Complete Decongestive Therapy for Lymphedema
While there is no cure for Lymphedema, a treatment plan is offered to reduce/control pain and swelling.
What is lymphedema?
Lymphedema is an abnormal swelling of a body part which is caused by lymphatic fluid building up in body tissue.
What does the lymphatic system do?
The lymphatic system, which includes lymph nodes, vessels and organs, carries lymph fluid away from body tissues, drains away extra fluids and protein and, as part of our body’s immune system, produces white blood cells.
Why does the lymphatic system fail to work properly after breast cancer surgery?
Lymphedema can occur when the lymphatic system is damaged, such as when lymph nodes are removed during surgery or exposed to radiation as part of breast cancer treatment. As a result, lymph fluid cannot drain normally and that part of the body becomes swollen and heavy with fluid. Breast cancer-related lymphedema may affect the arm, hand, breast or trunk.
How do you know if you’re at risk?
The risk of developing lymphedema after breast cancer treatment increases with the number of nodes removed and can be further increased if radiation therapy is performed. The swelling can occur weeks to months after breast cancer surgery or even years later. Although lymphedema is a lifelong condition, it can be managed with the right treatment and care.
Early signs and symptoms to watch out for:
- Heaviness, aching, or pain in arm
- Visible swelling in arm and/or hand
- Arm becomes tired more quickly than usual
- Skin of arm, hand, or breast feels tight
- Clothing or jewelry feels tight
The treatment plan for this form of care consists of:
- Exercise: Movement of your affected limb may encourage lymph fluid drainage and prepare you for necessary daily tasks.
- Wrapping the Affected Limb: Bandaging your affected area encourages lymph fluid to flow back toward the trunk of your body.
- Massage: Massaging techniques are used to encourage the flow of lymph fluid out of the affected area.
- Pneumatic Compression: A sleeve that is worn over the affected limb connects to a pump that intermittently inflates the sleeve, putting pressure on your limb and moving lymph fluid away from fingers and toes.
- Compression Garments: Long sleeves/stockings are made to compress the affected limb in order to encourage the flow of the lymph fluid out of the area.
- Complete Decongestive Therapy (CDT): This technique involves combining therapies with lifestyle changes. In addition, CDT involves lifestyles changes including four key components: MLD, compression, exercise and skin care. This approach is not recommended for those suffering from heart failure, blood clots or acute infections. It is recommended to be thoroughly evaluated by your physician and lymhedema therapist prior to beginning CDT.
It is recommended that you work with a physical therapist who will assist you identifying and managing the risks that you can control to avoid it.
Some treatment plans your physical therapist might recommend is to develop a safe home exercise program that will contribute to the following:
- Improve your overall fitness
- Avoid weight gain which can increase your risk of lymphedema
- Avoid straining the affected limb during daily tasks
Other recommendations may include periodically assessing the size of your limb to evaluate if there is an increase in limb size. This provides an early intervention to help prevent the swelling from getting worse. Another recommendation is to avoid cuts and abrasions, needle sticks and blood draws, burns and insect bites as all these things are susceptible to infection. Even the smallest of infections can trigger lymphedema.