Quang NinhThe right arm of a 68-year-old woman was swollen, twice the size of her left hand, and a doctor at Vietnam – Sweden Hospital Uong Bi diagnosed elephantiasis after cancer treatment.
On August 5, Doctor Tran Thi Hoa Binh, Department of Interventional Chemotherapy and Palliative Care, said that a patient with breast cancer in 2014 had a mastectomy and a right axillary lymph node dissection. About three months ago, the patient’s arm swelled and became twice as large as the other arm. Doctors diagnosed the patient with a complication after cancer treatment, called lymphedema, that required surgery.
According to Dr. Binh, lymphedema – also known as elephant’s hand edema – is a common complication after breast cancer treatment. The prevalence of elephantiasis accounts for about 15 to 20% of breast cancer patients. The cause of edema is due to surgery or radiation therapy in the breast and armpit, which causes loss of integrity of the surrounding lymphatic system, leading to stagnation of lymphatic fluid, causing pain.
Hand edema makes it difficult for patients to move and move, have difficulty in daily activities and significantly reduce quality of life. Elephant hand edema can cause recurrent infections (phlebitis), patients even have to live with enlarged hands for life if intervention is delayed.
Elephant hand edema usually progresses in several stages. In the early stages of the disease, there are no obvious symptoms, the patient has no swelling or is very mild. In the second stage, when the tissues have fibrosis, the edema is clearly shown in the arm, the edematous skin area has indentations, does not return to the original state, the disease cannot recover naturally. Skin infections are common at this stage due to reduced immunity in response to bacteria and foreign debris.
In the final stage, the disease has progressed to the point of permanent skin changes. At that time, it is difficult to grasp the skin of the affected area with two fingers because the skin is swollen and tight. The tissues were heavily fibrotic and increased in volume, leading to skin changes such as rough papillae, cystic, fistula, and keratosis. Deeper skin folds at the wrist.
The most common symptom of hand edema is gradual swelling in one or both arms from the shoulder blades to the fingers. The patient has pain, aching, heaviness in the arm, limitation of movement.
According to doctors, treatment of hand edema needs to combine many measures to bring the best effect and treat as soon as possible. Some measures to treat hand edema such as skin care, exercise, compression with gloves or gauze, surgery…
To prevent lymphedema, the main measure is screening for early cancer detection, reducing interventions affecting the lymphatic system such as lymph node dissection, radiation therapy. After breast cancer treatment, swelling in the arms or legs does not go away, patients should go to specialized facilities for examination.
“Usually, once the swelling of the hands has appeared, it is not possible to completely treat the swelling, but it is possible to control it from getting worse, reduce symptoms and prevent infection,” the doctor said.