Edema or Fluid Retention

This section has been reviewed and approved by the Cancer.Net Editorial Board, 07/2012

Edema is swelling caused by the abnormal buildup of fluid in the body. The fluid collects under the skin within the tissues that are outside of the circulatory system (the system that carries blood through the body). Edema is most common in the feet and legs, but it can occur in the hands, arms, face, abdomen (where it is called ascites), and around the lungs (where it is called pleural effusion).

Causes

Edema may be caused by the following factors:

  • Cancer, especially kidney, liver, or ovarian cancers
  • Some types of chemotherapy, including cisplatin (Platinol) and docetaxel (Taxotere)
  • Other medications, including corticosteroids (medications used to reduce swelling), hormone replacement medications, nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen), and some blood pressure medications
  • Low levels of protein in the blood, caused by poor nutrition
  • Inactivity, which can cause fluid to collect in the feet and legs
  • Problems with kidney, liver, or heart function

Symptoms

People with edema may experience the following symptoms:

  • Puffiness, swelling, or a “heavy” feeling
  • The feeling that clothes, shoes, rings, or watches are too tight
  • Decreased flexibility of the joints in the arms and legs, such as the ankles, wrists, and fingers
  • Shiny, tight, or stiff skin
  • Indentation of the skin when it is pressed (Although, the skin no longer indents when edema is severe.)
  • Sudden or rapid weight gain
  • Decreased amount of urine

Diagnosis

To diagnose edema, your doctor may perform a physical examination to check whether the skin over the swollen area indents when pressed and may ask you questions about recent weight gain, tightness of clothes or jewelry, and other symptoms. The doctor may also order blood and urine tests and x-rays. 

Management 

Relieving side effects—also called symptom management, palliative care, or supportive care—is an important part of cancer care and treatment. Talk with your health care team about any symptoms you experience, including any new symptoms or a change in symptoms.

Managing edema focuses on correcting the underlying cause of fluid buildup. Edema caused by medications or poor nutrition is reversible in some people. Edema caused by cancer or by kidney, heart, or liver problems may be more difficult to treat and may be permanent. The following suggestions may help reduce swelling and relieve symptoms:

  • Ask your doctor about prescription diuretics (medications that eliminate excess fluid from the body by increasing urination).
  • Eat a well-balanced diet.
  • Reduce the amount of salt in your diet.
  • Walk or do other exercises, which helps pump fluids back to your heart.
  • Elevate the affected area when sitting or lying down.
  • Avoid standing for long periods or sitting with your legs crossed.
  • Wear compression stockings or elastic sleeves to help push fluids back into your circulation system.
  • Do not reduce amount of water or other fluids you drink without consulting your doctor.
  • Talk with your doctor about whether physical therapy or occupational therapy may be helpful.

More Information

Fluid in the Arms or Legs or Lymphedema

After Treatment for Breast Cancer: Preventing Lymphedema

Lower Extremity Lymphedema: Leg Swelling After Cancer Treatment