lymphedema

Lymphedema is the name of a type of swelling. It happens when lymph builds up in your body's soft tissues. Lymph is a fluid that contains white blood cells that defend against germs. It can build up when the lymph system is damaged or blocked. It usually happens in the arms or legs.

Causes of lymphedema include:

• Infection
• Cancer
• Scar tissue from radiation therapy or surgical removal of lymph nodes
• Inherited conditions in which lymph nodes or vessels are absent or abnormal

Treatment can help control symptoms. It includes exercise, compression devices, skin care, and massage.

NIH: National Cancer Institute

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Types of arm injuries include :

• Tendinitis and bursitis
• Sprains
• Dislocations
• Fractures (broken bones)
• Nerve problems
• Osteoarthritis

You may also have problems or injure specific parts of your arm, such as your hand, wrist, elbow, or shoulder.

Breast cancer is a cancer that starts in breast tissue. It happens when cells in the breast change and grow out of control. The cells usually form a tumor.

Sometimes the cancer does not spread any further. This is called "in situ." If the cancer spreads outside the breast, the cancer is called "invasive." It may just spread to nearby tissues and lymph nodes. Or the cancer may metastasize (spread to other parts of the body) through the lymph system or the blood.

Breast cancer is the second most common type of cancer in women in the United States. Rarely, it can also affect men.

There are different types of breast cancer. The types are based on which breast cells turn into cancer. The types include:

• Ductal carcinoma, which begins in the cells of the ducts. This is the most common type.
• Lobular carcinoma, which begins in the lobules. It is more often found in both breasts than other types of breast cancer.
• Inflammatory breast cancer, in which cancer cells block lymph vessels in the skin of the breast. The breast becomes warm, red, and swollen. This is a rare type.
• Paget's disease of the breast, which is a cancer involving the skin of the nipple. It usually also affects the darker skin around the nipple. It is also rare.

Breast cancer happens when there are changes in the genetic material (DNA). Often, the exact cause of these genetic changes is unknown.

But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.

There are also certain genetic changes that can raise your risk of breast cancer, including changes in the BRCA1 and BRCA2 genes. These two changes also raise your risk of ovarian and other cancers.

Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.

The factors that raise your risk of breast cancer include:

• Older age
• History of breast cancer or benign (noncancer) breast disease
• Inherited risk of breast cancer, including having BRCA1 and BRCA2 gene changes
• Dense breast tissue
• A reproductive history that leads to more exposure to the estrogen hormone, including
  • Menstruating at an early age
  • Being at an older age when you first gave birth or never having given birth
  • Starting menopause at a later age
• Taking hormone therapy for symptoms of menopause
• Radiation therapy to the breast or chest
• Obesity
• Drinking alcohol

The signs and symptoms of breast cancer include:

• A new lump or thickening in or near the breast or in the armpit.
• A change in the size or shape of the breast.
• A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
• A nipple turned inward into the breast.
• Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
• Scaly, red, or swollen skin in the nipple area or the breast
• Pain in any area of the breast.

Your health care provider may use many tools to diagnose breast cancer and figure out which type you have:

• A physical exam, including a clinical breast exam (CBE). This involves checking for any lumps or anything else that seems unusual with the breasts and armpits.
• A medical history.
• Imaging tests, such as a mammogram, an ultrasound, or an MRI.
• Breast biopsy.
• Blood chemistry tests, which measure different substances in the blood, including electrolytes, fats, proteins, glucose (sugar), and enzymes. Some of the specific blood chemistry tests include a basic metabolic panel (BMP), a comprehensive metabolic panel (CMP), and an electrolyte panel.

If these tests show that you have breast cancer, you will have tests that study the cancer cells. These tests help your provider decide which treatment would be best for you. The tests may include:

• Genetic tests for genetic changes such as in the BRCA and TP53 genes.
• HER2 test. HER2 is a protein involved with cell growth. It is on the outside of all breast cells. If your breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body.
• An estrogen and progesterone receptor test. This test measures the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly.

Another step is staging the cancer. Staging involves doing tests to find out whether the cancer has spread within the breast or to other parts of the body. The tests may include other diagnostic imaging tests and a sentinel lymph node biopsy. This biopsy is done to see whether the cancer has spread to the lymph nodes.

Treatments for breast cancer include:

• Surgery such as
  • A mastectomy, which removes the whole breast
  • A lumpectomy to remove the cancer and some normal tissue around it, but not the breast itself
• Radiation therapy
• Chemotherapy
• Hormone therapy, which blocks cancer cells from getting the hormones they need to grow
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
• Immunotherapy

You may be able to help prevent breast cancer by making healthy lifestyle changes such as:

• Staying at a healthy weight
• Limiting alcohol use
• Getting enough exercisee
• Limiting your exposure to estrogen by
  • Breastfeeding your babies if you can
  • Limiting hormone therapy

If you are at high risk, your health care provider may suggest that you take certain medicines to lower the risk. Some women at very high risk may decide to get a mastectomy (of their healthy breasts) to prevent breast cancer.

It's also important to get regular mammograms. They may be able to identify breast cancer in the early stages, when it is easier to treat.

NIH: National Cancer Institute

Cancer is a common disease. Almost 40 percent of Americans will be diagnosed with cancer during their lifetimes. Even though cancer may be life-threatening, many people have successful treatment. Others live with cancer for a very long time.

For most people with cancer, learning to live with the disease is one of the biggest challenges they've ever faced. That's because having cancer touches just about every part of your life and the lives of those around you.

Cancer and its treatment may change:

• Your daily routines and ability to work
• Your important relationships
• The way you look, feel, and think about yourself

You may feel more in control and prepared to cope with these changes if you learn about what to expect. Your health care provider can help you find information and support services that are right for you.

Having cancer may cause a range of strong emotions, such as sadness, anger, fear, worry, or guilt. These feelings are normal, and they're likely to change over time. It's helpful to sort out your feelings in a way that's comfortable for you. You might try:

• Talking openly with someone you trust
• Writing about your feelings
• Using relaxation methods, such as meditation and other complementary and alternative medicine (CAM)
• Doing things you enjoy to give yourself a break from focusing on cancer

If your emotions seem to take over your life, tell your provider. You may need extra support if you have symptoms of depression, stress, anxiety, or panic disorder.

During cancer treatment, you usually have a team of providers. Along with doctors and nurses, you may be able to talk with social workers, pharmacists, dietitians, and other health professionals.

These professionals are prepared to help you deal with the issues that cancer brings up, including concerns about finances. But it's up to you to let your team know what's on your mind.

Good communication with your providers may help you feel more in control and satisfied with your care. Your communications may be better if you:

• Tell your providers how much you want to know about your cancer and its treatment. Do you want all the details or just the big picture?
• Write down your questions and concerns before your visits.
• Bring a family member or a friend to your visits. This person can help by listening, taking notes, and asking questions.

Cancer changes the daily routines and roles of the people who love and support you. They may need to start doing the things you've always done for them. And you may need their help doing things you've always done for yourself. These changes can be difficult for everyone.

It may help to have an honest talk about changing roles and needs. If that sounds too difficult, ask a social worker or other member of your care team to help you talk with family and friends who are helping with your care. These caregivers may need some support, too.

Cancer and its treatment may cause some big changes in how you look, feel, and think about yourself. For example, you may have:

• Less energy
• Temporary or permanent changes in your body, such as scars, or hair loss from chemotherapy
• Problems being sexually close or doubts about dating

Coping with these changes can be hard. But most people find ways to feel more positive over time. If you feel well enough, you might try:

• Exercise. Walking, yoga, or other movement may help you feel stronger and more in control of your body. But check with your provider first.
• Staying involved in life and helping others. Think about volunteering, hobbies, or other activities that might make you feel good about yourself.
• Counseling for sexual problems. Talking with a professional, either with a partner or on your own, may help.

After treatment, you'll have regular cancer follow-up care. Your provider will explain the schedule of checkups and tests you'll need. This is a good time to discuss the challenges you may face ahead. Knowing what to expect may help you make plans as you find a "new normal" with cancer as part of your life.

NIH: National Cancer Institute

Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures (broken bones).

These injuries can affect the entire leg, or just the foot, ankle, knee, or hip. Certain diseases also lead to leg problems. For example, knee osteoarthritis, common in older people, can cause pain and limited motion. Problems in your veins in your legs can lead to varicose veins or deep vein thrombosis.

The lymphatic system is a network of tissues and organs. It is made up of:

• Lymph - a fluid that contains white blood cells that defend against germs
• Lymph vessels - vessels that carry lymph throughout your body. They are different from blood vessels.
• Lymph nodes - glands found throughout the lymph vessels. Along with your spleen, these nodes are where white blood cells fight infection.

Your bone marrow and thymus produce the cells in lymph. They are part of the system, too.

The lymphatic system clears away infection and keeps your body fluids in balance. If it's not working properly, fluid builds in your tissues and causes swelling, called lymphedema. Other lymphatic system problems can include infections, blockage, and cancer.

Edema means swelling caused by fluid in your body's tissues. It usually occurs in the feet, ankles and legs, but it can involve your entire body.

Causes of edema include:

• Eating too much salt
• Sunburn
• Heart failure
• Kidney disease
• Liver problems from cirrhosis
• Pregnancy
• Problems with lymph nodes, especially after mastectomy
• Some medicines
• Standing or walking a lot when the weather is warm

To keep swelling down, your health care provider may recommend keeping your legs raised when sitting, wearing support stockings, limiting how much salt you eat, or taking a medicine called a diuretic - also called a water pill.

A mastectomy is surgery to remove a breast or part of a breast. It is usually done to treat breast cancer. Types of breast surgery include:

• Total (simple) mastectomy - removal of breast tissue and nipple
• Modified radical mastectomy - removal of the breast, most of the lymph nodes under the arm, and often the lining over the chest muscles
• Lumpectomy - surgery to remove the tumor and a small amount of normal tissue around it

Which surgery you have depends on the stage of cancer, size of the tumor, size of the breast, and whether the lymph nodes are involved. Many women have breast reconstruction to rebuild the breast after a mastectomy.

Sometimes mastectomy is done to prevent breast cancer. Only high-risk patients have this type of surgery.

NIH: National Cancer Institute