ASk The Doctor: Lymphedema

I’ve been suffering from lymphedema ever since my lumpectomy. What can I do to relieve the pain and swelling?
By Susan Lark, MD

Luckily, there are several ways to relieve the painful arm and leg swelling caused by secondary, or acquired, lymphedema. This condition, which affects an estimated 3 million cancer survivors, occurs when lymph nodes are damaged or removed during surgery or radiation treatment causing lymph fluid to accumulate in the tissues.

Your lymph system is a network of nodes and vessels. The vessels carry lymph—a clear fluid that collects bacteria, viruses, and dead cells—throughout your body. The nodes strain out these impurities, which are then “gobbled up” by infection-fighting white blood cells. The nodes also work to maintain just enough water between cells so that the cells can exchange nutrients, wastes, and gases as needed. When these powerful little nodes are removed or damaged, lymph can accumulate in your tissues, causing the uncomfortable swelling we call lymphedema. This can lead to painful infections as well as skin folds, which are prime breeding grounds for fungi.

The standard treatment for lymphedema—and an important first step—is manual lymphatic drainage massage (MLD). It’s a gentle, carefully plotted routine that presses, strokes, stretches, and twists the tissues to encourage lymph to flow freely and eliminate waste products from your system. To find an MLD therapist, check the National Lymphedema Network’s website, lymphnet.org.

Once MLD has reduced swelling in your arms or legs, talk to your physician about getting fitted for a compression garment to help keep it down. These specially made garments provide just enough pressure to prevent the re-accumulation of fluids that leads to swelling.

Edema-fighting nutrients
Beyond MLD and compression garments, you can take several steps on your own to ease discomfort and help keep lymph fluid from building up in your extremities. First, avoid alcohol and caffeine, since both depress the system and make lymph flow less efficiently. Second, make sure to get enough of the following nutrients, which can improve lymphatic system function:

Diosmin is a bioflavonoid extracted from the peels of citrus fruits. It enhances lymph flow and circulation by increasing the strength and frequency of the lymph vessels’ contractions. Take 1,000 mg per day, along with 500 to 1,000 mg of diosmin’s cousin, hesperidin, a citrus flavonoid that improves capillary strength.
Bromelain is a natural diuretic and anti-inflammatory in pineapple that research shows may reduce lymphedema swelling. Take 350 to 450 mg twice each day on an empty stomach.
Horse-chestnut extract shows promise in alleviating lymphedema. Its active ingredient, aescin, reinforces connective tissues and vein tone and seals off small pores in your veins, strengthening them and reducing leakage. It also strengthens lymph-vessel walls. Take 250 to 500 mg per day.
Rutin is a bioflavonoid from buckwheat that also reduces swelling and strengthens lymph-vessel walls. Take 400 mg twice daily.
Potassium-rich foods act like diuretics to reduce fluid retention in affected limbs. Good choices include bananas, figs, sweet potatoes, artichokes, raw almonds, and tomato juice.

Hustle and (lymph) flow
Since the lymphatic system doesn’t have a pump (like the heart), it needs activity to flow effectively.
Walk, swim, hike, cycle, or lift light weights. Whichever you choose, tailor your exercise program to your fitness level and ability—talk to your doctor about workout length and intensity.
Bounce on a trampoline (with your physician’s blessing, of course) to encourage lymph flow. A trampoline works your leg muscles, including those you don’t engage when walking on a flat surface. The Lympholine rebounder (lymphforlife.com) is a trampoline developed specifically for lymphatic enhancement that comes with a safety rail.
Note: Just one hour of exercise a day won’t suffice, since after that hour you likely leave your system idle for 23 hours, which can lead to swelling. To increase activity throughout the day, ride your bike to the office or store and take stairs instead of elevators.

Red-light therapy
Many studies have shown the healing benefits of light—especially red light. Various wavelengths of red light easily penetrate the skin to stimulate mitochondria, the cells’ energy-producing powerhouses that work to make every tissue and organ run more efficiently.

The first study of red-light therapy and secondary lymphedema, published in the journal Lymphology in 1998, showed that women treated with red light once or twice a week for 10 weeks experienced measurably less arm swelling, fluid volume, and tissue pressure, as well as marked improvement in pain, tightness, heaviness, cramps, and arm mobility.

When red light penetrates the skin, it reduces lymphedema and helps activate the local immune system by, among other things, stimulating the white blood cells that kill, consume, and carry away pathogens. This creates a more sanitary cellular environment, thereby reducing the risk of skin infections. One of these types of white blood cells, called phagocytes, further reduces tissue swelling by breaking down protein-based debris in the damaged area. Overall, red-light therapy appears to create a healthier tissue environment with faster regeneration of damaged vessels and enhanced circulation.

To treat yourself, hold a red-light device to the affected area. The amount of time varies depending on which device you use, so follow individual instructions. It may take up to two or three months to see improvement in lymphedema symptoms, so don’t give up too soon. Try the X Light from the Chee Energy Company (cheeenergy.com) or the Light Shaker from the Light Energy Company (lightenergycompany.com).

 

Susan Lark, MD, is a women’s health expert and author of the alternative health newsletter Women’s Wellness Today.