As a breast cancer survivor, What is my risk of getting lymphedema?

Estimates vary and, fortunately, the risk has been progressively declining. In the beginning, breast cancer surgery carried a 50% risk of lymphedema development. Today, patients who have axillary lymph node dissection have a lifetime risk of 15-25%. For individuals whose surgery is limited to sentinel node techniques, without adjuvant radiation, the risk is about 6%.

Cancer and the Lymph System: The Crucial Importance of Lymphatic Drainage

The question is no longer “Am I toxic?”, but rather “How toxic am I?” Unfortunately, we live in an extremely noxious world today. For many of us, the foods we eat are full of pesticides, and the water we drink rates 3/ppm for chlorine. (If this were pool water, the manufacturer would tell you not to swim in it.) The air we breathe is full of microscopic particles that are affecting our health and well-being. We test 100% positive for at least half a dozen lethal compounds in our adipose tissues1. We are bombarded with toxic materials, yet we ignore the solution that nature has provided us.

The situation is even worse now than when it was described by Rachel Carson 50 years ago thusly: “For the first time in the history of the world, every human being is now subjected to contact with dangerous chemicals from the moment of conception until death. In the less than two decades of their use, the synthetic pesticides have been so thoroughly distributed throughout the animate and inanimate world that they occur virtually everywhere.”2

Our ill health is directly related to the assaults we face every day. Increasing stress and the subsequent rise in hormonal levels are depleting our immune systems. We no longer get a cold or flu for a few days; we get sick for three to four weeks at a time, start feeling better and then relapse. Probably the most dangerous outcome of poor immune function is cancer. According to the American Cancer Society, one in two men and one in three women will develop some kind of cancer in his or her lifetime.

Healthy Immune Function and the Lymphatic System

A crucial factor in maintaining a healthy immune system is an efficient lymphatic system, yet almost nowhere in the health community is anyone paying specific attention to it.

The lymphatic system is the “other” circulatory system and is vital to our health. It manages elimination of toxins from our body, functions as the body’s primary immune defense, and is the body’s main system for waste elimination through the colon. It contains more than 600 “collection sites” called lymph nodes and has a network of connecting vessels more extensive than the venous system. Our lymphatic system is primarily responsible for carrying disease-fighting material to cells attacked by germs by transporting the dead germs away and supplying protein-rich plasma fluid back to the heart. When the system is blocked we become defenseless against attacks by fungi and bacteria because infection-fighting material is prevented from destroying them. Additionally, cell-nourishing material is prevented from reaching the bloodstream. The end result is that germs grow, our blood loses necessary proteins, and infectious diseases could potentially invade our body.

Most chronic disease problems occur at the junction of lymph vessels, or lymph nodes. There are 160 lymph nodes located in the face and neck region and over 300 lymph nodes in the trunk of the body. Women’s largest reservoirs of lymph fluid are located in their breasts. The lymph nodes in the axilla (under the arms) and breast tissue are probably the most palpable nodes in the trunk region. You can feel lymph nodes by pressing underneath the arms, just below the collarbone, abdomen, or in the crease between the thigh and pelvic area. When touching these areas, most people feel small lumps and bumps and sometimes pain. The bumps and pain are symptomatic of blocked lymph nodes. Blocked lymph nodes indicate a breakdown in the mechanical functioning of the lymph system and as a result, a breakdown in your immune system.

Lymphedema

Toxins carry electrical charges with them; some are electrons, others protons. These electrical charges are sometimes referred to as free radicals. Free radicals attach themselves to the neutral lymph fluid, which causes stagnation and pooling of lymph fluid in the nodes, which can be felt with palpation. This stagnation and pooling causes disease and toxic buildup in the tissues, sometimes referred to as lymphedema. Women, do you wonder why your breasts are sore and achy even if you don’t have your period? When your estrogen levels rise, as in the few days prior to menstruation, it gets even worse. This is your lymph system talking to you. It’s telling you it’s time to clean up your act and relieve these reservoirs of standing fluid.

The risk is even higher for those who have had a lymph node removed in combination with radiation to the area. Many patients have subtle clues that they are in early stages of lymphedema, but they are not knowledgeable about the signs.

Individuals may have a subtle fullness in the limb, a ring or shoe that is too tight, warmth, reddish tinge or blotchiness to the skin, tingling in the hands and fingers, an infection slow to heal, joint pain, or reduced range of motion. The literature states that lymphedema can occur many years after radiation treatment has ceased. A slight trauma, an infection, having your blood pressure taken, or receiving a flu shot in the affected limb can trigger an occurrence of lymphedema for those at high risk.4,5

What is Oncology massage?

Oncology massage is the modification of existing massage therapy techniques in order to safely work with complications of cancer and cancer treatment. Anyone who has ever received cancer treatment, from those in active treatment to those in recovery or survivorship, as well as those at the end of life, are best served by a massage therapist who has received training in oncology massage.

Essential aspects of an oncology massage therapist’s skill set are an informed understanding of the disease itself and the many ways it can affect the human body; the side effects of cancer treatments, such as medications, surgery, chemotherapy and radiation; and the ability to modify massage techniques in order to adapt for these side effects, as well as for the disease.

Oncology Massage Assessments

Clinical assessments and adaptations to the massage session for someone experiencing cancer or with a history of cancer treatment are critical to providing a safe massage. Standard oncology massage intake questions include those pertaining to:

• cancer treatment history
• tumor site or metastasis
• compromised blood cell counts
• lymph node involvement
• blood clots or blood clot risk
• medications (short and long term)
• vital organ involvement
• fragile or unstable tissue
• medical devices
• fatigue, neuropathy, or pain
• changes in sensation
• late effects of treatment

A properly trained massage therapist will ask questions about these issues and more, depending on your unique situation. Many of the changes that will be made to your session will be virtually imperceptible to you as a recipient (and others may be quite obvious), but they are essential to safety and proper support of your well being.