Reducing your risk of arm lymphoedema

Lymphoedema is a swelling that can happen when your lymphatic system is not working properly. The lymphatic system is part of the body’s immune system and carries a fluid called lymph. This system works together with the blood system to transport the lymph fluid and remove waste products. 
 
If the system is disrupted, which can happen if lymph nodes are removed during surgery to treat cancer, then the lymph can build up and cause swelling. 
 
Lymphoedema can occur within a few months, a couple of years, or 20 years or more after cancer therapy.
 

Who is at risk?

You are at risk of developing arm lymphoedema if you have had surgery or radiotherapy to your breast tissue and surrounding area, including your armpit.

What are the signs/symptoms to look out for?

You may notice swelling in your arms, hand, fingers or breast. The swelling may be less in the morning and increase as the day goes on. This swelling may be soft or hard depending on how long it has been present. Your arm may feel heavy and you may experience difficulty in carrying out simple everyday tasks. You may find it difficult to get clothes to fit. 
 
With proper education and care the swelling can be reduced and lymphoedema can be kept well under control.
 

What should I do to reduce the risk of developing lymphoedema? 

Lymphoedema cannot be totally cured but it can be controlled by following a straightforward treatment programme. This aims to restore limb size and function and decrease heaviness.
 
To reduce the risk of lymphoedema developing, the advice below should be followed every day – with particular attention to the arm on the same side as the site of cancer:
 

Take care of your skin

Skincare to maintain good skin quality and reduce the risk of infection is essential in the prevention and management of lymphoedema.
 
Part of the lymphatic system is a fine network of vessels running just below the skin. These vessels help to remove any extra fluid and waste substances from the body’s tissues.
 
It is therefore essential to look after the skin to prevent it becoming dry, cracked or broken. Damaged skin can lead to an infection called cellulitis, which can increase the risk of developing lymphoedema.
 

Skincare tips

  • Cleanse and moisturise your arms daily with unscented soap and cream using gentle upward strokes. 
     
  • Protect yourself against excessive heat, which can increase swelling, by avoiding hot baths/showers, saunas and extreme temperatures.
     
  • Use nail clippers or emery boards rather than scissors.
     
  • Use electric razors instead of normal razors or hair-removal creams.

Hints and tips - Preventing infection

  • Try to avoid cuts, scratches, burns and insect bites and use antiseptic and antifungal creams when necessary. Monitor any cut, no matter how small - even a rag nail.
     
  • Contact your doctor immediately if you notice that your skin has become red, hot and tender, as you may have an infection. This infection is often referred to as cellulitis and it is important to get this treated quickly with antibiotics.

Avoid trauma to your arm

  • If possible, never allow injections, blood-taking or blood-pressure cuffs on the at-risk arm.
     
  • Avoid tight, restrictive clothing, such as tight bra straps, watches, etc.

Exercise regularly

Gentle rhythmic exercises will help to pump your muscles and remove the build-up of lymph in your arm. Try gentle repetitions of the following exercises:
  • Slow ‘boxing’, ‘rowing’ or ‘breast-stroke’ type movements.
     
  • Slowly bend and straighten your elbow and wrist.
     
  • Make a fist and then straighten your fingers.

Take care when travelling

  • Flying with long periods of inactivity can affect circulation and lymph movement.It may even trigger lymphoedema in people at risk of developing it.
     
  • Stretch and move around as much as possible when travelling.
     
  • There is no evidence to suggest that wearing a compression garment when flying reduces the risk of developing lymphoedema and an inappropriate garment may cause more problems.
     
  • Skincare is very important on holidays so avoid sunburn and insect bites.
     
  • Prevent dehydration by frequently drinking water.

What should I do if I notice swelling?

If you notice swelling anywhere on your arm, hand or breast area, even if it comes and goes, you should tell your GP or current healthcare provider and ask to be referred to a specialist lymphoedema therapist. 
 
Early treatment is always recommended, when the swelling is soft and easily managed.

Hints and tips - Reducing your risk of arm lymphoedema

  • Try to use the at-risk arm normally – using the muscles will help to improve lymphatic circulation.
     
  • It is very important to keep your weight within normal limits, as excess weight can increase strain on the lymphatic system.
     
  • Exercise is important, but remember to gradually build up your level of activity over time. In most cases you will be able to continue with the exercises and activities you enjoyed before your cancer treatment.
     
  • Always do a ‘warm up’ and ‘cool down’ before and after exercise. Ask your physiotherapist for advice.
     
  • Avoid over-exertion of the at-risk arm; for example, avoid lifting or carrying heavy objects.

What treatment can I get if I begin to develop lymphoedema?

Your doctor will refer you to a trained specialist for assessment and treatment. The therapist may suggest a programme of complex decongestive therapy (CDT), which consists of gentle massage (manual lymphatic drainage (MLD)), multi-layer bandaging, skincare and exercises.
 
Skills will be taught to help you to manage the long-term condition yourself. The treatment aims to restore limb size and function and reduce swelling caused by the build-up of lymph.
 

Call our Cancer Nurseline

Freephone 1800 200 700 to talk to a specialist cancer nurse
It's open Monday-Thursday from 9am to 6pm and Friday from 9am to 5pm