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Signs and symptoms of lymphedema

Lymphedema is a condition caused by a blockage in your lymphatic system, leading to swelling in the affected area, most commonly in the arms or legs. This swelling can worsen over time if left untreated.

Besides swelling, other signs and symptoms are typical of lymphedema. If you’re at risk, monitor these signs and communicate with your Healthcare Professional about them, as early recognition and treatment are crucial for managing symptoms and preventing complications.

Common symptoms and signs

Swelling:

  • Swelling of the arm(s), leg(s) or other parts of the body: The most common sign of lymphedema is swelling that worsens throughout the day. This can include fingers or toes. Swelling in both arms or both legs (bilateral lymphedema) is relatively rare. Other affected areas can include the head, neck, or genitals.
  • Swelling progression and persistence: Swelling often progresses during the day and improves when you elevate the limb (helping lymphatic fluid return to the center of your body). Swelling that persists for more than three months should be monitored closely.
  • Pitting edema: Applying pressure to your skin, e.g. with your thumb, leaves an indentation.

Changes in sensation:

  • Heaviness or tightness: The affected area may feel heavy, tight, or stiff.
  • Aching or discomfort: The affected area may experience soreness or pain.

Skin changes:

  • Fibrosis: The skin may become hard and tight over time, and wart-like growths and skin folds can develop in the affected area.
  • Skin discoloration: The skin may change color and appear redder.
  • Lymphorrhea: Fluid may leak through the skin.
  • Skin infections: The affected area is more prone to infections, such as cellulitis.

Mobility issues:

  • Reduced mobility and range of motion: Swelling and discomfort may limit movement.

Other indicators:

  • Tighter clothing and jewelry: The effected area may cause clothes and accessories (especially rings and bracelets) to feel tighter than usual.

Lymphedema symptoms can evolve over time. Without treatment, swelling may become permanent, making the affected area feel hard and solid. Unlike earlier stages, this swelling does not improve overnight.

Who is at risk of developing lymphedema?

Lymphedema can develop in various individuals, especially those who have undergone cancer treatments. Knowing the risk factors can help you catch it early and get the treatment you need.

  • Cancer patients: Lymphedema can develop after cancer treatment, such as removing lymph nodes after surgery, radiation treatment, or after some types of chemotherapy or hormone treatment. It is most commonly seen with breast cancer in women and with prostate cancer in men.
  • Congenital conditions: Some individuals are born with underdeveloped or missing lymphatic vessels.
  • Infections or injuries: Trauma that damages the lymphatic system can lead to lymphedema.
  • Obesity: Carrying extra weight can increase the risk of developing lymphedema.
  • Chronic venous insufficiency: If you have vein issues, you might also be at a higher risk.

If you fall into any of these categories, it's important to keep an eye on your body for signs and symptoms of lymphedema and to consult your Healthcare Professional.

Swelling after cancer treatment

Certain cancer treatments can lead to the development of lymphedema. For example, after breast cancer surgery, lymphedema mainly occurs in the arm but can also develop in the chest/breast area, and chest wall. Obesity increases the risk of lymphedema after breast cancer treatment.

In patients with prostate cancer, swelling can occur around the groin and may affect the genitals. Other cancers associated with lymphedema include cancers in the pelvic area (bladder, testicles, penis, cervix, ovaries, vulva, or rectum), lymphoma, melanoma, and cancers of the head and neck.

Lymphedema is a significant burden, especially when associated with cancer. Treating it requires a holistic approach that also includes your mental well-being. Self-management and connecting with others facing the same challenges are crucial parts of the treatment process.

When to visit a doctor

If you start to see symptoms of lymphedema, such as persistent swelling, skin changes, or reduced mobility, it is crucial to visit a Healthcare Professional for proper diagnosis and treatment. Early intervention can prevent severe complications.

Should I expect to feel pain?

Pain can be a symptom of lymphedema, varying from mild discomfort to severe aching. The pain can result from swelling, skin changes, and reduced mobility. Managing pain is an essential part of lymphedema treatment, often involving physical therapy, compression garments, and medications.

Is swelling always a symptom of lymphedema?

Lymphedema should not be confused with other conditions that cause swelling. Unlike general swelling or edema caused by heart, liver, or kidney issues, lymphedema is specifically related to lymphatic system dysfunction. For a comprehensive guide, see our article "Understanding lymphedema."