Caring for a partner with prostate cancer and lymphedema

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November is National Family Caregiver Month

Lymphedema occurs when a watery fluid called lymph builds up in your body, causing chronic swelling, usually in an arm or leg. Lymph, which promotes your overall health and immune system function, flows from your tissues to the lymphatic vessels and then through a group of nodes (lymph nodes) that filter out bacteria and other unwanted substances.

If one of the lymph nodes is removed or damaged by cancer treatment, the remaining nodes have to work harder to filter the lymph. They can become inflamed or even blocked, causing lymph to flow back into the tissue.

There is no cure for lymphedema, but if you are actively involved in your partner’s medical care, it is helpful to know what you can do to manage this condition. There are steps you can take to reduce your partner’s inflammation, prevent infection, reduce discomfort, and improve their mobility.

“It is important to ensure that [el cuidador] Be aware of what’s going on so you can provide a massage, generally help your spouse, or take steps to provide care,” said Pragnan Kancharla, MD, medical oncologist and hematologist at MedStar Franklin Square Medical Center in Maryland.

Talking to a lymphedema specialist is helpful. But not everyone has access to it.

If your partner develops lymphedema, it’s important to understand how you can help.

Lymphedema in prostate cancer

Where lymphedema occurs depends on where the affected lymph nodes are located. In people with prostate cancer, lymphedema can affect the legs, penis, scrotum, or lower body in general.

Symptoms of lymphedema may include:

swelling
Tight or inflamed skin
Thick, scaly skin called hyperkeratosis
Small lumps and sores on the skin
Fluid (lymph) emerging from the skin.

Is your partner at risk of lymphedema?

A radical prostatectomy, in which the prostate and pelvic lymph nodes are removed, is the most common cause of lymphedema in people with prostate cancer. Radiation also sometimes damages the nodes. Men who have had surgery and radiation therapy are at higher risk of lymphedema, and the more nodes affected, the greater the risk.

Lymphedema can also have the following causes:

Infections or other complications at the site where the lymph node surgery was performed
A collection of fluid near the wound, called a seroma.
an advanced cancer

Diagnosing and beginning treatment for early-stage lymphedema can slow its progression. Severe, moderate swelling can make walking and everyday activities difficult.

Caring for someone with lymphedema at home

Simply lifting the affected leg can be very helpful, Kancharla said. Simple exercises can also be helpful. The exercises move the lymph and promote good joint mobility, which can be difficult if there is severe inflammation.

A healthcare provider, physical therapist, or lymphedema specialist may be able to show you and your partner which exercises are best. A lot of things can even be done while sitting.

Some good exercises for lymphedema are:

Walking without moving or sitting
Seated knee extensions, lift your leg and straighten your knee
Toe extensions, even while sitting, lift your toes as much as possible and then relax them

Here are some other tips to help your partner reduce swelling caused by lymphedema:

Control weight: Being overweight or obese can worsen lymphedema in the legs. It may also increase your risk of a skin infection called cellulitis. You or your partner could speak to a nutritionist if you need a healthier eating plan or if your partner needs help maintaining a healthy weight.
Reduce salt consumption: Salt causes your body to retain fluid. This is something you should avoid if you have lymphedema. If you value flavor when preparing your partner’s meals, many dishes taste good when you add fresh herbs instead of salt.
Drink plenty of water: The goal of treating lymphedema is to reduce fluid intake. Still, it’s important that your partner drinks at least eight 8-ounce glasses of water every day. This is useful for flushing out unwanted fluids.
Wear loose clothing: Encourage your partner to avoid tight socks and pants (especially elastic ones). The correct shoe size is also important to prevent blisters or sores that could lead to infections.
Protect the skin: Remind your partner to keep their skin clean and dry to prevent infections. If you help him by cutting his toenails, be careful not to cut his cuticles. She also recommends long pants for gardening, walking, or other activities that could scratch the skin. Use sunscreen (SPF 30 or higher) and insect repellent to avoid insect bites.
Don’t ignore skin lesions: Treat skin lesions immediately by cleaning, applying antibiotic ointments, and covering. Monitor the site for signs of infection, such as: B. a reddish color or warm temperature. This will help reduce the risk of infections, cellulitis and a serious complication called sepsis.

If your partner needs further help

If the initial measures at home do not work, there are other options. Your partner’s healthcare provider may also refer other healthcare professionals, such as occupational therapists or physical therapists.

Compression stockings: According to Kancharla, sometimes in addition to elevating the leg, patients also need to wear compression stockings or have a massage for relief. Compression stockings adapt specifically to the leg and thus prevent fluid accumulation in the tissue. A prescription is required and the stockings must be fitted by a professional. Since putting these stockings on can be difficult, ask the supplier to show you the best way to do this as well as tips and tricks that can make putting them on easier. No one should borrow their compression stockings because if they don’t fit snugly on the legs, it can worsen lymphedema.
Massages for lymphatic circulation: Your partner’s doctor may recommend a special type of massage called manual lymphatic circulation. This is not the type of massage most of us are used to. During a lymphatic circulation massage, lymph fluid is transported from the tissue to the lymph nodes through gentle pressure. Physical therapists, therapists with specialized massage training, and other health care providers can perform these massages. You or your partner can also do it at home, but it is important to learn the technique from a qualified person.
Intermittent pneumatic compression: If lymphedema is more severe, your partner’s doctor may prescribe intermittent pneumatic compressions with pumps. A compression sleeve is wrapped around the leg and then inflated and deflated, stimulating blood circulation. The duration of the sessions depends on your doctor’s recommendations.

Cost control

Exercise, lymphatic massage and a healthy diet are things that most people can do at home, but not everyone can afford lymphatic massage in a clinic or practice, compression stockings or pumps. Medicare covers lymphedema compression treatment items, as do some private insurers. Private insurance can also cover massages. It’s important that your partner asks for help when they need it.

When you and your partner work together as a team, you can reduce your anxiety and stress. Understanding your partner’s disorder and treatment will also help you defend their rights if necessary. “Lymphedema [con cáncer de próstata] “Right now it’s extremely rare, something we rarely see,” Kancharla said. “But if someone has lymphedema, particularly related to a tumor, cancer or after surgery, we have a lot of resources.”

This educational resource was created with support from Bayer and Merck.

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