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Beginning late November, Meagan Kirby will begin treating patients for lymphedema at Virginia Commonwealth University Massey Cancer Center. Kirby is an occupational therapist mentoring under Kim Ericson, a physical therapist who has been treating lymphedema patients in the Richmond area for 10 years. Both Kirby and Ericson received their certification in Complete Decongestive Therapy (CDT) from the Norton School of Lymphatic Therapy, making them two of only a handful of certified lymphedema specialists in the Richmond area.

As Breast Cancer Awareness Month draws to a close, we caught up with Kirby and Ericson and asked them a few questions about this condition that often affects breast cancer survivors.

What is lymphedema, and what are the symptoms?  

Lymphedema refers to an accumulation of lymphatic fluid, which can occur in any area of the body due to damage of the lymphatic system. The most common symptoms of lymphedema are swelling, a feeling of heaviness or fullness and aching pain in the affected area.  In advanced lymphedema, there may be skin changes (fibrosis) that can become permanent if not treated. 

There are several causes of lymphedema, but a major cause in developed countries is the surgical removal of lymph nodes or radiation therapy affecting the lymph nodes as part of cancer treatment. Lymphedema does not affect all cancer patients, but it most often occurs in breast cancer patients who have had lymph nodes removed from under their arms. It may also occur after surgery for uterine, prostate, and ovarian cancer, as well as after treatment for lymphoma and melanoma. It can also be caused by parasitic infections, and the condition can even be congenital.

What should I do if I think I have lymphedema?

Anyone experiencing lymphedema symptoms should see his or her doctor to make sure it is not an infection. If lymphedema is suspected, the doctor can refer you to a lymphedema specialist.

How is lymphedema treated?

There is no cure for lymphedema. However, with proper care it can be managed effectively. At Massey, therapists treat patients using the CDT method, which has been found to be the most successful way to treat chronic extremity lymphedema. CDT is composed of four steps:

1. Manual lymph drainage, which uses gentle manipulation to reroute lymph flow around blocked areas into healthy lymph vessels
2. Compression therapy, which uses multilayered bandages or gradient compression garments to increase tissue pressure and prevent the re-accumulation of fluid
3. Exercise designed to help lymphatic flow in affected limbs
4. Skin care to eliminate bacterial and fungal growth, which can lead to infections and contribute to lymphedema

Who is at greatest risk for lymphedema?

The majority of cancer patients do not develop lymphedema. However, anyone who has had surgery or radiation therapy that has impacted his or her lymphatic system is at risk. Age, obesity and arthritis can also contribute to an increased risk.

What are some things people can do to help manage lymphedema? 

There are several steps people can take to help manage lymphedema:

• Keep skin and nails clean to help reduce the risk of infection. Treat cuts immediately with antibacterial ointment, and keep the skin moist using cream or lotion. Avoid needle sticks in the affected limb, and consider using an electric razor for shaving. Use sunscreen when outdoors and wear gloves when gardening and cooking.
• Avoid strenuous activity after cancer treatment. Gentle stretching and controlled exercise is encouraged.
• Elevate the affected limb whenever possible.
• Avoid tight clothing or anything that could restrict blood flow. Ask that blood pressure be taken from the non-affected arm.

Are there any community support groups?

 Yes, an excellent lymphedema support group meets every third Tuesday of each month at 6:30-8 p.m. in the first-floor boardroom of Retreat Hospital at 2612 Grove Ave., Richmond, VA. Those interested in learning more should call (804) 270-9071 or email padonovan@comcast.net.

Where can I get more information?

VCU Massey Cancer Center, National Lymphedema Network, and the National Cancer Institute are excellent resources for learning more about lymphedema. Talk to your doctor if you suspect you have lymphedema, and ask to be referred to a lymphedema specialist in your area.  

Written by: John Wallace