Fluid Retention or Edema

Approved by the Cancer.Net Editorial Board, 10/2016

Edema is swelling caused by the abnormal buildup of fluid in the body. The fluid collects under the skin or within spaces inside the body, such as the abdomen or chest.

Edema most commonly occurs in the feet and legs. It can also occur in the hands, arms, face, chest, and abdomen. Edema may be called by a different name depending on where in the body it is located. Examples include:

  • Edema in the abdomen is called ascites.

  • Edema around the lungs is called pleural effusion.

  • Edema throughout the whole body is called anasarca.

  • Edema caused by a blockage in the lymphatic system is called lymphedema.

Causes of edema

The following factors may cause edema:

  • Cancer, especially kidney, liver, or ovarian cancers

  • Some cancer treatments, including the following:

    • Radiation therapy

    • Surgery that damages or blocks the flow of lymphatic fluid

    • Some types of chemotherapy, such as cisplatin (Platinol) and docetaxel (Taxotere)

  • Other medications, including the following:

    • Corticosteroids, which are drugs that reduce swelling

    • Hormone replacement medications

    • Nonsteroidal anti-inflammatory drugs (NSAIDS), drugs such as ibuprofen or naproxen

    • Some blood pressure drugs

  • Low levels of protein in the blood, caused by the following:

    • The cancer

    • Problems with the liver producing proteins

    • Problems with the kidney leaking protein into the urine

    • The body not being able to absorb protein in foods

  • Inactivity, which can cause fluid to collect in the feet and legs

  • Problems with kidney, liver, or heart function

  • Blood clots, particularly in the legs or arms

  • Problems with hormone levels, especially from the thyroid or adrenal glands

Symptoms of edema

People with edema may experience the following symptoms:

  • Puffiness, swelling, or a heavy feeling

  • 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 when it is pressing the skin. However, this happens with only certain types of edema and may not happen when edema is severe.

  • Sudden or rapid weight gain

  • Decreased amount of urine

  • Weeping of fluid out of the skin

Diagnosing edema

To diagnose edema, your doctor may check whether the skin over the swollen area indents when pressed. Your doctor may also listen to your lungs and examine your abdomen. He or she will likely ask you questions about recent weight gain, tightness of clothes or jewelry, and other symptoms. You may also need to have blood, urine tests, heart tests, and x-rays. 

Managing edema

Relieving side effects is an important part of cancer care and treatment. This is called symptom management or palliative care. 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 is reversible in some people, if it is caused by treatable cancers, drugs, hormonal imbalance, blood clots, heart function, kidney abnormalities, or nutritional problems due to the disease. Edema may be harder to treat when it is caused by cancers that no longer respond to treatments or by kidney, heart, or liver problems that have come back or worsened. In these situations, edema may be permanent. The following suggestions may help reduce swelling and relieve symptoms:

  • Ask your doctor about prescription diuretics, which help get rid of extra fluid from the body by increasing urination. However, diuretics do not always help and may cause different problems.

  • Reduce the amount of salt in your diet.

  • Walk or do other exercises, which helps pump fluids back to your heart.

  • Raise 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 talking with your doctor.

  • Talk with your doctor about whether physical therapy, occupational therapy, or visiting a certified lymphedema therapist (CLT) may be helpful.

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