Ann O’Mara, PhD, RN, MPH, Head of Palliative Research at the National Cancer Institute’s Division of Cancer Prevention, explains.
Who is at risk for getting lymphedema?
Having lymph nodes removed during breast cancer surgery can put you at risk. Women who have this along with chemotherapy are at highest risk. Patients with head and neck cancer, which is primarily men, who have radiation and lymph nodes removed also can get lymphedema. Women having lymph nodes removed for cervical cancer are also at risk.
On the other hand, head and neck cancer patients who don’t have lymph nodes removed but do receive radiation can develop lymphedema. So it’s not just the removal of lymph nodes.
Not everyone who has lymph nodes removed gets lymphedema. That’s the puzzle—who is and who is not going to get it? Right now, we don’t know, and that’s where the research is.
Trends in Lymphedema Research
- Lymphedema and Breast Cancer: Christine Miaskowski, RN, PhD, FAAN, of the University of California San Francisco is leading a study of a large group of women with breast cancer who received the same surgery and the same treatment after surgery. It aims to find out if genes cause lymphedema.
- Lymphedema and Gynecologic Cancer: Richard R. Barakat, MD, FACS, of Memorial Sloan Kettering Cancer Center, recently completed a study of women with gynecologic cancer. The study seeks to find why patients get lymphedema.
- Regenerating Lymphatic Tissue: Research funded by NCI is examining the possibility of reviving lymphatic tissue and restoring lymphatic flow. “That’s now being studied in animal models,” Dr. O’Mara says. “But if we can find a way to regenerate lymphatic tissue, that would be huge progress.”
Can you be born with lymphedema?
There is a lymphedema that people are born with. They have weak lymphatic drainage and it may be very subtle. Then it can become full blown. We do believe there likely are women with certain genes who are at higher risk.
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How can patients make sure they get timely lymphedema diagnosis and treatment?
Women will report a feeling of heaviness in their arms. They are not able to get their rings off, and then their fingers start getting stiff. Don’t ignore it! Get back to your surgeon because that’s the best time to treat it. Massage from physical therapists who specialize in lymphedema, wearing compression garments, and exercise are great ways to help control lymphedema.
Besides painful swelling, what are other complications of lymphedema?
The swelling of lymphedema disrupts blood flow. That can keep wounds from healing. It’s important to protect the affected arm. Infection is the major problem. Also, women with cancer of the vagina, uterus, or ovaries who have surgery are at risk for blood clots in the deep veins of the legs, known as deep vein thrombosis.