Alberta Cancer Foundation

Ask the Expert: Lympedema and weight loss during treatment

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Q: I have developed lymphedema as a result of my cancer treatment. What does this mean and what can I do to relieve the discomfort?
A:
Lymphedema is swelling that often occurs after cancer treatment. Susan Bocchinfuso, a physical therapist and owner of the private practice Oncology Rehab, explains that the lymphatic system is responsible for keeping people healthy. “It produces white blood cells that help fight disease and regulates fluid levels in your body,” she notes. “When the lymphatic system is injured from cancer treatment, it does not work as efficiently, and fluid can accumulate.”

Bocchinfuso says lymphedema most commonly occurs in the arm or leg, and that while surgery and radiation therapy are effective treatments for cancer, they are also the most common causes of injury to the lymphatic system. “During surgery, lymphatic vessels and nodes are commonly removed. If the remaining lymph nodes and lymph vessels can’t compensate for those that have been removed, lymphedema can result,” she says.

The lymph nodes and vessels can become scarred and inflamed as a result of radiation, thereby restricting flow of lymph fluid. If your arm or leg remains swollen after cancer treatment, or your affected leg feels heavy or achy, you might have lymphedema, says Bocchinfuso. It is important to speak with your doctor if this is the case, so he or she can rule out any other causes of swelling.

There’s no cure for lymphedema, but it can be controlled, says Bocchinfuso, who recommends exercise, specialized massage techniques and use of compression garments to manage lymphedema. “These three treatments work together in helping lymphatic fluid flow out of the affected limb to healthy lymph nodes elsewhere in your body, where it can drain,” she says. “Your doctor can refer you for guidance in managing lymphedema from physical and occupational therapists that have special training in the area. If you do seek treatment for lymphedema in the community, ensure it is with someone who is a certified lymphedema therapist.”

Q: Is it a good idea to shed my extra weight while undergoing cancer treatment?
A:
“No matter what your weight, it is never a good idea to lose weight during cancer treatments,” says Kallee Marshall, clinical dietitian in Nutrition and Food Services at the Central Alberta Cancer Centre. “When you lose weight during treatment, you also lose muscle. Losing muscle will make it harder to do your regular activities, and to lose weight after treatment.”

Marshall adds that during radiation and chemotherapy, a patient’s body requires extra energy and protein to maintain appropriate weight and muscle mass. “You may be struggling with a lack of appetite, nausea, taste changes and fatigue that make it harder to eat,” she says. “But even though you may feel like you have no desire to eat, your body needs the extra energy and protein to fight infections, keep you strong and recover from treatment. Treat food as the medication that will give you the strength and energy to be able to do your regular activities.”

Marshall also advises that, although weight loss should not be the goal, patients undergoing cancer treatments can still keep moving with light activity. She suggests taking walks with a friend as a great way “to keep spirits high, lower your stress and reduce fatigue while maintaining your muscle mass.”

If you are looking to lose weight after treatment, Marshall suggests first checking with your family doctor. If it is suitable for you to get started on a plan, she advises then getting a doctor’s referral to a dietitian, to help achieve weight loss in a healthy manner – and maintain it for the long term.

Ask our experts questions about general health, cancer prevention and treatment. Please submit them via email. Remember, this advice is never a substitute for talking directly to your family doctor.