Study Evaluates Incidence of Lymphedema Resulting from Cancer Treatment

A systematic review of 47 studies evaluating treatment for melanoma, head and neck cancer, genitourinary cancers, gynecologic cancers, and sarcoma indicates that lymphedema is a common side effect of treatment for these diseases. These findings were recently published in the journal Cancer.[1]

Lymphedema is the buildup of lymph fluid in the tissues just under the skin, resulting in swelling, tightness, and discomfort in the affected limb. Damage to or blockage of the lymph system is the cause of lymphedema, and in cancer patients this damage is usually due to surgery or radiation therapy. While there is no single treatment for lymphedema, steps can be taken to manage the symptoms, including compression of the area, a specific type of massage to increase lymph flow, and specialized exercises. Although the incidence of lymphedema resulting from the staging and treatment of early breast cancer is well understood, less is knowm about this side effect in other cancer types. Researchers recently conducted a study to determine the incidence and risk factors of lymphedema in cancer types other than breast cancer.

In this study researchers systematically reviewed data from 47 clinical trials conducted between 1972 and 2008. The studies included data on lymphedema assessment following treatment of melanoma, gynecologic cancers, genitourinary cancers, head and neck cancer, as well as sarcoma.  In these studies the researchers determined that the overall incidence of lymphedema was 15.5%. Among patients undergoing pelvic lymph node dissection, 22% experienced lymphedema (see Table 1). In addition, 31% of the patients in these studies who underwent treatment with radiation therapy reportedly experienced lymphedema. The researchers also determined that data from these studies indicated that longer follow-up was associated with an elevated incidence of lymphedema. Interestingly, studies that included objective measurement strategies for lymphedema reported elevated incidence of this side effect.

Table 1: Lymphedema incidence and number of studies analyzed by cancer type

Cancer Type Number of studies analyzed Lymphedema incidence
Melanoma 15 16% (5% for upper extremity melanoma and 28% for lower extremity melanoma)
Gynecologic Cancers 22 20%
Genitourinary Cancers 8 10%
Head and Neck Cancer 1 4%
Sarcoma 1 30%

The researchers concluded that the incidence of lymphedema resulting from the treatment of cancer is associated with a variety of factors, including cancer type as well as type and extent of treatment. In addition, the reported incidence is a factor of the length of follow-up as well as method of lymphedema assessment.  Patients undergoing treatment of their cancer with radiation therapy or surgical removal of lymph nodes should ask their healthcare team about the risk of lymphedema and what they can do to help prevent and manage this side effect.

Reference:


[1] Cormier JN, Askew RL, Mungovan KS, Xing Y, Ross MI, Armer JM. Lymphedema beyond breast cancer: A systematic review and meta-analysis of cancer-related secondary lymphedema. Cancer. [Early online publication]. July 27, 2010.

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