Treatment Side Effects - Lymphedema

The body’s lymphatic system contains vessels, tissues, and organs that transport lymph fluid. The lymphatic system, including the lymph nodes, play a critical role in the body’s immune response, helping us to fight off infections and other foreign invaders. When lymph nodes are damaged or removed, it’s possible for lymph fluid to buildup in certain areas of the body. This fluid buildup causes swelling that may occur right after surgery or months after surgery or radiation. Common signs of lymphedema include:

• Loss of flexibility or range of motion in ankles, feet, wrists, or hands
• Feeling of fullness in the legs or arms
• Clothing or jewelry feeling too tight
• Swelling of the abdomen or genital area
• Thickening of the skin
• Itching of legs or toes
• Burning feeling in legs¹

How can prostate cancer treatment cause lymphedema?

Prostate cancer treatment can lead to the development of lymphedema, specifically secondary lymphedema. When a person with a healthy or normally-developed lymphatic system experiences damage to the system later in life, it is considered secondary lymphedema. Radiation therapy can cause damage to the lymphatic system and lymph nodes. Additionally, surgery, specifically surgical removal of lymph nodes (including the pelvic lymph nodes), can cause secondary lymphedema. Lymphedema can occur with any intervention that blocks or impairs the flow of lymph fluid. The extent of disruption to your lymphatic system depends on the type and intensity of treatment you received or how many lymph nodes may have been removed from your body. The more lymph nodes that are removed, the higher the risk of lymphedema.^1,2

What are ways to manage it?

Managing lymphedema is very important. Lymphedema tends to be easier to treat when diagnosed early. Not only for general comfort and ease of movement, but also, because trapped fluid can make it easier to develop a serious infection and destruction of the skin.

It is important to monitor yourself for signs of infections including pain, redness, heat, fever, and red streaks under the skin. It is also important to avoid having an injection or needle stick in the affected area, as well as to protect the skin while gardening, cooking, or performing any other activity that could lead to cuts, bruises, or scrapes. It’s also very important to wear sunscreen and bug spray when outside, as well as to practice hygienic behaviors when it comes to shaving and using razors. If you notice you have a concerning cut, bruise, or any signs of infection, contact your doctor immediately.

Moving around regularly is another key component to managing lymphedema. Practicing gentle exercise (pre-approved by your doctor), avoiding crossing your legs or sitting in one position for more than 30 minutes, and getting up to walk around every so often while sitting or lying down can be simple, yet efficient, ways to reduce swelling. Additionally, avoiding tight clothing and jewelry, and extreme temperatures (both very hot and very cold) can also help reduce lymphedema and increase fluid movement and drainage. Massages given by a trained professional and designed to help drain fluid may also be an option.

Your doctor may also recommend custom fitted compression garments or devices to help the flow of lymph fluid and prevent future swelling. Occasionally, lymphedema may cause pain or discomfort. In situations like this, you may be able to utilize pain medications, pain-relieving relaxation techniques, or transcutaneous electric nerve stimulation (TENS therapy), among other options.^1-4

Impact on quality of life

It’s important to talk with your doctor about lymphedema and make an effort to manage it whenever possible. This is not only for the physical benefits, but also for the mental and emotional benefits as well. Lymphedema has been linked to decreased quality of life in cancer survivors. This can be due to the loss of function, strength, range of motion, or flexibility of joints or limbs, as well as the potential inability to perform normal tasks.

Additionally, body image issues may develop if an individual has visible swelling of different regions of their body, or has clothes, jewelry, and accessories that no longer fit. These frustrations can grow and can lead an individual into developing depression, anxiety, or social avoidance.

Not everyone will experience these issues when dealing with lymphedema, however, if you or a loved one begins to show signs of these struggles, consult a healthcare provider for support.