The issue of lymphedema as a risk resulting from cancer surgery is still not always discussed. Since my cancer diagnosis in 1990, you would think this would have improved. It has to a small degree, but still there is much that is not shared.
One of these concerns is the risk of lymphedema due to the pressurization of the plane cabin when flying. Since winter heralds flocks of snowbirds and those of us tired of snow and sleet to warmer climates, I wanted to make sure you were aware and knew what to do.
Please invest in a lower compression (preventive) lymphedema sleeve. Wear it on the flight and make sure you also get a gauntlet (glove) with it. Some lymphedema sleeves have the gauntlet as part of the garment. Not only will the sleeve moderate the pressure on your arm, but will also remind you to be mindful when lifting your luggage as heavy lifting is also a risk factor.
Prevention is key. Once you are diagnosed with lymphedema, it will be a lifelong commitment of maintenance. Better to prevent if at all possible – at least reduce the risk by being aware.
Exercise plays a key role in both reducing the risk of lymphedema as well as the management of lymphedema.
Lymphedema is caused by an interruption or restriction in the flow of lymph fluid following surgery. Most people are aware of arm lymphedema caused by breast cancer surgery, but leg lymphedema can be a side effect of prostate or abdominal surgeries. Torso lymphedema can happen from neck and throat surgeries.
There are several ways to reduce the risk of lymphedema, however, exercise for lymphedema is extremely helpful and well documented by research.
Here are some important things to remember when exercising:
Open the lymphatic system first. The lymphatic drains are located by your throat and will allow the flow of lymph fluid which will increase with the exercise. The Healthy-Steps program (formerly The Lebed Method) has a wonderful Lymphatic Opening exercise and program for those who may be at risk for lymphedema.
Make sure the exercise movements are slow to medium speed and smooth flowing versus jerky. After surgery, especially if lymph nodes have been removed, the lymphatic transport system will be compromised and could become congested if the flow of lymph fluid is too fast. Think of a superhighway where the traffic is rerouted from four lanes to one lane.
Wear proper compression garments which are designed to assist the flow of lymph fluid (i.e. lymphedema sleeve) during exercise if you already have lymphedema. This includes the gauntlet (glove) to ensure the build up of fluid does not travel to the hand.
After a mastectomy, choices for undergarments take a new turn. Some women have opted for breast reconstruction to eliminate this issue. However, there are many women who choose not to go that route and therefore look for functional but attractive mastectomy camisoles and bras .
One mastectomy camisole that is very useful and a welcome addition to any wardrobe is a black shaper camisole. This camisole is not only designed to accommodate a prosthesis, it also has compression for those who develop torso lymphedema. Do not confuse this garment with SpanX which has compression, but not the graduated compression required for torso lymphedema.
A bonus is the trimming effect on the midriff. Often when undergoing treatment, women gain weight, especially around the middle, so something that will make us look and feel trim for special occasions boosts self esteem.
Following surgery (mastectomy or lumpectomy), it’s important to take proper precautions to reduce the amount of discomfort and swelling that may follow post surgery. Purchasing a new bra is high on the list of steps to reduce the risk of swelling and increase your overall comfort. Depending on your surgery, your doctor may recommend that you wear a compression bra.
A compression bra has a padded front zipper closure for ease of getting on and off when you arm is sore, adjustable hook-and-eye shoulder straps to ensure a proper fit and a latex-free fabric that pulls moisture away from the body and dissipates heat buildup. The bra also has a soft compression band that encircles the torso gently, has attachments to easily manage the draining tubes, and delivers comfort for the surrounding skin and muscle tissue. Patients who are susceptible to lymphedema are often told to wear a compression bra.
To determine what bra size you are you’ll want to measure your chest directly under your breasts and around your back, thus determining band size. To determine cup size you’ll want to measure the fullest part of the larger breast from the midpoint of your chest, over the larger breast, and to the center of your back. Multiply the number by two. Then check the manufacturers sizing charts for your correct size.
Many women opt for breast reconstruction after a mastectomy. It entails another two surgeries – one for the insertion of the tissue expander, followed by several stages of expansion of the tissue, and then finally, the final insertion of the permanent implant.
During this time, a comfortable bra that gives you the support and comfort you need is very important. You will be tender, so soft cotton will feel gentle against your skin. Plus you want to minimize seams which can cut into areas of scarring. It pays to be prepared, have a look at the options available and make sure you have a compression bra that works for you.
Lymphedema is still not widely understood or acknowledged as a risk of cancer, especially breast cancer. There are guidelines for prevention if known beforehand. The sad thing is that once a person gets lymphedema, there is no cure. So, prevention is key.
So, what is Lymphedema. Here is an excellent video explaining exactly what lymphedema is.
A verbal definition of lymphedema, as stated by the National Lymphedema Network, is:
“Lymphedema is an accumulation of lymphatic fluid in the interstitial tissue that causes swelling, most often in the arm(s) and/or leg(s), and occasionally in other parts of the body. Lymphedema can develop when lymphatic vessels are missing or impaired (primary), or when lymph vessels are damaged or lymph nodes removed (secondary).
When the impairment becomes so great that the lymphatic fluid exceeds the lymphatic transport capacity, an abnormal amount of protein-rich fluid collects in the tissues of the affected area. Left untreated, this stagnant, protein-rich fluid not only causes tissue channels to increase in size and number, but also reduces oxygen availability in the transport system, interferes with wound healing, and provides a culture medium for bacteria that can result in lymphangitis (infection).”
Lymphedema can occur in the upper and lower extremities (arms and legs – and even torso). You are at risk if you have had surgery for cancer that involves removal of lymph nodes. For more detailed information, read the following books about Lymphedema.
Over the next few posts, I will be covering some the issues related to lymphedema and cancer.