Raising Awareness of Cancer Related Lymphoedema Macmillan Community Lymphoedema Specialists

1. Raising Awareness of Cancer Related Lymphoedema Macmillan Community Lymphoedema Specialists • What is it? • Lymphoedema is a swelling caused by a build up of lymphatic fluid in the tissues of the body. • At risk patients groups • a cancer diagnosis with lymph node involvement • radiotherapy to lymph nodes (e.g. axillary or inguinal nodes) - see fig 1 • lymph nodes surgically removed • Common cancers involving inguinal and axillary node removal • Breast • Cervical, uterine and vulval • Prostate • Melanoma/sarcoma • Not all patients will develop cancer related • Lymphoedema for example statistics show that • 1 in 5 breast cancer patients will be affected by • Lymphoedema following cancer treatment • (Cancer Research UK). • Additional trigger factors • Trauma to affected limb (cut, graze, insect • bite, puncture wound from blood taking) • Seroma drainage • Infection • Secondary disease (tumour obstruction) • Chemotherapy • Figure 1 • Figure 2 • Reducing the risk of developing lymphoedema • Avoid having blood taken from affected side • Avoid sunburn • If trauma to the skin occurs, wash, keep covered until healed and check wound for infection • Infection must be treated promptly • Avoid extremes of temperature hot baths, sauna, ice baths) • Continuing post surgery exercises on a daily basis • Daily skin care to prevent infection, using non perfumed cream • Treatment and Management • Treatments vary according to the severity of the lymphoedema. Patients with minimal oedema can commence on a self care maintenance programme. This may include wearing a compression sleeve (see fig 2) or stockings, daily skin care, mobility exercises and self massage to the affected limb. • Intensive treatment is indicated if the Lymphoedema is severe (this is unusual if early referral to a specialist is made). Treatment would include a 2 to 3 week period of multi layer lymphatic bandaging, and if indicated specialist manual lymphatic drainage. • Conclusion • Whilst Lymphoedema is essentially not curable, it is very manageable. Early detection and referral to a Lymphoedema service, will increase the chances of success with treatment. • julie.smith@hchs.nhs.uk susan.hammond@hchs.nhs.uk • anna.hoon@hchs.nhs.uk ruth.wagner@hchs.nhs.uk