After Cancer Treatment

What is Lymphoedema After Cancer Treatment?

Lymphoedema can be a side effect of the treatment of cancer.

During surgery for cancer, nearby lymph nodes are removed and during radiation therapy, lymphatics are destroyed. Both of them alone or in combination in a susceptible patient can disrupt the flow of lymph which leads to lymphedema in the arm or leg.

When Does Post-Cancer Treatment Lymphoedema Develop?

People who do develop lymphedema do so within two to three years after their surgery, but it is important to note that the risk remains over a person’s lifetime and increases with trauma or injury to a limb.

Exploring Causes of Post-Cancer Treatment Lymphoedema

Also, some people can develop lymphedema even when lymph nodes are not removed if the lymphatic system in the skin is injured from extensive surgery or from radiation therapy.

The Most Notable Example: Breast Cancer-Related Lymphoedema

Often during breast cancer surgery , some or all lymph nodes are removed from the arm. Added damage to the lymphatics is done by postoperative radiation therapy because of which there is a higher risk of lymphedema in breast cancer survivor patients.

Identifying Symptoms of Post-Cancer Treatment Lymphoedema

• Swelling of the involved extremity.
• The feeling of fullness or heaviness.
• Itching and Burning sensation.

Untreated Lymphoedema: Potential Complications

• Thick skin, deformed part.
• Recurrent infections /oozing of fluid out from the skin of the affected part.

Diagnosis of Lymphoedema

• Physical examination and history give a clue about the diagnosis
• Lymphoscintigraphy – Here a radioactive dye is injected into the lymphatics and then scanned by a probe to know and delineate the flow of lymph through the lymphatic vessels to diagnose the obstruction of lymphatics.

Preventing the Progression of Lymphoedema

• Avoid constrictive clothing
• Wear compression garments
• Manage weight effectively
• Consult a lymphoedema therapist
• Incorporate aerobic exercise and weightlifting into your routine
• When possible, steer clear of skin-penetrating medical procedures in the affected limb
• Seek prompt medical attention if concerning symptoms emerge in the affected limb.
• Contact your doctor if the affected arm or leg develops a rash; becomes red, blistered, painful, or warm to the touch; or if you get a fever (temperature greater than 100.4ºF or 38ºC).

Effective Treatment Options for Arm Lymphoedema

• A compression garment or a lymphedema sleeve or stocking.
• Compression therapy devices.
• Limb elevation and exercises.
• Massage therapy.
• Preventing infection.
• Surgical treatment.

Effective Surgical Approaches for Arm Lymphoedema

MICROSURGICAL APPROACHES:

There are 2 surgical procedures that can treat lymphedema in post-cancer patients in the initial phases .

1. Free vascularized lymph node transfer : Superficial lymph nodes are harvested from the neck with an artery and vein and microsurgical anastomosis to a recipient artery and vein after tissue release at the wrist region.

• a) Advantage of recruitment of healthy vascularized tissue.
• b) Challenging and technically demanding procedure.
• c) Post-op period with initial rigorous monitoring and maintenance of position by the patient.
• d) Subjective improvement was reported by 100% of patients with 78% being able to discontinue compression therapy.

2. Lympho-venous bypass : In this procedure, the blocked lymphatics are connected to the veins.

• a) Super-microsurgical technique to anastomose distal subdermal lymphatic vessels and adjacent venules <0.8mm.
• b) Minimally invasive, minimal pain, discharged within 24 hours.
• c) Challenging and technically demanding procedure.

Debulking Procedures

If the extremity is severely deformed or is in an advanced stage of lymphoedema, then debulking procedures will help in reducing the severity of the disease. EXCISIONAL procedures or LIPOSUCTION of the arm can be done.

Rely on Kayakriti's Expertise

At Kayakriti, we specialize in advanced techniques and are staffed with experienced professionals who ensure patients with lymphoedema receive optimal care and treatment.

Furthermore, our minimally invasive lymph-venous bypass procedures are associated with minimal discomfort and rapid recovery. Dr. Amit Agarwal , a specialist in these treatments, aids patients in regaining their quality of life after cancer-related lymphoedema.