Lymphedema is a common side effect of cancer treatment, most often breast cancer surgery. Lymph node removal does not cause lymphedema in everyone. Only 3 or 4 out of every 10 people who have this procedure develop lymphedema. Further, radiation lymphedema is a side effect of radiation therapy that can cause swelling, aching, or a feeling of tightness in an arm (or leg depending on the area being radiated). It occurs when radiation therapy damages lymph nodes, which can prevent them from working properly and cause fluid to build up in the surrounding tissues.
During my surgery, I had four lymph nodes removed from my left side and two from my right side. Zero of them were positive for carcinoma. This was great news on the cancer front, but only time would (and still will) tell if I would have lymphedema from the removal of those lymph nodes. I also had a focused radiation field that included by left lymph nodes. So far so good. I delayed writing this post as I didn't want to jinx myself!
So how did I help to avoid getting lymphedema (so far)?
- I wore a silicone wedding band in case my hand started to swell. I did not want to have my actual metal wedding rings cut off my hand.
- I listened to the surgeons and radiation oncologists to not massage my left side as it could overload my lymph nodes. I really wanted to do scar massage but stopped myself due to their instruction.
- I performed only gentle range of motion despite wanting to go full PT on it. Again, instructions from my surgeons and radiation oncologist.
- I always knew I had the ability to see a physical therapist who specializes in lymphedema if we began to see signs. I recommend you have one in your back pocket to get into as soon as possible if you do see early signs of lymphedema.
- Signs of lymphedema include:
- Swelling in your arm, hand, breast, or chest wall.
- Feeling of heaviness, aching, or tightness in your arm.
- Your arm gets tired easily.
- Pain in your arm.
There is research going into sentinel lymph node biopsy for early stage breast cancer as we always know, less is more when removing your own tissue, but removing the correct things to ensure it does not spread is crucial. According to this study, "These findings suggest that patients with BC of a diameter equal to or smaller than 2 cm and a negative result on preoperative axillary lymph node ultrasonography can be safely spared any axillary surgery whenever the lack of pathological information does not affect the postoperative treatment plan." We live in a time when optimal research is being done so we can expect ongoing advancements in recommendations which is why your care team is so important!
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