mCancerPartner recently talked about men and lymphedema with Katherine Konosky, OTR/L, MS, CLT-LANA, an occupational therapy clinical specialist in the U-M Department of Physical Medicine & Rehabilitation. She is the lead occupational therapist for the Cancer Rehabilitation/Lymphedema Program. Her team does a monthly lymphedema education class at the U-M Comprehensive Cancer Center for patients whose cancer surgery involved the arm, chest or back.
mCancerPartner: In your practice, do you treat many men who have lymphedema?
Ms Konosky: First, lymphedema, which is swelling that happens when the body’s flow of lymph fluid is damaged or blocked, which can occur following any surgery that removes or blocks lymph nodes or following radiation that can damage the superficial lymphatics. There’s a stereotype that only women with breast cancer develop lymphedema, but that’s not true. Anatomically, the lymphatic system is not significantly different between men and women. There’s no difference between men with lymphedema and women with lymphedema. So yes, I’ve worked with many men who have lymphedema. Whether by individual appointment or in class, all our lymphedema patients learn about skin care, lymphatic drainage through massage, compression and stretching, and how to manage symptoms at home.
mCancerPartner: What kinds of cancer surgeries might a man have that remove lymph nodes or damage the lymphatic system?
Ms Konosky: Surgery for prostate cancer is the only one that’s gender-specific. Otherwise, it’s the same as for women – treatment for cancers of the head/neck, breast, bladder or kidney, liver or pancreas, parts of the digestive system; really, any cancer treatment in which lymph nodes are removed or the flow of lymphatic fluid has been damaged or blocked.
mCancerPartner: Do you have a sense for what proportion of surgical patients end up with lymphedema?
Ms Konosky: It depends on the type of surgery and a person’s individual risk factors. For example, about 16% of melanoma patients develop lymphedema, and roughly 10% of genitourinary patients will experience lymphedema.
Someone’s individual risk factors also make them more likely, or less likely to develop lymphedema. These can include:
- How extensive the surgery was
- Whether the patient had radiation treatment and to what extent the lymph nodes were targeted
- Whether the wound took more time than usual to heal
- Whether the tumor was obstructing the lymph system prior to surgery
- If there was scarring from the surgery – scar tissue can act as a barrier to the lymph system
- Pre-existing condition like diabetes, thyroid disease or obesity
- People with venous disease in their legs prior to inguinal (groin area) lymph node removal are at higher risk for lymphedema.
mCancerPartner: Someone has said that men’s and women’s styles for handling various situations are as far apart as the planets Venus and Mars. Do you see that with the men you treat?
Ms Konosky: Yes, I do. Men seem more concerned about what’s going on right now, and less concerned about factors affecting the future. I had one male patient who was worried about his leg bandages falling down when he walked, so he duct taped them in place. That’s concern for the present. In contrast, I don’t think I’ve ever had a male patient say that he typically takes extra care when doing something rough to cover and protect the limb with lymphedema. That would demonstrate concern for the future. So there’s some extra effort in treating or educating men with lymphedema about self-care, since an important goal is to reduce the severity of future lymphedema episodes.
It’s important for any lymphedema patient to understand and adopt these elements of self-care:
- Try to minimize skin or tissue trauma to the involved limb.
- Set a goal to maintain your ideal body weight.
- Modify eating habits to lower salt intake and avoid preservatives/artificial sweeteners.
- Stay hydrated by drinking plenty of water.
- Aim for an active lifestyle, because movement stimulates the lymphatic system.
- For people with lymphedema, screening before starting an exercise program, slow progression of weights, close monitoring for form/swelling, and modification if there is increased swelling or pain after activity.
Take the next step:
- Learn more about lymphedema education classes at the Comprehensive Cancer Center.
- Read more from the Cancer Center blog: Five FAQs about lymphedema.
- Get information about lymphedema from the National Cancer Institute, including a diagram of the network of lymph vessels, tissues and organs that carry lymph throughout the body.
- Find education and support from National Lymphedema Network.
The University of Michigan Health System’s Department of Physical Medicine & Rehabilitation (PM&R) provides a variety of classes and services promoting better health and fitness for both our patients and the general population. We offer more than 20 medically based exercise classes and programs taught by degreed and/or certified professionals, including cancer survivor personal training services at the Transitions Studio
The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan according to U.S. News & World Report. Our multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.