Lowering your risk of lymphoedema

There are many things you can do to lower your risk of lymphoedema after cancer treatment.

Maintaining a healthy weight

Some research suggests that being very overweight (obese) can increase your risk of lymphoedema.

Maintaining a healthy weight is part of being fit and well. Try to eat a healthy well balanced diet and exercise regularly.

Exercise

Research has found that exercise and movement can help to lower the risk of developing lymphoedema. Most of this evidence comes from research into lymphoedema and breast cancer.

Talk to your physiotherapist or your specialist doctor or nurse before you exercise. They’ll tell you what you can and can’t do after your type of cancer treatment. It is important to build up what you do gradually and get advice if you’re unsure. Take care with movements that are sudden, repetitive or those that make your arm or leg feel tired easily. Examples are lifting, pushing or carrying.

Researchers looked at early physiotherapy after breast cancer surgery. They found that it can help to reduce the number of women who develop lymphoedema. The physiotherapy includes exercises that build up movement over time.

Researchers also looked into the effect of following a year-long exercise programme. This was after breast cancer treatment. The exercise programme included weight lifting. They found that weight lifting didn’t increase the incidence of lymphoedema.

Other good exercises include:

swimming: use a variety of strokes so you’re not always doing the same movement
aerobics: build up gradually if you haven’t done it before and ask at the gym if there's a fitness instructor trained in helping people who have cancer
Tai Chi, yoga and water based exercise: you need to find an instructor with training in working with people with cancer

Skin care

You can help to lower your risk of lymphoedema by looking after the skin of the limb where you've had treatment to lymph nodes. Any trauma, such as cuts and infections, can increase the risk. Sometimes an infection shows as a spreading red area or red streaks along the limb.

To care for your skin you should:

wash your skin gently and make sure you dry it completely
moisturise with a non perfumed emollient
wear insect repellent to avoid bites and stings
be careful when you cut your nails to avoid cutting your skin
be careful when removing body hair – using hair removal cream can be better than shaving, but test the cream first on another part of your body
avoid extremes of temperature, both hot and cold
clean and dry any scratches, burns or cuts, then apply an antiseptic cream and a plaster

Contact your doctor or specialist nurse immediately if the area becomes swollen, sore, red and hot because you might have an infection.

People at risk of developing arm lymphoedema should also:

wear gloves when gardening and washing up
wear oven gloves to avoid burns when taking things in or out of the oven

Avoiding injections

Avoid injections and blood tests in any part of your body where you've had treatment to your lymph nodes. This is because they could increase the risk of developing lymphoedema. Pricking the skin can cause infection or inflammation which can trigger swelling.

There is only anecdotal (word of mouth) evidence for this and we need more research. But for now, it’s best to avoid having injections and blood tests in an area of the body at risk of lymphoedema. This isn't always easy, especially if you're having treatment such as chemotherapy or if you need regular blood tests.

You might need to explain to the health professional that you're at risk of lymphoedema. It can help to have an alert card or bracelet to show them and to remind you about your risk. You can get alert cards or bracelets from the Lymphoedema Support Network (LSN).

Taking blood pressure

Avoid having blood pressure checks on an arm that’s at risk of developing lymphoedema. There is not much evidence to support this, but doctors think the pressure may damage small vessels in the lymph system. This can cause swelling.

Air travel

Research suggests that flying doesn't increase the risk of developing lymphoedema.

Check with your doctor or nurse before flying if you’ve had any early signs of lymphoedema. These signs can include a feeling of heaviness or tightness in a limb. Or you might find that your rings or other jewellery are getting tight.

Your specialist might suggest wearing a compression garment when flying. This can help to prevent further problems if you have had swelling before.

You need to wear a compression garment before and during a flight if you have lymphoedema. You also need to carry on wearing it for a few hours afterwards. This helps to stop the swelling from becoming worse.

A compression garment must fit properly, without being too loose or too tight. A trained specialist needs to measure you for a garment.

Evidence suggests not to wear compression garments if you've never had swelling before. They might restrict the flow of lymph and increase the risk of swelling.

When on a flight, move around as much as you can. Circle your ankles and move your legs and arms while you are sitting. This helps lymph fluid to circulate. Deep breathing can also help.

Tips when you're on holiday

Avoid extreme temperatures and keep cool as much as possible.
Avoid getting sunburned.
Use insect repellent.
Look after your skin – keep it clean and moisturise it.
Clean any cuts, use antiseptic cream, and cover the area.
Look out for signs of infection such as redness, soreness, swelling and hotness.
Drink plenty of water.