Lymphedema and Gynecological Cancer: What You Need to Know

Lymphedema is a condition that affects the quality of life for those who have undergone treatment for gynecological cancers such as ovarian, cervical, or uterine cancer. This condition arises when lymph fluid builds up in the tissues, typically due to damage or removal of lymph nodes during surgery or radiation therapy. Understanding lymphedema, its causes, symptoms, and management options is crucial for patients and caregivers alike. 

 In gynecological cancer, lymphedema often results from surgical interventions such as a lymph node biopsy, where lymph nodes are removed to determine cancer spread. Radiation therapy, while effective in targeting cancer cells, can also damage the surrounding lymph nodes and vessels. As a result, the lymph fluid cannot drain properly, leading to swelling in the legs, lower abdomen or pelvic area. 

Symptoms can vary widely but often include: 

•  Swelling in the affected area, which may feel heavy or tight 

• A sensation of heaviness in the swollen region 

• Changes in skin texture, such as hardening or thickening 

• Recurrent infections due to impaired lymphatic drainage 

 Early detection is essential. If you notice swelling after cancer treatment, it’s important to consult your healthcare provider for assessment and intervention. 

While anyone undergoing treatment for gynecological cancer may develop lymphedema, the number of lymph nodes removed during surgery and the use of radiation treatment can increase the risk of developing lymphedema.  

Managing lymphedema requires a comprehensive approach requiring specialized treatment by a Certified Lympedema Therapist (CLT).  The steps for treatment include:  

1. Manual Lymphatic Drainage (MLD). This specialized therapy stimulates lymph flow through specific techniques. A CLT therapist can provide this treatment, which can help reduce swelling and discomfort.  The therapist will also train the patient and caregivers in how to complete MLD for ongoing care after therapy is complete. 

2. Compression Garments. While undergoing more frequent MLD, the compression may be specific lymphedema bandaging.  As the lymphedema becomes more controlled, the patient can be fitted for a specialized garments like capri pants or stockings to promote continued lymph fluid drainage and prevent an increase in more lymphedema.  

3. Exercise. Gentle, regular exercise can improve circulation and lymphatic function. Activities like walking, swimming, or yoga can be beneficial, but it’s essential to discuss a suitable exercise plan with your CLT therapist. 

4. Skin Care. Maintaining good skin hygiene is crucial to prevent infections. Moisturizing the skin, monitoring for any cuts or scratches, and having good foot care are all techniques that your CLT therapist will teach the patient.  

Living with lymphedema after gynecological cancer can be challenging, but understanding the condition and its management options can make a significant difference. Early intervention and proactive management are key to minimizing symptoms and improving quality of life. If you or someone you know is experiencing lymphedema, reach out to a CLT trained physical therapist for guidance tailored to your individual needs.  

Written by Jennifer Cumming, PT, MSPT, CLT, WCS