Kathy Bates Advocates for Lymphedema Awareness
- Oscar-winning actress Kathy Bates, 74, is both a breast and ovarian cancer survivor.
- After treatment for breast cancer, Bates developed lymphedema, a condition in which extra lymph fluid builds up in tissues and causes swelling, usually in the arm and hand. It can be painful and uncomfortable.
- Bates said the condition became so stressful she was worried she wouldn’t be able to continue working.
- Now, she advocates for awareness for the disease. There is currently no cure, but there are several ways to treat lymphedema.
The Titanic and American Horror Story actress 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.
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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."
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."
What is 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.
Dr. Dung Nguyen explains what lymphedema is and how doctors monitor the condition.
"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 told SurvivorNet in a previous interview on the condition. "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.
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.
Lymphedema usually affects an arm or leg, but it can also affect other parts of the body. The disease can also cause long-term physical, psychological, and social problems for patients.
How is Lymphedema Treated?
There are four stages of lymphedema (stage 0 through 3), 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 said. "When a patient presents with stage 0, [we] typically would start out with conservative therapy, which would include physiotherapy, compression garments. Patient who presents with stage 1 lymphedema are surgical candidates."
Dr. Nguyen explains the treatment options for different stages of lymphedema.
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," Dr. Nguyen explained.
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."
Contributing: Marisa Sullivan
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