My name’s Annabel and I was diagnosed with
breast cancer in my left breast.
Immediately after the specialist told me I had breast cancer, I was taken to a consulting
room and my breast care nurse explained the various different procedures that were going
to happen and what type of cancer I had.
She also explained that because my lymph nodes were involved, and that they were going
to do a clearance of my lymph nodes, that there was a danger that I would get lymphoedema.
My name is Dawn Heal and I’m a lymphoedema nurse specialist.
Lymphoedema is a build-up of fluid within the body.
We see it as a swelling and it occurs when the lymphatic system, which normally drains
the fluid away is not working properly.
The lymphatic system is actually part of our immune system and it’s the system that drains
away the body fluid from the tissue space, and also helps us fight infection.
Lymphoedema can be caused in cancer patients by the surgery itself, and especially if this
includes removal of the lymph nodes.
The cancer itself can, once its invaded the lymph nodes, can block off the lymphatic pathways
and this can cause a swelling too.
Any one or a combination of all of these things can cause a lymphoedema in cancer patients.
Not everybody will get lymphoedema but we do know it puts
somebody with cancer treatment at a very high risk.
And therefore, it is important to understand the signs and symptoms
of lymphoedema and how to manage it.
The symptoms of lymphoedema started on
I think it was the fourth day of my radiotherapy treatment and I woke up in the morning and
my hand and my whole arm on my left side were really swollen.
You couldn’t see my wrist, my wristbone had disappeared, and my fingers had gone all podgy.
I wouldn’t say it hurt, it was heavy and uncomfortable,
and my joints were a little bit sore as well.
I went straight to the lymphoedema nurse at Charing Cross hospital and she basically confirmed
what I suspected, that it was lymphoedema.
The symptoms of lymphoedema include swelling;
a change in sensation often occurs; and you may experience a tingling or a feeling of
heaviness or aching within the limb.
Skin changes can occur with lymphoedema. Your skin may feel tight. It may ache.
It may feel stretched and certainly it can become drier.
And the main area where this is likely to be seen is in an arm or a leg.
Your lymphoedema will be diagnosed by your doctor or your nurse specialist,
or it maybe a physiotherapist or a member of your radiotherapy team.
They will then refer you on to a lymphoedema nurse specialist.
If you, as a patient, has a lymphoedema and you’re not getting help, with that, other
tests may be required – such as a scan.
As cancer patients do tend to get blood clots, it is essential that a doctor perform special
tests to rule out a blood clot as this requires more urgent treatment.
If your swelling is due to the damage from the cancer treatment, then she will measure
your limb perhaps with a tape measure or use a specialist equipment.
It is common to get a swelling immediately after your surgery. We call any swelling an odema.
But this is not a lymphoedema.
Swelling immediately after your surgery usually goes away after a few days or weeks, whereas
a lymphoedema can develop months or even years after initial surgery to remove your lymph nodes.
Not everybody that has cancer surgery will get a lymphoedema.
Even if you’ve had removal of lymph nodes and/or radiotherapy,
you still may not get a lymphoedema.
But it is important to understand the risks of lymphoedema and the signs and symptoms
so, that if it does develop, you know how to treat it in the future.