrease pain and swelling.
    • Your lymphedema therapist may also recommend a pneumatic compression sleeve.
      • These sleeves have an attached pump that inflates and deflates the sleeve around the affected arm or leg.
      • The pump helps move lymph fluid through the system.
  • Follow the same guidelines for avoiding lymphedema listed above.
  • Lymphedema can make it easier to have infections in the affected area.
  • Tell your healthcare team immediately if you notice any of the signs of infection:
  • Fever
  • Redness or red streaks
  • Warmth or heat at the swelling area
  • Cloudy pus or drainage