Lymphoedema after treatment for vulval cancer
If the lymph nodes in your groin have been removed by surgery or you’ve had radiotherapy to this part of your body, there’s a risk you could develop swelling in one or both of your legs. This is called lymphoedema.
The lymph nodes normally help to remove lymph fluid from your legs. Taking the lymph nodes away or treating them with radiotherapy can block the flow of lymph fluid. If this happens, fluid will collect in the tissues under your skin, making your legs swell. Lymphoedema can develop any time from a few weeks up to several years after treatment.
The following suggestions can help to lower your risk of getting lymphoedema, or help improve it if it does develop.
Protect the skin on your legs and feet
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Use a soft soap to clean your skin with and apply a perfume-free moisturising cream (such as E45 cream or aqueous cream) every day to keep it supple. Don’t wax your legs, and avoid hair removal creams. If you shave your legs, use an electric razor to avoid cuts. Wear long trousers when gardening to avoid being scratched. Protect your skin in the sun and avoid getting sunburnt.
Wear well-fitting footwear. Don’t walk around barefoot in case you step on something or stub your toe. Wash and dry between your toes carefully. If you notice any signs of athlete’s foot, such as soreness and/or peeling between the toes, treat it straight away. Use nail clippers instead of scissors to cut your nails, as there’s less risk of accidentally cutting the skin with clippers.
Avoid infection in your legs and feet
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If you get a graze or cut, treat it with antiseptic and keep it clean until it heals. See your GP if there are any signs of infection, such as redness, warmth or tenderness or you have a high temperature.
If you’re planning on travelling abroad, ask your GP whether you should carry antibiotics with you, just in case you develop an infection in one or both legs.
Gentle exercise such as walking and swimming helps lymph drainage, but exercising too hard can lead to lymphoedema for some people. Ask your doctor or specialist nurse when you can start exercising and which types of exercise are right for you. Remember to gradually build up your fitness level, and take regular breaks between repetitive activities. We have more information about the benefits of physical activity during and after cancer treatment.
Keep to a healthy body weight
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Being overweight can increase your risk of lymphoedema. If you feel you need to lose weight, talk to your nurse or doctor for advice. You may find it helpful to see our section on weight management after cancer treatment.
Raise your feet and legs when you’re sitting down - this helps lymph drainage. Make sure your feet are well supported on a pillow or cushion if possible. Don’t cross your legs when sitting. If you’re going on a long car journey, wear support stockings and plan to stop occasionally so that you can get out and walk a short distance to encourage lymph drainage. Try to avoid standing for long periods of time.
Avoid temperature extremes
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Test the temperature of water before bathing to make sure it’s not too hot, and avoid using saunas or hot tubs. Avoid situations where your legs or feet are exposed to a rapid temperature change, for example from hot to cold.
You should contact your nurse or doctor straight away if you notice any swelling, redness, pain or heat in one or both legs. These symptoms may be due to cellulitis, which is an infection of the deeper layers of skin and underlying tissues. Cellulitis needs to be treated quickly with antibiotics, which your doctor can prescribe.
Lymphoedema can be improved with special massage techniques, exercises, bandaging and support stockings. Many hospitals have a nurse or physiotherapist who specialises in treating lymphoedema. The earlier treatment is started, the more likely it is to be successful, so let your doctor know if you notice even mild swelling of your leg or foot.
We have more information in our section on lymphoedema.