Lymphoedema Awareness Month
For those that might not know, it’s Lymphoedema awareness month!! According to Australian Lymphology Association, an estimated 40,000 people in Australia and New Zealand are living with Lymphoedema; while up to 20% of all breast, ovarian and prostate cancer survivors develop the condition.
What is Lymphoedema?
For those of you who are unsure about exactly what Lymphoedema is, it is the swelling which occurs when the lymph fluid builds in the tissues of the arms/ legs /other areas of the body. This usually occurs due to damage of the lymphatic system resulting in insufficient drainage, and leading to swelling (oedema). During treatment of various cancers (most commonly breast cancer), it may be necessary to remove one or more lymph nodes from the surrounding area to which may be affected by cancer cells (Cancer Council). Any person who has had lymph nodes removed as part of treatment may be at risk of developing lymphoedema (Westmead Breast cancer Institute).
In the case of breast cancer, the greatest risk occurs with the removal of the nodes from the axilla (armpit), known as axillary lymph node dissection (ALND); radiotherapy in combination, further increases risk. The sentinel node/s, is/are the node/s to which breast fluid drains initially. Removal of the sentinel node/s reduces the risk of developing lymphoedema. Lymphoedema can occur at any stage of treatment even when cancer free or in remission, months to years down the track.
If you or someone you know is at risk, symptoms to be aware of include:
- Swelling of the arm/hands/fingers (or lower limbs if nodes have been removed from the groin or knee).
- Swelling in regions of the breast/chest/ armpit/ or lower limbs.
- Feelings of pain, aching, tightness or bursting, heaviness in the hand, arm or lower limbs, tingling.
- Pitting of the skin (following pressure applied, the indent remains in the skin)
- Dry/ sensitive skin
- Clothing feels tight
*symptoms may be mild, moderate, or severe(Cancer Council).
The good news is the condition is manageable. Treatment for Lymphoedema includes Complex Lymphatic Therapy: Manual lymphatic drainage, compression garments, skin and arm care, low level laser therapy, psychological support and yes exercise!
In the case of breast cancer, we understand that you or your loved one may have concerns when moving the arm, as many women fear this will make the condition worse; as an exercise physiologist this is something we come across often. To the contrary however, movement is fantastic! Moving and using the arm actually aids lymph fluid movement and drainage (IT RELIES ON IT!); the muscles of the arm act like a pump to push the fluid out of the tissue. Resistance training has also been shown to be effective in lymph drainage. Providing progression is gradual, exercise is SAFE and should be encouraged (Westmead Breast cancer Institute). There is evidence to show that moderate exercise will not worsen symptoms and will not increase susceptibility; with some evidence suggesting it may help to prevent the occurrence (Breast Cancer Network Australia).
If you love to exercise, or enjoy various activities, don’t let lymphoedema hold you back. Gradually increase load/intensity to normal levels, progress slowly, modifying to symptom response. Flexibility exercise can help to decrease scarring and or tightness, as well as improve lymph flow. Aerobic training and deep respiration can also enhance drainage, and you should modify your strength training according to your symptoms. Aim to build to 150 min/wk aerobic exercise, being mindful of overall arm work that stresses the lymphatic system (eg. Sunburn, bruising, blisters, cuts etc.) (Cancer Council).
Things to be aware of:
- Compression garment fitting will advise that the garment should be worn during exercise.
- Stay hydrated when exercising.
- Work toward normal activities, however start slow and gradually build up to previous activity intensity/load.
- Be aware of symptoms.
- Avoid periods of inactivity or stillness: stretch and move.
- Keep skin healthy, unbroken – treat quickly if skin is broken.
- Avoid using the arm in a manner that places extra load on the lymph system:
- Avoid getting too hot: exercise in the morning or evening
- Use aircon if possible
- Avoid getting sunburnt or hot water to skin contact.
- Take short breaks if you find yourself getting too hot
- Avoid repetitive tasks with the affected limb: use pacing or short burst with intermittent breaks.
- Avoid clothing and activities that make the arm feel tight: wear loose fitting clothing, BP readings using the unaffected arm etc. (Westmead Breast cancer Institute).
- If upper limb lymphoedema: avoid lifting or carrying heavy objects with the affected limb if you’re not used to doing so.
- If lower limb lymphoedema: avoid crossing your legs, move around if you have to sit for work, or standing for long periods of time (Cancer Council).
All in all, find something you enjoy doing, whether it is swimming, aerobics class, running, cycling or general gym work as exercise can help to reduce the symptoms of, and may even work to prevent lymphoedema from occurring.
If you would like more information, shoot us a message, email or give us a call, or if you’re in the area pop in and say hi!
Yours in health, happiness and healing,
Occupational Therapist – Alchemy in Motion