Sheila H. Ridner, PhD, RN, FAAN, is the Martha Rivers Ingram Professor of Nursing at Vanderbilt University School of Nursing in Nashville, TN. She is an internationally recognized scientist and expert in the field of lymphedema and lymphatic research.
Hi. I am asking the question on behalf of a family member. As a result of being diagnosed with cancer of the uterus approx 14 years ago they underwent a full hysterectomy, they subsequently had chemotherapy and radiotherapy. The lymph nodes were removed from the left leg area. Over the past 4 years lymphodema has become an increasing problem down the left leg. A large lump has grown on the inner thigh and treatment is having very little impact. They are under the care of the Christie Hospital but due to this condition being extremely under funded there are very few options. They currently wear a compression stocking every day which is bearable however trying to obtain a second stocking has become impossible as the nurses never get the measurements right. Very frustrating!! They have visited a clinic in London to investigate the possiblity of lymph node transplant but apparently this is not an option as it has been stated there is a lot of scar tissue?? Whatever that means. I would like to know if there is anywhere in the UK that specialised in lymphodema and what does your research suggest for long term treatment? Many Thanks
As per Dr. Mortimer-
The large lump that has grown on the inner thigh is presumably a large lymphoedema fold although without imaging such as ultrasound examination one cannot be sure. Treating lymphoedema folds is difficult and needs very skilled bandaging. It is important to ensure there is no (over)weight issues as that makes these folds more likely to develop, and more difficult to treat. If all else fails one might have to consider liposuction but everything depends on the circumstances of this patient. Reconstructive lymphatic surgery is unlikely to be an option.
The biggest lymphoedema centre in the UK is at St George’s Hospital in London. The lymphoedema Support Network in the UK (http://www.lymphoedema.org/lsn) should be contacted for advice”
Hello Dr. Ridner: In 1999 I had 15 lymph nodes removed in association with a diagnosis of breast cancer and I am currently lymphedema free. I am interested in flying as a mode of transportation but have heard that the cabin pressure changes could cause Lymphodema. Is there any new information and/or treatment options for people who want to travel by air, but are at risk for lymphedema?
Response from Dr. Ridner:
“Thanks so much for your question and congratulations on 15 years of survival and being lymphedema free. I am unaware of any new information regarding air travel, or any older evidence based information that addresses this concern. Some lymphedema at-risk patients chose to see a certified lymphedema therapist prior to flying and purchase a well-fitted compression sleeve to wear when flying. This is the most common risk reduction practice for air travel, though it is not based on research. If you think you would like to obtain a sleeve, please see a certified lymphedema therapist and be fitted by someone who is experienced in measuring arms for the compression sleeves, as a wearing poor fitting sleeve is believed to put you at risk for lymphedema. For more information on this please check out http://lymphnet.org/resources/position-paper-lymphedema-risk-reduction-practices. I hope you enjoy you upcoming travel!
I have lymphedema in my legs that started when I was about 13 and they say it is primary lympehdema. I am worried about having children. Can I pass this lymphedema on to my children?
I am sorry to hear about your problem, but commend you for asking this thoughtful, very important question. Unfortunately some types of primary lymphedema can be passed on through your genes. I strongly suggest you locate a genetic counselor to assist you in determining if this might be a risk for any children you may have.
Everyone seems to think surgery is what causes lymphedema after breast cancer, but I had very little surgery and a sentinel node biopsy. I also had radiation to my breast. I think the radiation caused my lymphedema in my arm. Can radiation cause lymphedema?
The short answer to your question is yes, potentially life-saving radiation can cause lymphedema. A recent publication, Lymphedema Predictor Factors after Breast Cancer Surgery: A Survival Analysis by Monleon, Murta-Nascimento, Bascuas , Macià, Duarte, & Belmonte addresses radiation in survivors of breast cancer and the role it plays in lymphedema. You can read a summary of this article at http://www.ncbi.nlm.nih.gov/pubmed/?term=lymphedema++and+monleon.
I've had secondary lymphedema for 11 years resulting from removal of lymph nodes under my arm. I exercise, wear a sleeve and a Solaris garment at night. My arm swells sometimes when I take prescribed medications and then I have to work with it for weeks to get it down. It has never been back to normal size even with the PT manual drainage I have had. I have trouble with clothes with this big arm. Would low level laser help to break up scar tissue and could this help? Sincerely, Anne (I've tried a pump also.)
There is some scientific evidence to support that low level laser may be helpful to some people, though results are never guaranteed. You can go online to : http://www.ncbi.nlm.nih.gov/pubmed/ and search for” low level laser and lymphedema”. There you will find a few studies that are free to read that will help you understand low level laser and lymphedema. If you decide to try a laser it is very important to locate a trained lymphedema therapist with experience in using the laser for lymphedema to provide the treatment.