Lymphoedema

Lymphoedema is swelling (oedema) that develops when lymph fluid builds up in the tissues under the skin or sometimes deeper in the abdomen and chest areas. This happens because the lymphatic system is not working properly in that part of the body. It usually occurs in an arm or leg, but can also affect other parts of the body.

Lymphoedema can be either primary (when the lymphatic system has not developed properly) or secondary. This fact sheet is only about secondary lymphoedema following treatment for cancer.

Cancer or cancer treatment can damage or block the lymphatic system, which can stop the lymphatic system from working properly. This means that lymph fluid doesn’t drain as it should and instead builds up in the tissues, causing swelling.

Learn more about:

• The lymphatic system
• When does lymphoedema develop?
• What are the risk factors?
• How common is lymphoedema?

The lymphatic system

The lymphatic system is part of both the circulatory and immune systems. It consists of:

Lymph vessels – A large network of thin tubes found throughout the body. Lymph vessels carry lymph fluid from our tissues, organs and structures to the lymph nodes.

Lymph fluid – This normally clear fluid travels to and from the tissues in the body, carrying nutrients and taking away bacteria, viruses, abnormal cells and cell debris.

Lymph nodes (glands) – Small, bean-shaped structures found along the lymph vessels. Lymph nodes are located throughout the body, including in the neck, underarms, chest, abdomen and groin. The lymph nodes filter lymph fluid as it passes through the body, before emptying most of the fluid into the bloodstream.

Other lymph tissue – As well as lymph nodes, lymph tissue is found in other parts of the body including the spleen, bone marrow, thymus, tonsils and some lymph tissue in the digestive tract.

The lymph fluid, lymph nodes and lymph tissue contain white blood cells called lymphocytes, which help protect the body against disease and infection.

The lymphatic system

When does lymphoedema develop?

Lymphoedema can affect people at any time – during active cancer treatment, after treatment or in remission. It can also develop while you’re living with advanced cancer or during palliative treatment. Lymphoedema can occur months or years after treatment. It usually develops slowly.

What are the risk factors?

Whether or not you develop lymphoedema after treatment for cancer depends on the location of the cancer, its stage and the type of treatment. While the risk is lifelong, most people who are at risk never develop lymphoedema.

Some factors increase the risk:

• surgery to remove lymph nodes – the more nodes removed, the greater the risk of developing lymphoedema; having a sentinel lymph node biopsy reduces the chance of getting lymphoedema but it can still occur in a small number of people
• radiation therapy that causes scarring and thickening of the tissues and often the lymph nodes and lymph vessels
• taxane-based chemotherapy drugs (talk to your oncologist if you are concerned)
• an infection in the limb at risk of developing lymphoedema (i.e. the arm or leg on the side where the lymph nodes were removed)
• injury of the lymphatic system – for example, a tumour growing near a lymph node or vessel can block the flow of lymph fluid
• an existing problem with the lymphatic system (underlying primary lymphoedema)
• rheumatoid arthritis
• being overweight or obese
• not being able to move around easily.

See the How to reduce your risk of lymphoedema table for tips on lowering the risk of developing lymphoedema.

How common is lymphoedema?

Lymphoedema can occur following treatment for many different cancers. There is little statistical information about how common lymphoedema is following cancer treatment. However, one Australian study estimated that lymphoedema occurs in over 20% of all cancer patients treated for gynaecological (vulvar/vaginal, ovarian, uterine and cervical), breast, prostate cancers or melanoma.