Lymphedema after surgery for OC?

starzhere

Lymphedema after surgery for OC?

starzhere

Hi ladies.  I had BC 23 years, ago and have been a member here for quite a few years.  I had surgery for OC almost two years, ago.  I found out I am BRCA 2+.  I was diagnosed with Primary Peritoneal cancer, which has no envolvment of the ovaries.  My surgery went from my diaphragm down to the pelvic area.  I can't seem to find an answer to my question by going through the OC forums.  I recently flew to Florida and during the five hour plane flight, my midriff area swelled up.  The area between the ribs and my navel.  It really had me scared, because it felt just like the build up of fluid (ascites) that I had when I was diagnosed with OC.  The fluid went away the following day and didn't return on the flight home.  I spoke with my oncologist and he said he's never seen lymphedema develop in this are with OC surgery.  It's occurs in the legs and feet.  Well, now it happened again last week, when I took a short car trip with my daughter.  My bra fit really tight and I had a nice roll around my midriff.  It took about two days to get back to normal.  Has anyone ever heard of lymphedema in this area?

Thanks!

~elaine

kira66715

Starz: I recently spoke to the gynecologic oncologists at the local women's hospital, and I reviewed lower extremity lymphedema after surgery for ovarian and endometrial cancer, and the incidence is, unfortunately, increasing due to more nodes coming out during robotic surgery.

I also attended a re-certification of experiences lymphedema therapists at the Vodder school, and they talked about lymphedema in the bowel, in the abdomen--as both are areas of many lymph nodes. If your surgery was so extensive, I'll bet a lot of nodes were taken, and the lymphatics in the abdomen/pelvis were disrupted.

Lymphedema can develop in any part of the "quadrant" the area of the body, where the lymphatic system was disrupted. It does not have to start "distally"--in the feet and toes.

I met with the head of the Vodder School in Austria, Hildegard, and she spoke of working on the abdomen on many patients, and the main area of collection, the chyla cisterna, is in the abdomen.

I would say, first, make sure that there is no medical reason for you to swell, but next, I'd seek out a very good and very experienced lymphedema therapist--interview them first--and have them address this and consider treatment. It's far harder to treat the abdomen than the limbs, but it can be done.

http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

A quick google search brought up a lecture from Bonnie Laskinski's school on atypical LE:

http://www.lymphedema-therapy.com/03paper.htm

A basic understanding of the normal anatomy of the lymphatic system is critical for anyone evaluating an individual with edema of unknown origin, where testing has already ruled out most of the common causes of edema, namely cardiac, renal, hepatic, thyroid, venous, or drug induced. The major lymph node basins for the extremities are the axillary (armpit) for the upper extremities and the inguinal (groin) for the lower extremities. Lymph from both lower extremities and the genitalia drains into the pelvic and abdominal lymph node basins. From here, the lymph eventually moving into the thoracic duct which is the major lymph vessel that transports lymph fluid form the lower half of the body into the left venous angle between the left jugular and left subclavian veins, and into the right side of the heart. Lymph from the right upper extremity drains into the right axilla and then into the right lymphatic duct which empties into the right venous angle between the right jugular and right subclavian veins, into the right side of the heart. Anatomically, one can see that disruption from infection, scarring, inflammatory processes, accidental injury during a surgical procedure in the pelvic/abdominal areas can result in lower extremity lymphedema as well as abdominal and genital edemas. In the same way, any injury along the path from the upper extremity to the axilla and then into the chest can result in lymphedema in the arm/hand. Trauma, infection, or the formation of a blood clot in the area around the venous angles can cause lymphedema.  

Kira

starzhere

Kira, thanks for the information.  I knew I came to the right place!

HUGS, Elaine