- Question from Ann: What's the best way to treat (and prevent) painful arm swelling?
Julie Gralow, M.D.
Arm swelling after breast cancer treatment is something that can range from none at all to swelling that seriously interferes with your everyday life. In general, lymphedema—which is arm swelling after lymph node removal or radiation to the lymph node area—is something that occurs to different degrees in different patients. We're hoping that the new sentinel node biopsy techniques being used to evaluate breast cancer patients' lymph node involvement will decrease lymphedema overall in our breast cancer patients. Adding radiation on top of lymph node surgery increases the risk of lymphedema. Recurrence of breast cancer in the armpit area, or the axilla, can also set off arm swelling after a patient has had her lymph nodes evaluated and disrupted.
We generally recommend trying to avoid anything that can disrupt lymphatic flow to the arm. Therefore, we recommend that you not get your blood pressure taken on the arm of your lymph node surgery, and that you not have IVs placed on that side, or have blood drawn from that arm. Always wear gloves when gardening to help prevent cuts and scrapes that could lead to infection. And at the first sign of any redness or infection in that arm, report it promptly to your healthcare team. Antibiotics need to be started soon, because an infection in the arm on the side of the lymph node surgery may cause or increase lymphedema.
Marisa Weiss, M.D.
Keep in mind that your skin is one of your best friends when it comes to protecting you against lymphedema; it's a barrier against infection. So as Dr. Gralow said, do your best to avoid any cuts or scrapes in the garden where there's dirt, avoid burns while in the kitchen, avoid bug bites and poison ivy, and aggressive manicures—anything, that is, that can disrupt the integrity of your skin.
Now that it's winter, the air is often very dry. Many patients experience dry skin and dry hands at this time. For women who are experiencing side effects to their nails from Taxol, for example, the skin around the nail can also get very irritated. A good solution for dry, irritated skin is to use a lot of Eucerin cream, A & D ointment, or plain Vaseline on your hands at night and then put on thin, white, cotton gloves and wear them through the night for a good moisturizing treatment. You can get these gloves from the Vermont Country Store catalog online.
The experience of having breast cancer makes it much more important for you to take care of yourself in ways that you may never have done before. You are important, and you need to treat yourself that way.
You can read more about how to prevent and manage arm swelling in the Breastcancer.org section on Lymphedema.
The Ask-the-Expert Online Conference called Managing Treatment Side Effects featured Julie Gralow, M.D. and Marisa Weiss, M.D. answering your questions about many of the short-term and long-term side effects of breast cancer treatment, and ways of minimizing them, so you can get on with your life and enjoy your day-to-day activities.
Editor's Note: This conference took place in January 2003.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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