Lymphedema: Suggestions

The suggestions that follow are based on the information presented in the Detailed Information document. They are meant to help you take what you learn and apply the information to your own needs. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Additional Resources document for links to more resources.

Discuss treatment alternatives that may reduce your risk for lymphedema with your health care team:

Before any major procedure - a biopsy, lymph node mapping or an operation - talk with your health care team about your potential risks for lymphedema and ways to reduce these risks. With proper education and care, you can decrease your chances of developing lymphedema.

Talk to other survivors about ways they manage their lymphedema:

Support groups provide a safe environment to share experiences with other survivors, learn new ways to handle difficult situations and talk about the emotions. You will see different styles of coping with stress and adjusting to life as a cancer survivor. If you are uncomfortable talking about certain subjects with your family or friends, a support group offers you a place to talk freely about what is important to you.

Ways to find out more about support groups in your area:

Ask your health care team for suggestions. Some cancer programs offer support groups for cancer survivors and their family members right in the clinic or hospital.
Call a nearby cancer center or university hospital and ask about support groups.
Call the American Cancer Society at 1-800-ACS-2345 (1-800-227-2345) and request a list of support groups and cancer centers in your area.
Visit LIVESTRONG^TM SurvivorCare at www.livestrong.org/survivorcare, or call 1-866-235-7205 for information on support groups.

Learn about strategies to minimize your risk for lymphedema:

Review these suggestions carefully with a member of your health care team.

Strategies	Management
Watch for even slight increase in size or swelling of the arm, hand, fingers, chest wall, trunk or legs.	Contact your health care team as soon as you notice any one of these symptoms.
Avoid having injections, finger sticks, or blood draws from the arm that might be at risk for lymphedema.	If there is no other option, the injection or stick site needs to be carefully prepared with an antiseptic and covered with a protective bandage afterwards. You should tell the person injecting your arm that you might be at risk for lymphedema.
Do not have blood pressure checked from the at-risk arm.	After procedures involving the breast or the armpit, use the arm on the unaffected side for blood pressure checks. When procedures have involved both sides of the body, use the thigh for blood pressures checks. You should tell the person taking your blood pressure that you might be at risk for lymphedema.
Keep the skin of at-risk arms or legs very clean and healthy.	Use moisturizing cream or lotion (such as Eucerin, Lymphoderm, Curel) after bathing. Dry gently but thoroughly.
Make sure the at-risk arm or leg gets proper circulation.	You can do this by occasionally raising the at-risk or affected arm or leg above the level of your heart.
Avoid vigorous, repetitive movements against resistance with the at-risk arm or leg.	Use the other limb if possible or ask for help. You should also avoid scrubbing, pushing, pulling, etc.
Avoid heavy lifting or putting excessive pressure on the affected limb.	Limit lifting to less than 15 lbs Women using breast prostheses after mastectomy should select a lightweight prosthetic Use only loose-fitting jewelry around at-risk or affected fingers or arm(s).
Never carry heavy handbags or bags with at-risk or affected arm.	Do not use over-the-shoulder straps on the at-risk or affected side.
Avoid extreme temperature changes on the at-risk arm or leg.	Closely monitor temperature changes when bathing or washing dishes. Avoid saunas and hot tubs, or at least keep affected limbs out of extreme temperatures.
Protect affected limbs from the sun at all times.	Wear protective clothing and sunscreen.
Minimize chances of any injury: bruising, cuts, sunburn or other burns, sports injuries, insect bites, animal bites or scratches to the affected arm or leg.	Shave with an electric razor rather than a safety razor. Wear gloves while doing housework, gardening, or any type of work that could result in even a minor injury. Wear shoes or house slippers to protect feet. If you are getting your nails done, tell the manicurist or pedicurist of special needs and precautions. If injuries do occur, watch for signs of infection including swelling, redness, pain, and fever.
Establish a safe exercise program.	Consult with a member of your health care team before starting an exercise program. Try not to use an at-risk arm or leg too much. If there is discomfort, aching or pain, lie down and elevate the limb. Walking, swimming, light aerobics, bike riding, and specially designed ballet or yoga may be included in your safe exercise programs.
Take special precautions when traveling by air.	Wear a well-fitted compression sleeve or stocking. Additional bandages may be required on long flights. Increase fluid intake while in the air. Ask for guidance from a lymphedema specialist before travel.

Learn about lymphedema therapy:

Lymphedema therapy is provided by a therapist (physical therapist, occupational therapist, registered nurse, or massage therapist) who has specialized training in lymphedema management.

Part of Standard Lymphedema Treatment	What the Treatment Involves
Compression Bandaging	A well-fitted daytime compression garment prevents daytime swelling. An overnight garment reduces night-time swelling. Specialized bandaging is used around the clock during intensive treatment to reduce limb volume. Overnight bandaging may be continued as part of self-management to control swelling.
Exercise	Exercise under the guidance of the therapist and while the limb is under compression is carried out daily to help reduce limb swelling. Over-exertion is avoided to prevent fatigue and further swelling.
Skin Care	The skin is moisturized and protected from breakdown to prevent infection, which further increases limb swelling and can lead to life-threatening systemic infection.
Healthy Diet	Maintain a healthy weight with a well-balanced diet. Drink enough fluids. No dietary protein restriction is recommended, even though lymph is a protein-rich fluid.

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