Lymphedema
Overview
Lymphedema is swelling that develops due to the abnormal collection of fluid beneath the skin, most commonly in an arm or leg. This can occur when lymph nodes are removed or damaged during cancer treatment.
If you have been diagnosed with lymphedema, or if you may be at risk of developing it, the multidisciplinary lymphedema program specialists at City of Hope will provide you with the information and expertise you need. Our specialized team of doctors, surgeons, nurses and certified lymphedema therapists will guide you through each step of the journey, from diagnosis to treatment to long-term management.
- What is lymphedema?
- What are the signs and symptoms of lymphedema?
- How is lymphedema evaluated and diagnosed?
- How is lymphema treated?
- Surgery as a treatment for lymphedema
- What should I expect from surgery?
- Learn more about our renowned lymphedema surgeons
Request a consultation
City of Hope’s multidisciplinary lymphedema program offers patients the latest surgery, technology, research and innovation while providing compassionate care. Please call 800-826-4673 for personalized assistance or request an appointment online. Visit Making Your First Appointment for additional information.
Request an Appointment Online
800-826-4673City of Hope is one of a small number of cancer centers in the U.S. that offers microsurgery treatment for lymphedema.
Located near Los Angeles, City of Hope is a nationally recognized leader in the research and treatment of cancer. We are one of the few facilities designated a comprehensive cancer center by the National Cancer Institute, For more than a decade, U.S. News & World Report has named City of Hope one of the top cancer hospitals in America.
NEWS & BREAKTHROUGHS
What is lymphedema?
What is the lymphatic system?
Are you at risk for lymphedema?
What are the signs and symptoms of lymphedema?
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The limb or affected area feels heavy or full
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Tightness or decreased flexibility in the nearby joints
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Slight puffiness or swelling in the limb or nearby tissue
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A lasting ‘dent’ in the skin when you press it with your finger
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Veins, tendons or knuckles become harder to see
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Skin that was wrinkled becomes smooth
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Clothes or undergarments become too small
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Swelling that makes removing watches and rings more difficult
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Changes in skin texture, such as swelling, hardening or redness
Lymphedema evaluation and diagnosis
Prior to your cancer treatment our certified lymphedema therapists will meet with you to collect diagnostic baseline measurements, educate you about how to reduce your lymphedema risk, teach you what symptoms to look for, and answer any questions or concerns.
During this evaluation your lymphedema therapist will ask questions and perform tests.
These include:
- Your cancer history and your complete medical history
- Detailed information about any symptoms you may be experiencing
- A personal history regarding lifestyle, work or school requirements, nutrition and exercise regimens
- A physical examination of the skin and soft tissues of the affected area
- Precise measurements of the circumference along multiple points of the affected limbs or area of the body
- Bioimpedance scanning: This test detects the amount of fluid in the limb. The device passes a small and painless electrical current through the limb and measures the level of resistance to the current. The higher the fluid content, the lower the resistance reading. The test is particularly useful in cases where visible symptoms are slight or absent.
- Additional imaging studies such as magnetic resonance imaging or computed tomography scans to rule out other problems that could be causing lymphedema
How is lympedema treated?
- Skin Care - It is very important to avoid injury and infection. Practice good hygiene and put on moisturizing lotion. We will teach you how to care for your skin.
- Massage - Manual lymph draining is a precise and gentle form of massage that helps move the fluid to other parts of the body for clearance.
- Exercise - Stretching, strengthening and range-of-motion exercises can help restore limb volume to a more normal functional level and improve the movement of fluid. Exercise may also be helpful with weight control, which is an integral part of lymphedema therapy. Exercises should be performed under the guidance of a certified lymphedema therapist.
- Bandaging - Cotton, low stretch bandages apply constant pressure on the limb. Bandaging is usually combined with other methods of treatment.
- Compression Garments - Elastic fabric garments similar to a girdle or support stocking put pressure on the arm or leg to help move fluid and keep new fluid from collecting.
- Presurgery Evaluation - Prior to surgery for lymphedema, the use of specialized imaging allows your surgeon to visualize the affected tissues more precisely using ICG fluorescent technology.
Surgery for lymphedema
At City of Hope’s multidisciplinary lymphedema program, certified lymphedema therapists work with our world-renowned surgeons, oncologists and nurses. They combine expertise with the latest in research and technology to provide you with the most effective treatment.
We are one of a small number of cancer centers in the U.S. that offers microsurgery for lymphedema. Although the surgery is not a cure, it has been shown to improve the severity of the condition and to reduce the number of complications.
Thanks to rapid advances in technology that allow imaging of the extremely small lymphatic vessels, as well as microscopes and instruments that make it possible to see and operate on the structures of the lymphatic system, several microsurgery techniques are now available to patients who fall within certain specific criteria.
What should I expect from surgery?
While many patients see improvement, every patient’s treatment experience will be unique. Our multidisciplinary lymphedema care team is made up of plastic surgeons, certified lymphedema therapists and interventional radiologists. The team will provide a thorough evaluation prior and postprocedure to assess and document your improvement and provide follow-up care if necessary. The surgery may not help every patient or offer complete cure.
The skilled physicians at City of Hope use the following procedures to treat lymphedema:
- Lymphaticovenous bypass - Also known as LVA, this procedure redirects the lymph fluid to small veins. This is essentially an outpatient procedure which takes between four to six hours and results in virtually no blood loss. Patients typically stay less than 24 hours for observation.
- Vascularized lymph node transfers - A surgical procedure in which lymph nodes from elsewhere in your body are transplanted in order to replace those removed as part of cancer treatment
What care would I need after surgery?
What are the risks?
Does lymphedema go away?
Although there are rare cases when lymphedema has improved and been eliminated, in many patients it requires long-term treatment and management.
What are the advantages of the procedure?
Would I still need lymphedema treatment postsurgery?
Although you may experience some improvement postsurgery, we recommend you continue your prescribed treatment to get the best possible results. For example, we would recommend continued use of your compression garments, consistent massage and exercise, and caring for your skin.
