Lymphedema (PDQ®): Supportive care - Patient Information [NCI] - General Information About Lymphedema
When part of the lymph system is damaged or blocked, fluid cannot drain from nearby body tissues. Fluid builds up in the tissues and causes swelling.
There are two types of lymphedema.
Lymphedema may be either primary or secondary:
- Primary lymphedema is caused by the abnormal development of the lymph system. Symptoms may occur at birth or later in life.
- Secondary lymphedema is caused by damage to the lymph system. The lymph system may be damaged or blocked by infection, injury, cancer, removal of lymph nodes, radiation to the affected area, or scar tissue from radiation therapy or surgery.
This summary is about secondary lymphedema in adults that is caused by cancer or cancer treatment.
Possible signs of lymphedema include swelling of the arms or legs.
Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
- Swelling of an arm or leg, which may include fingers and toes.
- A full or heavy feeling in an arm or leg.
- A tight feeling in the skin.
- Trouble moving a joint in the arm or leg.
- Thickening of the skin, with or without skin changes such as blisters or warts.
- A feeling of tightness when wearing clothing, shoes, bracelets, watches, or rings.
- Itching of the legs or toes.
- A burning feeling in the legs.
- Trouble sleeping.
- Loss of hair.
Daily activities and the ability to work or enjoy hobbies may be affected by lymphedema.
These symptoms may occur very slowly over time or more quickly if there is an infection or injury to the arm or leg.
Cancer and its treatment are risk factors for lymphedema.
Lymphedema can occur after any cancer or treatment that affects the flow of lymph through the lymph nodes, such as removal of lymph nodes. It may develop within days or many years after treatment. Most lymphedema develops within three years of surgery. Risk factors for lymphedema include the following:
- Removal and/or radiation of lymph nodes in the underarm, groin, pelvis, or neck. The risk of lymphedema increases with the number of lymph nodes affected. There is less risk with the removal of only the sentinel lymph node (the first lymph node to receive lymphatic drainage from a tumor).
- Being overweight or obese.
- Slow healing of the skin after surgery.
- A tumor that affects or blocks the left lymph duct or lymph nodes or vessels in the neck, chest, underarm, pelvis, or abdomen.
- Scar tissue in the lymph ducts under the collarbones, caused by surgery or radiation therapy.
Lymphedema often occurs in breast cancer patients who had all or part of their breast removed and axillary (underarm) lymph nodes removed. Lymphedema in the legs may occur after surgery for uterine cancer, prostate cancer, lymphoma, or melanoma. It may also occur with vulvar cancer or ovarian cancer.