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Supportive
Lymphoedema care
A long-term consequence of good cancer treatment, and one that responds well to unglamorous work.
What it is
Removing or irradiating lymph nodes can leave an arm or leg swollen, heavy and prone to infection , sometimes years later. It is not dangerous in itself, but it is disabling and it does not resolve on its own.
Complete decongestive therapy, manual lymphatic drainage, compression, exercise and skin care, is the established treatment. It is tedious, it works, and it is more effective the earlier it starts.
When it is used
- After axillary or groin node surgery
- After nodal radiotherapy
- Any new limb swelling, heaviness or tightness after treatment
- Recurrent cellulitis in a treated limb
How the decision is made
- Baseline limb measurement before surgery, so change can be detected early rather than argued about.
- Compression garment class and fit, the commonest reason treatment fails is a badly fitted garment.
- Whether infection risk needs a standing antibiotic plan.
Assessed and treated here in the rehabilitation clinic; garments through a fitted supplier.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Pre-surgical baseline limb measurement
- Complete decongestive therapy sessions
- Garment prescription, fitting review and replacement schedule
- Skin care and cellulitis prevention plan
- Home exercise programme
Performed and billed elsewhere
- Compression garment manufacture
- Imaging where an alternative cause is suspected
- Sudden swelling with redness, heat and fever suggests cellulitis and needs antibiotics the same day, not at the next appointment.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- What is my risk after this operation?
- What should I do differently with this arm or leg?
- How often do I need therapy sessions?
- How often should the garment be replaced?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.