Lymphoedema resulting from pelvic radiotherapy

The lymph nodes act as filters within the lymphatic system, helping to fight infection and disease. If the nodes have been removed or are damaged, the lymph fluid is unable to pass along the vessels and excess fluid can build up.

This can cause one or both legs to become swollen, although it is uncommon. This is called lymphoedema| and can occur a few weeks or several years after pelvic radiotherapy. It happens in up to 1 in 10 people (10%).

The risk of it happening depends on the type of cancer you had, as well as any other treatments you had. Rarely, the torso or genital area can become swollen.

The area affected by lymphoedema is also more prone to infection and if infection happens it can be difficult to get rid of it. Lymphoedema can also occur if the cancer has come back and is blocking the lymph drainage channels.

If your leg is swollen because of lymphoedema it may

become stiff, uncomfortable and awkward to move, making daily activities like dressing difficult. The skin may get tight and stretched.

Once lymphoedema has occurred, it can’t be completely cured. However, many things can be done to help reduce the swelling and discomfort.

Preventing lymphoedema Back to top

After pelvic radiotherapy it's important to avoid any infection of your legs, as this increases the risk of lymphoedema. It is important to avoid any cuts or grazes on your legs and to look after the skin by using moisturisers if the skin gets dry. Clean any cuts, grazes or wounds with antiseptic.

Some things may trigger lymphoedema, such as:

• insect bites
• standing for long periods
• air travel
• sunburn
• being overweight.

It is helpful to avoid these if possible. You can help to prevent lymphoedema by following a healthy lifestyle and exercising regularly. Walking (in well-fitting shoes) and swimming stimulate fluid to drain from the legs.

The earlier treatment is started, the more likely the lymphoedema can be controlled. So it's important to let your doctor know if you notice any swelling of your foot, leg, thigh, lower abdomen or genital area.

Dealing with lymphoedema Back to top

If you develop lymphoedema, you should be referred to a lymphoedema specialist for treatment and advice. The specialist may be a nurse, physiotherapist or doctor. Your treatment will depend upon how much lymphoedema you have. Treatment is given to help reduce the swelling, prevent further swelling and to relieve discomfort. There are four main types of treatment:

• skin care (with moisturisers)
• use of compression stockings or bandages
• positioning and movement of the leg
• a particular type of massage called manual lymphatic drainage (MLD) or self-massage lymphatic drainage (SLD).

If the area affected by lymphoedema gets infected you may have a temperature or flu-like symptoms, with a blotchy rash, pain in the area or increased swelling. Let your doctor know if this happens as you will need treatment with antibiotics.