Causes of lymphoedema and how to reduce your risk

Lymphoedema can be caused by cancer itself or develop as a side effect of its treatment. Lymphoedema is a condition that can appear months or years after cancer treatment. It can be the result of:

  • surgery to remove the lymph nodes
  • radiotherapy to the lymph nodes
  • cancer that has spread to the lymph nodes or that presses on the lymph vessels.

Lymphoedma can affect different parts of the body, especially the arms and legs. However, not everyone who has radiotherapy or surgery to the lymph nodes will get lymphoedema.

If you’re at risk, there are several things you can do to reduce your chances of developing lymphoedema:

  • Look after your skin. This means moisturising your skin and avoiding cuts and scratches.
  • Look out for risks of infection. Recognising the first signs of an infection will help get it treated quickly.
  • Keep active and exercise. This will stimulate the flow of lymph fluid in the body.
  • Keep to a healthy weight.

Take care when travelling. Moving around and stretching regularly will reduce the risk of developing lymphoedema.

Causes of lymphoedema

Cancer-related lymphoedema is caused by cancer treatments or the cancer itself:

  • Surgery to remove lymph nodes can interrupt the normal flow of the lymphatic system, leading to a build-up of fluid in the affected area.
  • Radiotherapy to the lymph nodes can cause scar tissue that blocks the flow of lymph fluid.
  • Cancer cells that spread to the lymph nodes can cause a blockage, leading to a build-up of fluid.
  • A nearby cancer that is pressing on the lymph vessels can cause a blockage in the lymph nodes close by.

Lymphoedema in the body

Lymphoedema can develop weeks , months or even years after cancer treatment. The most common places for lymphoedema to occur after cancer treatment are:

  • in the arm after breast cancer treatment (surgery and/or radiotherapy) to the armpit
  • in the leg if cancer or its treatment affects the lymph nodes in the pelvis or groin area – this usually happens after surgery and/or radiotherapy to the lymph nodes in the pelvis for gynaecological cancers (cancers of the womb, cervix, ovary, or vulva) or anal cancer
  • in the leg after treatment to the lymph nodes in the groin for a type of skin cancer called melanoma.

Sometimes, lymphoedema can develop in the breast or chest after breast cancer treatment. Occasionally, lymphoedema can develop in the pelvic area and genitals. This can happen after surgery and/or radiotherapy to lymph nodes in the pelvis for cancers of the prostate, bladder, womb, vagina, testis, penis or rectum.

Lymphoedema can also develop in the face, head and neck after surgery and/or radiotherapy to lymph nodes in the neck.

Not everyone who has surgery to remove lymph nodes or radiotherapy to the lymph nodes will get lymphoedema.

It’s common to get swelling (oedema) near the surgery scar in the first days after surgery, but this usually settles down gradually. This is different from lymphoedema. If you’re concerned about any swelling, always talk to your doctor or nurse.

Causes of lymphoedema

Causes of lymphoedema

Macmillan University Teacher Rhian Davies describes the causes and symptoms of lymphoedema.

About our cancer information videos

Causes of lymphoedema

Macmillan University Teacher Rhian Davies describes the causes and symptoms of lymphoedema.

About our cancer information videos


Reducing your risk of getting lymphoedema after treatment

If you’ve had surgery to remove lymph nodes in your armpit or groin, and/or radiotherapy in the same area, you’re at risk of developing lymphoedema. The risk is greater if you’ve had both surgery and radiotherapy to the lymph nodes.

People who have had a sentinel lymph node biopsy (SLNB) are still at risk of getting lymphoedema, although the risk is lower. The sentinel node (or nodes, as there may be more than one) is the first node that lymph fluid from a part of the body drains to.

It’s not clear why some people develop lymphoedema after certain cancer treatments and others don’t. It’s thought that some things, such as overuse of a limb (causing inflammation) or a skin infection, may trigger swelling in someone who’s at risk of developing lymphoedema.

The body responds to inflammation and infection by producing extra fluid to help deal with it. If the lymphatic system in that area isn’t working as efficiently as it should be, the extra fluid could overload it and lead to lymphoedema.

Following the precautions and advice in this section may help to reduce your risk of lymphoedema.


Look after your skin

Looking  after the skin in the area that’s at risk of lymphoedema is very important. Keeping it clean and well-moisturised reduces the risk of inflammation and infection. It’s also important to protect it from cuts and grazes, as well as insect bites and sunburn.


Look out for the early signs of infection

It’s important to recognise the early signs of an infection in the arm or leg at risk of lymphoedema. You can then have the infection treated immediately with antibiotics before it puts stress on the lymphatic system. Contact your GP straight away if you notice flu-like symptoms and any of the following signs of infection:

  • redness or warmth in the limb that’s at risk
  • painful swelling in a limb that wasn’t swollen before
  • pain or discomfort in the limb that’s at risk
  • red streaks that go up or down from the affected area.


Try to exercise and keep active

Gentle stretching exercises help your arm or leg get back to normal after surgery or radiotherapy. They may help reduce the risk of lymphoedema in women with breast cancer who have had surgery to remove lymph nodes under the arm.

Exercises should be done gently and gradually. Exercise helps with joint mobility and encourages lymph to drain. A physiotherapist will usually show you what exercises to do.

Exercise is an important part of recovery after surgery to remove lymph nodes, and it’s important to carry on with it for as long as advised. It may be helpful to continue with your exercises even after your wound has healed.

After your treatment is over you can usually get back to any physical activity or exercise programme you were involved in before, or begin a new one. It’s important to start slowly and gradually increase the intensity. There may be some exercises you’ll need to be more careful about, such as weightlifting or contact sports. This is because they make you more likely to get a break in the skin or an injury in the affected limb.

Physical activity will help you feel better generally and help to keep your weight down. It also encourages deeper breathing, which stimulates lymph flow. Breathing exercises on their own or as part of yoga or pilates can also be beneficial.

Ask your physiotherapist or nurse for advice about exercise. You may also find our section on physical activity useful.


Keep to a healthy weight

Being overweight can increase the risk of developing lymphoedema, so try to keep your weight within the normal range for your height. Your GP can tell you what your ideal weight should be. You can also ask them, or a dietitian, for advice and support on eating healthily.

We have more information about healthy eating and managing your weight.


Take care when travelling

Here are some tips on what you can do to reduce your risk of developing lymphoedema when travelling:

  • avoid sitting in one position throughout the journey
  • move around frequently and do gentle stretching exercises when travelling by air or train
  • during longer car journeys, make regular stops and get out and walk around
  • wear comfortable clothes and shoes, and avoid anything tight-fitting or restricting
  • wear flight socks that fit well
  • use luggage on wheels that can be pulled instead of picking up or carrying heavy luggage.

If you’re at risk of getting lymphoedema, you don’t normally need to wear a compression garment when travelling by air