Managing Lymphedema (swelling)

in Your Arm or Leg

What is lymphedema? Your lymph nodes can be damaged by: Lymphedema (lim-fuh-dee-muh) is a build-up of  Cancer and cancer treatments. lymph fluid in your tissues. This build-up causes  Surgery (lymph nodes may be removed). swelling (“edema”) in your arm or leg.  Inflammation (your body’s immune system What causes lymphedema? response). Your lymphatic system helps fluid flow through your  Infection. body tissues. The lymphatic system carries fluid back to the bloodstream, through a network of channels Breast cancer treatment is the most common cause and lymph nodes. of lymphedema. Most people with breast cancer do not get lymphedema. The lymph nodes filter lymph fluid and help fight infections. If your lymph nodes are damaged or Lymphoma, melanoma, uterine, prostate, vulvar or removed, lymph fluid can build up and cause ovarian cancers and treatments are also associated lymphedema. with lymphedema. Your chance of getting lymphedema will also go up if The Lymphatic System you have:

 More than one treatment in the same area (for example, surgery and radiation).

 Extra body weight.

 Repeated infections in the same arm or leg.

Signs of lymphedema

 Your sleeve, wristwatch, rings or socks leave marks in your skin.

 Your arm, leg or pelvis feels full, puffy or heavy.

 You have swelling in your arm or leg, including your fingers or toes.

 It is hard to move the joints in your arms or legs.

 Your skin is tight, warm, shiny, and thick or the texture has changed.

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Lymphedema usually starts in your underarm, neck, For the arm or leg that has lymphedema, pelvis or groin (the area where your upper leg meets or is at risk for lymphedema: your pelvis). Lymph fluid can then build up in your chest, pelvis, arm or leg.  Try not to get needles (injections or shots) or blood pressure measurements, especially if Lymphedema does not spread to other parts of the there is swelling. body. It will only be in areas of your body where you  Treat cuts or burns quickly. Keep the area clean, have damaged lymph nodes. If you have damaged use an antiseptic ointment (for example lymph nodes, you will always have a risk of getting Polysporin) and cover with a bandage. lymphedema.  If you notice redness, warmth and pain in your Can lymphedema be cured? skin, you may be getting an infection. Talk to your health care team right away. We cannot cure lymphedema, but it can be managed. By getting treatment early, you will increase the  Keep your skin clean and moisturized likelihood if successful treatment. Do not wait to start  In the sun, wear sunscreen and long sleeves or treatment. pants

What can I do for myself?  Wear loose fitting jewelry and clothing without tight cuffs or waistbands Talk to your health care team if you notice any signs of lymphedema or if your lymphedema gets worse  Do not carry a heavy bag on the arm with despite treatment. Lymphedema is easiest to treat lymphedema when it is mild.  Do not use extreme heat or cold, such as ice Your health care team will give you instructions on packs and hot packs. Check with your health how to care for your arm or leg. It is very important care team before using saunas, steam baths and you follow these instructions. hot tubs.

By managing your lymphedema, you can:  Wear gloves when gardening or cooking so you do not get cuts or bug bites  Reduce swelling.  Do not wax. Use an electric shaver. This is  Improve movement. unlikely to cut your skin. If you have to use a  Lessen pain. razor, use clean, sharp blades with soap or  Prevent infection. shaving cream.

 Stop your lymphedema from getting worse. Get a Compression Garment

How to manage your lymphedema These are sleeves, stockings or gauntlets (gloves). Take very good care of your skin to: They are made of elasticized fabric that put pressure on your arm or leg. This pressure helps drain lymph  Prevent infections. fluid and stop it from building up.

 Keep your skin healthy. You usually need to wear these garments all day.

To get a compression garment, a certified fitter needs to measure you. February 2020 2

You can find fitters at medical supply shops or  They use compression bandages, a type of pharmacies. massage called manual lymphatic drainage,

Check the B.C. Lymphedema Association website for exercise, and skin care. a list of shops or ask your health care team  You can get a list of certified therapists from (www.bclymph.org). the B.C. Lymphedema Association website

If you have lymphedema from breast cancer (www.bclymph.org). treatment, Pharmacare may pay for two compression  Your health insurance may cover the cost. garments each year for each arm that has lymphedema. To get coverage you must have had: Talk to a counsellor or go to a support

 A mastectomy (removal of one or both of your group

breasts) Lymphedema can be very hard to deal with. B.C. OR Lymphedema Association (www.bclymph.org) has support groups.  A lumpectomy (removal of a part of your breast).  You can find online support through the Canadian Cancer Society at Pharmacare does not cover compression garments www.cancerconnection.ca for lymphedema that is caused from anything other than breast cancer treatment.  Call your local BC Cancer Patient & Family Counselling program if you want to talk to a Try to Exercise Regularly counsellor.

Exercising has many benefits: Where can I learn more?  Increases muscle tone.  BC Cancer Library Recommended Lymphedema  May help move lymph fluid out of your arm or leg Websites: www.bccancer.bc.ca/our- and reduce swelling. services/services/library/recommended- websites/managing-symptoms-and-side-effects-  Helps keep a healthy body weight. websites/lymphedema-websites

Exercise tips  BC Cancer Library Lymphedema pathfinder:

 Talk to your health care team before starting an www.bccancer.bc.ca/library- exercise. site/Documents/pathfinder_Lymphedema- General.pdf  Pick exercise you enjoy.  Find a trained Physiotherapist:  When you rest after exercise, raise your swollen bcphysio.org/find-a-physio arm or leg to help drain the excess fluid. Advanced search > Areas of Practice: See a Certified Lymphedema Therapist Lymphedema, Breast Health, Women’s Health.

 Specially trained Physiotherapists and Massage  BC Cancer Supportive Care Services: Therapists who can help you manage www.bccancer.bc.ca/supportivecare lymphedema.

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