Leg Swelling After Cancer Treatment

September 23, 2009
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In this podcast, we'll review why people treated for certain types of cancer have a higher risk of leg lymphedema, symptoms to watch out for, and some things to do to reduce the risk of leg lymphedema.

Transcript: 

You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, the world's leading professional organization for doctors that care for people with cancer.

Our topic today is Leg Swelling After Cancer Treatment.                                        

Lymphedema is a condition where the arms or legs swell up due to the effects of certain types of cancer or its treatment. It is most commonly thought of as a possible side effect in women’s arms after breast cancer treatment. However, this condition can affect both men and women with other types of cancer, as well. Besides the arm, lymphedema most often involves the lower extremity -- meaning the leg -- and it can affect one or both legs.

In this podcast, we’ll review why people treated for certain types of cancer have a higher risk of leg lymphedema, symptoms to watch out for, and some things to do to reduce the risk of leg lymphedema.

Let’s start by discussing what lymphedema is. Lymphedema is swelling caused by the buildup of lymph fluid in the tissues. This fluid normally carries immune cells all around the body. It is like a highway for your immune system, and lymph nodes can be compared to “rest stops”. When cancer  treatment damages or removes lymph nodes, there may be a backup of fluid because those rest stops are gone. This results in lymphedema. It can be very uncomfortable, and sometimes painful. It can also slow wound healing and raise the risk of infection.

Leg lymphedema can occur after surgery or radiation therapy for several cancers. In particular, treatment to a person’s groin can increase the risk for this type of lymphedema. The groin is the area of the body where the abdomen ends and the legs begin. For example, leg lymphedema can occur after treatment for prostate cancer in men, cervical cancer in women, or bladder cancer, to name a few.   

It is also possible that lymphedema is not related to cancer or its treatment. For instance, infection or injury to the lymph nodes also may cause this problem. 

The development of lymphedema is often subtle, and first symptoms can appear as a heaviness of the leg, or actual swelling. It can also cause a pain in your leg, and a feeling that your clothing is too tight. If you have tightness of your leg skin, or weakness or decreased flexibility of your leg or ankle, these also may be symptoms of lymphedema.     

The condition may develop within a few days, months, or occasionally years after treatment. Lymphedema that occurs soon after cancer treatment usually is mild and may go away within weeks. Lymphedema that is chronic, which means long-term, is more common and may be severe. Talk with your doctor if you have any symptoms after cancer treatment.

There is no cure for lymphedema, so it is important to take steps to reduce risk and to begin proper care should it develop. The standard treatment for leg lymphedema is called complete decongestive therapy or CDT.  It may also be referred to as complete or complex decongestive physical therapy. A physical therapist or other person who is specially trained in treating lymphedema should perform CDT.

CDT combines four main types of treatments.

The first treatment is skin care. You will receive instructions to keep your affected leg clean, moisturized, and free of infection. Chronic lymphedema increases the risk of infection.

The second CDT treatment is manual draining of the lymph nodes. This is the use of gentle massage to help blocked lymph fluid drain properly into the bloodstream.

Third is the use of compression. A lymphedema therapist will apply multiple layers of stretch bandages to your leg, or fit you with a compression stocking or other garment for you to wear at home. An alternative treatment to this is an air compression pump. Use a compression pump only under a trained therapist's supervision.

And the fourth CDT treatment is exercise. Your therapist will show you specific exercises to help your leg range of motion and strength.

In addition, the therapist may include medications to treat related problems, such as antibiotics to treat infections or drugs to relieve pain. Surgery is only used to treat severe lymphedema after other treatments have failed.

Some studies show that lymphedema may improve with certain dietary supplements. However, supplements may cause side effects of their own and can interfere with other medications. Talk to your doctor before taking any supplements.

If you are at risk for leg lymphedema, it’s recommended to follow some basic self-care guidance to prevent the condition. Here are eight tips to follow. These steps can also help leg lymphedema from getting worse, should it occur. 

  • Tip number one: Exercise helps lymph drainage. Talk to your doctor about what exercise plan works best for you.

  • Tip two: Maintain a healthy weight. If you're overweight, losing weight can lower your risk of lymphedema.

  • Number three: If your leg hurts, raise it and prop it up on pillows.

  • Tip number four: Protect your skin by applying daily moisturizer to prevent chapped skin, and avoid cuts, burns, needle sticks, or other injury to the legs and feet. And when you’re outside, wear sunscreen with a sun protection factor, or SPF, of 15 or higher.

  • Number five: Avoid temperature extremes. For instance, avoid hot tubs or saunas or applying a heating pad or ice to your leg. Use warm water while bathing.

  • Tip six: Change your position often. Avoid standing or sitting for a long time. While sitting, don’t cross your legs.

  • Tip number seven: Wear proper footwear. Shoes and socks should not be tight. Wear closed shoes -- not flip-flops or sandals -- in order to better protect your feet.

  • And here’s the final tip: Pay close attention to changes to your leg. Call your doctor if you have any symptoms of lymphedema, or if you have any signs of infection, including a fever, leg redness, swelling, pain, or heat. It’s important to get treatment for this side effect of cancer treatment.

For more information on this topic, contact your doctor or visit www.cancer.net. Thank you for listening to this Cancer.Net podcast.