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What You Need to Know about Lymphedema

What Is Lymphedema?

There are so many issues that develop when you have cancer. There are many, many symptoms that can occur, but usually one does not develop all of them. One condition is called Lymphedema. I’m sure you want to know – What is Lymphedema? In my case, I developed almost every single symptom. However, I was lucky that I did not have to deal with Lymphedema What I should say is I have not had to deal with it YET! And I hope I never have to. But just because it has not developed to date does not mean I will not be affected by it.  I do feel it is important to talk about everything that might affect someone while fighting cancer. I did not experience this, but I did learn a lot of information that I feel I can pass on. This is one topic that my surgeon and my cancer liaison discussed with me at length. If one does experience this, it is crucial to understand the reasoning for why one gets it and also what to do about it if you are affected with lymphedema. Lymphedema can OCCUR AT ANY TIME after having surgery and having lymph nodes removed. Once you have been through cancer and have had lymph nodes removed, you can be afflicted by lymphedema at any time for the rest of your life. This is one topic that one keeps in the back of their mind because it can creep up on you later down the road.

Definition of Lymphedema

Lymphedema is a chronic condition most commonly caused by the removal of/or damage to your lymph nodes during or after surgery. It results from a blockage in your lymphatic system, which is part of your immune system. This is due to disruption or damage to the normal drainage pattern in the lymph nodes.  The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling. It usually affects the arm, but it can also affect the breast, the chest and, in some cases, even the legs. The abnormal collection of too much fluid in an affected area causes swelling and this leads to lymphedema. The removal of the auxiliary lymph nodes increases the risk for developing lymphedema. It is worthwhile to learn about preventative measures for lymphedema BEFORE surgery so you have the knowledge of what to look for and can catch it in the early stages. You should have this conversation with your surgeon before surgery and learn all of the warning signs. This is a very serious condition and should not be taken lightly! There are also special compression sleeves that one must wear if one develops Lymphedema. These sleeves are quite tight and fit over the entire arm from the armpit to the wrist. In most cases, they must be worn every day to help control the pooling of fluid in the arm.

In my particular case of breast cancer, the tumor was on the back wall of my chest behind my right breast. Usually, when one develops cancer, it will move into the lymph nodes which are located in many areas of the body. Because of the location of my breast cancer, the cancer had moved into the lymph nodes under my right arm. I was told by my doctor that he would have to remove the tumor and also remove some of the lymph nodes under my arm. In my case, my cancer was a Stage 2, the tumor was about the size of  the end of my middle finger, and the doctor thought that he would need to remove minimal lymph nodes. As it turned out, he only had to remove 4 lymph nodes. You have a total of 20 lymph nodes in two clumps under the arm in each armpit. In my case, 4 were removed from one clump. There are two groups and they are called Level 1 and Level 2. Level 1 lymph nodes are the easiest to reach and remove. Other additional lymph nodes are located under the collarbone and on either side of the breastbone. The lymph nodes are rarely removed during surgery.

The Relation of Lymph Nodes and Breast Cancer

Breast cancer is sometimes predictable even though it is not easily controlled. Cancer cells typically spread through a customary path, migrating out from the tumor into the surrounding lymph nodes. The cancer will likely take this path before progressing to other parts of the body.

The first lymph node we will talk about is the sentinel, which is the first node downstream from the cancer in the circulatory lymph system. In most cases, the cancer travels away from the tumor in the breast and into the lymphatic system. This is the first line of warning. This lymph node will be the first to show symptoms. However, before you are diagnosed with breast cancer, there really is no way to know if this lymph node has been affected. Once you have been diagnosed with breast cancer, you will undergo what is called a sentinel node biopsy. In most cases, the surgeon will remove the sentinel node and send it off for dissection.

There is another procedure called an axillary node dissection. This procedure is used to determine if the cancer has spread to more than one lymph node. The removal of this node is then sent for dissection. The axillary lymph nodes are located in the armpit itself.

Symptoms of Lymphedema

One of the first things the nurses will ask you after breast surgery is if you have any extreme pain. Lymphedema causes unusual and very painful swelling. This pain can be in the armpit, at the surgical location, anywhere in the shoulder area, in the arm, the chest and sometimes even in the legs. There is no cure for lymphedema, and once you develop it, you may live with it for the rest of your life. It is imperative, that if you have any symptoms, you seek help right away. Even though there is no cure, your doctor can help you develop a plan to control the condition as much as possible to reduce the swelling and maintain the reduction. If you exercise, develop healthy habits, eat right and practice  healthy nutrition, you may be able to reduce the symptoms of lymphedema. Also, it is very important to understand the use of lymphedema sleeves to help control the swelling.

What to Do for Lymphedema

No one knows who will develop Lymphedema and who will not. This is one of those medical mysteries. In my opinion, it really depends on the severity of your surgery and how many lymph nodes need to be removed. Once the biopsy has been done, it will reveal how many lymph nodes need to be removed. Obviously, the more lymph nodes removed the more serious the condition. I believe, in my case, because I only had to have 4 removed, my probability of developing Lymphedema was limited. THANK GOD!! With all the problems I already had, I was so relieved that I did not experience this. Of course, I am never out of the woods. I can still develop it at any time during my lifetime. How unfair is that?

Even though Lymphedema is a very serious condition, it is controllable. Once one has experienced Lymphedema, it is imperative to get fitted for a Lymphedema sleeve. These sleeves are made of a rubberized product that causes compression and helps to encourage the flow of the lymph fluid out of the affected limb. In some less serious cases, one can try using a rubberized bandage, like an Ace Bandage, to accomplish the same effect. Some people will try this first because Lymphedema sleeves can be expensive, and not everyone can afford to get one right away. There are so many excess expenses during a cancer bout. This just happens to be one of them!

Lymphedema sleeves are woven with an inlay thread that is either lycra or rubber, providing a high level of compression consistency. It is woven throughout the entire sleeve. By adjusting the tension of this inlay thread, different levels of compression can be achieved.

 

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