A Side Effect After Cancer Surgery
- Academy Award-winning actor Kathy Bates is a spokesperson for the Lymphatic Education & Research Network after developing the condition as a side effect after her breast cancer surgery.
- Lymphedema, or chronic swelling, can occur after surgery and radiation treatment for breast cancer. It occurs when the lymph vessels that carry fluid throughout the body are affected and cannot properly dispose of the fluid.
- A leading expert from Stanford Medicine explains that it’s difficult to predict which patients will develop the condition, but women who have many lymph nodes removed and/or radiation therapy have a higher risk of long-term lymphedema.
Actress Kathy Bates has been spreading the word about lymphedema after it affected her following surgery for breast cancer. In honor of Lymphedema Awareness Month, we are looking back at our interview with the American Horror Story star.Read More
Bates was diagnosed with breast cancer in 2012 (and also battled ovarian cancer in 2003). She had a double mastectomy, removing both breasts, which led to one of the hardest parts of her journey: lymphedema, a side effect of her surgery.
Lymphedema is a condition in which extra lymph fluid (clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases) builds up in tissues and causes swelling, usually in the arm and hand. There is no cure but it’s important that patients recognize the signs and get treatment as early as possible.
View this post on Instagram
“I didn’t want to have cancer … and I really don’t want to have lymphedema,” Bates said in a previous interview with SurvivorNet. But “I feel blessed [to have the condition] because if I didn’t, I wouldn’t be in a position to use my celebrity to do something that can maybe help people.”
Bates said that lymphedema was almost worse than having her breasts removed.
“I was bitter, I was depressed,” she said. “I thought my career was over, I thought, ‘There’s no way, I’m done, everything is done.’ I have to wear compression sleeves on the plane, and I have problems keeping my arms up to read books. I’m not supposed to lift things. … It’s a stress and a strain.”
View this post on Instagram
Bates said that there isn’t much attention given to the condition. “Doctors are focused on curing cancer. My feeling is that they don’t have time [to focus on lymphedema]. They’re getting so good [at the cancer part] and more and more of us are surviving so, in my opinion, more and more of us need aftercare.”
However, Bates said she has faith in the scientists she’s met who are working in the field of lymphedema, “It’s been an uphill climb and it still is, but researchers are making progress. … It’s very exciting — they think this is going to be the beginning” in terms of finding better treatments.
Learning More About Lymphedema
Lymphedema, or chronic swelling, can occur after surgery and radiation treatment for breast cancer. It occurs when the lymph vessels that carry fluid throughout the body are affected and cannot properly dispose of the fluid. This causes fluid build-up and swelling, usually in the arm and hand on the same side as the treated breast.
Doctors cannot predict which patients will develop the condition but women who have many lymph nodes removed and/or radiation therapy have a higher risk of long-term lymphedema. Lymphedema can happen shortly after treatment or even years later.
“Lymphedema is a disorder in which the lymph fluid– which is basically interstitial fluid that leaks out from our tissue continuously– cannot recirculate properly and stays stagnant in the tissue. It’s critical that you monitor for swelling since detecting lymphedema early is key,” Dr. Dung Nguyen, the director of breast reconstruction at Stanford Medicine tells SurvivorNet. “It’s uncomfortable and can be painful and there is no cure but there are a number of ways to treat it.”
Lymphedema can become a problem after surgery or radiation treatment for nearly any type of cancer, but it’s most commonly seen in breast cancer, prostate cancer, pelvic area cancers, lymphoma, melanoma and head and neck cancers like throat cancer.
View this post on Instagram
“If a woman has breast cancer on the right side, she should look for signs and symptoms of lymphedema in her right arm. That includes the hand, all the way up to the axilla. Over time, lymphedema can spread on to the chest wall as well.”
“It’s not a dangerous, life-threatening condition,” she adds. “But we do know that, it being a progressive disease without a cure at the moment, it can negatively impact the patients’ function and quality of life long term.”
According to the National Cancer Institute, lymphedema occurs when the lymph system is damaged or blocked. Fluid builds up in soft body tissues and causes swelling. It is a common problem that may be caused by cancer and cancer treatment. Lymphedema usually affects an arm or leg, but it can also affect other parts of the body. Lymphedema can cause long-term physical, psychological and social problems for patients.
Some key points:
- Lymphedema is the build-up of fluid in soft body tissues when the lymph system is damaged or blocked.
- The lymph system is a network of lymph vessels, tissues and organs that carry lymph throughout the body.
- Lymphedema occurs when lymph is not able to flow through the body the way that it should.
- There are two types of lymphedema.
- Possible signs of lymphedema include swelling of the arms or legs.
- Cancer and its treatment are risk factors for lymphedema.
- Tests that examine the lymph system are used to diagnose lymphedema.
Lymphedema usually happens gradually, but some people experience it coming on suddenly. If you have sudden, severe swelling, get in to see your doctor immediately. It could be an infection, a blood clot, or a cancer recurrence, but don’t assume the worst before you are evaluated by your medical team.
There are four stages of lymphedema, with treatment options ranging from compression garments, physiotherapy (which helps restore movement and function when someone is affected by illness or injury) and exercise to different surgery methods including lymph node transfer and a technique called lymphovenous bypass (a surgical treatment option for lymphedema).
“We have surgical options as well as non-surgical options that help to control the progression of the disease,” Dr. Nguyen says. “When a patient presents with stage 0, typically would start out with conservative therapy, which would include physiotherapy, compression garments. Patient who presents with stage 1 lymphedema are surgical candidates.”
Usually when patient presents with stage two lymphedema, this is more advanced disease where they tend to have recurrent infections. “In these group of patients, vascularized lymph node transfer is the option of choice. And that is because with lymph node transfer, the lymph nodes themselves will bring lymphatic tissue to the extremity and helps fight infection. So the risks and the rate of infection significantly decreases with lymph node transfer.”
In patients with stage 3 lymphedema, “the first approach is to do de-bulk the dense fiber fatty tissue that has built up. And we do this using a technique called dry liposuction, where the tissue is extracted from the extremity using suction device,” she says.
Once the patient has recovered from the surgery, which can typically at least a year, “then that patient can become a candidate for procedures like lymph node transfer or the lymphovenous bypass procedure to help reestablish the lymphatic drainage system in the extremity.”