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The lifesaving surgery and radiation therapy used to treat cancer sometimes can damage a patient's lymphatic system. Lymph vessels normally carry excess fluid out of the limbs and back into central circulation. When this flow is interrupted, the protein-rich lymph fluid can build up. This eventually leads to abnormal swelling in the soft tissues of the limbs, or less often, the trunk.

The resulting condition is called lymphedema, and it is particularly common in people receiving chemotherapy, radiation and/or surgical treatment for breast or gynecological cancer or lymphoma. If left untreated, the outcome is often disabling, painful and continually progressive. While lymphedema often is a chronic condition, specialized therapy is available to help relieve symptoms, reduce the risk of infection, and equip patients with the knowledge and techniques necessary to effectively manage the condition.

Two therapists on hand

The Blount Memorial Cancer Center recently teamed up with hospital's rehabilitation department to develop a lymphedema therapy program. Two certified lymphatic therapists -- physical therapist Andi Garris and occupational therapist Tammie McDowell -- are available to provide the highly specialized complex decongestive therapy required to effectively treat and manage lymphedema.

"We provide manual lymph drainage, compression wrapping and garment fitting, and equip lymphedema patients with techniques to care for themselves at home for the long term," says Garris. "The treatment is a highly effective intervention in reducing the edema (swelling) and maintaining the lymph node drainage."

Unlike typical massage, which affects the deeper muscles and tissues, the technique used by a lymphedema specialist gently massages tissues to stimulate the lymphatic vessels located just beneath the skin. This method helps improve the activity of intact lymph vessels, which reduces swelling, pain and the risk for infection.

"When people experience that kind of swelling in their limbs, they generally experience the feeling that their body is out of control. The limb is big and heavy, so they're self-conscious. There are a lot of self-image issues," Garris explains. "But with just two or three lymphedema treatments, people begin to feel like themselves again. You can see it on their faces. You can hear it in their voices. As a therapist, that restoration process is so rewarding."

According to Garris, the initial lymphedema treatment generally lasts between one and three weeks. After that, patients use techniques learned through the program to manage their conditions on their own. Of course, if any problem or question arises, they can return to the Cancer Center for additional treatment.

Specialized training

Garris came to Blount Memorial in August 2007 specifically to be part of the new lymphedema program. She has been a certified lymphatic therapist since 2000 and helped establish a hospital-based lymphedema program in Kentucky. McDowell chose to receive the specialized training required to earn her certification in 2007 when she learned that Blount Memorial was expanding its lymphedema therapy services.

Although physicians typically refer patients for lymphedema therapy, Garris encourages people being treated for cancer to be pro-active in seeking information about and treatment for lymphedema.

"We can achieve great outcomes through therapy if we can treat the edema before it turns into a moderate or severe situation," says Garris. "When patients know in advance of their cancer treatment that lymphedema is a possibility, then they are better prepared to know what to look for and get the condition resolved early on."

For more information about the new lymphedema therapy program, call the Blount Memorial Cancer Center at 980-5025.

h3>Early symptoms of lymphodema

Areas (typically near the surgical or treatment site) that are soft to the touch and take time to fill in when pressed (called pitting edema)

Swelling of part or all of an arm or leg, including fingers or toes

A feeling of heaviness or tightness in arm or leg

Restricted range of arm or leg motion

Aching or discomfort in the arm or leg

Recurring infections in the affected limb

Hardening and thickening of the skin on the arm or leg