Lymphedema Treatments

How is lympedema treated?

Complete decongestive therapy is the most common treatment for lymphedema. At City of Hope, this process begins with a certified lymphedema therapist evaluating you and creating a treatment plan that may include one or more of the following strategies:
  • 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.

Meet the Lymphedema Surgeons

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?

There is usually limited pain, and you may have to limit some of your activities or movement after surgery.

What are the risks?

As with any surgery, there are risks such as infection. Your surgeon and your care team will review the risks and answer any questions you may have. The procedure will leave small, permanent scars in the treatment area.

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?

The procedure may help reduce the severity and progression of the lymphedema, reverse some of the changes seen within the affected limb, and diminish pain, heaviness and infection.

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.