Diuretics, Benzopyrones, Surgery

Expert Quote

“The action, efficacy, and safety of benzopyrones have not been satisfactorily demonstrated by clinical trials or laboratory studies. In addition, a recent study indicates that these drugs can cause liver damage. Given the absence of clear benefit and the presence of real risk, they should be avoided. ”

Marisa Weiss M.D., president and founder, breast radiation oncologist, Philadelphia, PA

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Diuretics

Diuretics ("water pills") are a medication that removes excess water from your whole body. But they are generally NOT recommended for treating lymphedema. That's because they don't eliminate the protein that attracts and hangs onto the extra lymph fluid. Once you stop taking the medicine, the protein pulls the fluid back to your arm, and it swells up again.

It's best to first try treatments that specifically deal with your arm, and not your whole body. An occasional use of a diuretic before a special event, like an outdoor wedding, is not unreasonable.

On the other hand, you might have to use diuretics if you have certain medical conditions that cause general swelling throughout the body. These conditions include high blood pressure, congestive heart failure, or general edema.

Taking diuretics requires a doctor's supervision. Regular use of a diuretic also requires regular blood tests to make sure there is no problem with your blood chemistry.

Benzopyrones

Benzopyrones are used in Europe to treat lymphedema, but the Food and Drug Administration has not approved these drugs for use in the United States.

Coumarin is the most commonly used benzopyrone. (Don't confuse it with Coumadin, a blood thinner.) The manufacturer claims the drug helps to "eat up" proteins in stagnant lymphatic fluid, reducing both the water and the swelling. Therapists who use it say it can take weeks, maybe years, to experience the drug's benefits.

Surgery

Surgery has been the last resort for cases of lymphedema that do not respond to the less invasive, less aggressive techniques described above. The theory behind the surgery is to create new avenues for the fluid backup to escape from the arm.

This surgery is done mostly in Europe. Approach this option with extreme caution. Even in experienced hands, surgery can make your condition worse, and consequences can be disastrous.