Treating lymphedema after breast cancer


Lymphedema symptoms can include swelling in the hands or feet.

Katherine Konosky is making a presentation on lymphedema on Saturday, April 12 at the U-M Comprehensive Cancer Center’s Breast Cancer Summit. See more details below about this free event.

As many as 10 million Americans suffer from lymphedema, which causes swelling in arms, legs or other parts of the body. It can be a frustrating and chronic long-term side effect of cancer treatment. Although it is more common than multiple sclerosis, Parkinson’s disease and breast cancer – combined – lymphedema has historically been little understood, even by health care professionals. The good news is that with improved imaging equipment, we are understanding more about the function of the lymphatic system.

The lymphatic system includes:

  • bone marrow
  • spleen
  • thymus
  • tonsils
  • the  lymphatic network

The lymphatic network is composed of delicate branching vessels that cover your entire body which transport  fluid from the tissue space to lymph nodes and eventually back to the circulatory system.

The role of the lymphatic system is to keep people healthy which includes:

  • fighting infection
  • maintaining fluid balance in the tissues
  • breaking down fat in the intestines
  • helping with blood pressure regulation

Anyone who has undergone lymph node dissection and/or radiation is at risk for developing lymphedema. For people who were treated for breast cancer,  lymphedema  may occur in the breast, chest wall, and/or arm on the side that was treated. We don’t know why some breast cancer survivors get lymphedema and some don’t, but the longer a person survives, the greater her risk for developing lymphedema.

The first signs of lymphedema include swelling or a feeling of fullness in an arm or leg. People with lymphedema should talk to their physician and get a referral to see a therapist who is certified to treat lymphedema (CLT)  for  complete decongestive therapy that includes:

  • skin care
  • manual drainage (a special form of light massage)
  • bandaging
  • stretching
  • compression garment recommendations
  • education about self-care

We recommend that all people with an altered lymphatic system follow the risk reduction guidelines of the National Lymphedema Network.

I encourage everyone to take these steps for better lymphatic health:

  1. Drink plenty of water: stay hydrated but limit caffeinated beverages.
  2. Get plenty of sleep: your lymphatic system is most active when sleeping. Aim to get 7-9 hours a night.
  3. Reduce consumption of foods with preservatives or artificial sweeteners, which add extra load onto your lymphatic system.
  4. Exercise/stretch regularly: contraction of your muscles, movement of your skin and the pulsing of your arteries and veins stimulate lymphatic return to the circulatory system.
  5. Reduce body fat: the lower your Body Mass Index, the less chance you have of developing lymphedema
  6. When working at computer: limit time of sitting, pay attention to posture, take breaks away from computer, and take a short walk. Your posture can affect lymphatic return.
  7. Deep breathing: by deep breathing you accelerate the rate at which the thoracic duct pumps , helping to keep the lymph system moving.
  8. Take care of your skin: It is your first line of defense against infection.
  9. Manage stress because cortisol, the ‘stress hormone,’ inhibits the lymphatic system from doing its job.

Take the next step:

  • Attend the U-M Cancer Center’s Breast Cancer Summit on Saturday, April 12. Free, but registration is required. Round trip bus transportation provided from East Lansing and Jackson. Talks include:
    • How decisions are made in breast cancer treatment
    • Inherited susceptibility to breast cancer
    • Movement for lymphatic health
    • Guided imagery for managing difficult times
  • Attend a lymphedema class at the U-M Comprehensive Cancer Center.
  • Call 734-936-7070 to make an appointment with a U-M occupational therapist.
  • Learn more about lymphedema from the National Cancer Institute.

KKonosky.fwKatherine Konosky, OTR/L, MS, CLT-LANA, is an occupational therapy clinical specialist in the U-M Department of Physical Medicine and Rehabilitation. Its Division of Occupational Therapy offers a team approach to help patients reach their daily living goals, under the care of licensed occupational therapists and occupational therapy assistants, certified therapeutic recreation specialists and support staff.



Cancer-center-informal-vertical-sigThe 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 for cancer patient care. Seventeen 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.