Sentry Aging welcomes our next guest writer, Katie Henk, DPT, CLT. Katie is a Pittsburgh-based physical therapist who works primarily with people living with lymphedema.
October is Breast Cancer Awareness Month—a time to recognize the importance of awareness, screening, and support throughout treatment and recovery. For some people, breast cancer treatment can affect the lymphatic system and lead to lymphedema, a condition that can cause lasting swelling. Learning what to look for and where to turn for help can make a difference.
We’re fortunate to share a Q&A with Katie, who brings both expertise and compassion to her work with patients. If you’ve heard the terms swelling and lymphedema used in conversation or by your doctor and wondered how they differ, this information is for you.
What are the doctors referring to when they mention the lymphatic system?
The lymphatic system is a network throughout the body with 3 important jobs: return fluids into the bloodstream, absorb fats and other nutrients, and support the immune system. When functioning properly, you really don’t even know this system is working.
What is lymphedema?
In most cases, lymphedema results secondarily from damage to or removal of part of the lymphatic system, causing protein-rich lymphatic fluid to accumulate and leading to chronic inflammation and swelling. Some causes of lymphedema include crush injuries of a limb in an accident, surgeries, cancer treatments, or even joint replacements (to name a few). Primary lymphedema is a congenital defect caused by abnormal lymphatic development. It can stay dormant and then show up in teenage years or even later.
Is swelling after an injury the same thing as lymphedema?
No, simply put, this is not the same thing. After an injury, your body creates inflammation and swelling as part of the healing process. However, with a fully functioning lymphatic system, it can drain this extra fluid, and it is relatively short-term. Lymphedema is chronic swelling and inflammation that lasts more than 3 months.
What can cause swelling and lymphedema after breast cancer?
Surgery itself can cause enough damage to the lymphatic system to cause lymphedema. Lymphedema can occur in the breast, chest region, armpit, or even the back from a partial or total mastectomy. If doctors remove lymph nodes, the risk of developing lymphedema in the arm is higher. This risk increases even more with radiation therapy, obesity, how many lymph nodes are removed, or previous injuries to the area.
Where can lymphedema occur in the body?
Anywhere, but most commonly in the legs and arms. It is also quite common to occur in the breasts after cancer treatments and surgery. It can also present in the abdomen after a major operation.
Why is it important to treat lymphedema?
The protein-rich fluid that collects in the tissue causes long-term inflammation and swelling. Long-term, if left untreated, this can cause pain, limited mobility and joint movement, and in more severe cases can lead to wounds. Seek diagnosis and treatment from your physician as soon as possible.
What is the treatment for lymphedema?
Treatment can vary depending on the location and severity. Treatment typically includes compression, exercise, weight management, skin care, and lymphatic drainage massage.
What are some early signs/symptoms to be on the lookout for?
Lymphedema can develop months or even years after a surgery or injury. Most common symptoms of lymphedema include heaviness, aching, swelling, and sometimes tingling. You may also notice less visible ankle bone prominence or veins compared to the other arm or leg.
What to do if you suspect lymphedema?
Talk to your doctor about your symptoms and discuss when it started. They may recommend trying elevation or compression garments. If swelling continues, you may be directed to a lymphedema therapist or lymphedema doctor. There is testing available to confirm lymphedema. Sometimes lymphedema can occur along with venous issues in the legs, and you may be referred to a vascular specialist.
If you are interested in learning more about lymphedema or the lymphatic system, here are a few great resources:
https://lymphnet.org/
https://lymphaticnetwork.org/living-with-lymphedema/lymphedema
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/treating-lymphedema
https://www.nortonschool.com/blog/pitting-edema-vs-lymphedema/
Sentry Aging thanks Katie for sharing her knowledge with our readers and for the care she provides to people living with lymphedema. If you or someone you know is looking for a physical therapist with experience in this area, Katie may be just the person to reach out to! October is also a good reminder to stay familiar with your body and keep up with the breast cancer screenings recommended by your healthcare provider. Awareness, education, and helping people find the support they need are all part of what Sentry Aging is about.
Meet The Clinician
Katie Henk, DPT, CLT, is a Pittsburgh-based physical therapist who primarily works with people living with lymphedema. She currently practices at UPMC Outpatient Rehab in Bethel Park and earned her Doctor of Physical Therapy degree from Wheeling Jesuit University. Outside the clinic, Katie and her husband, Tyler, love traveling and spending time outdoors. Their dog, Reno, is always ready to join the itinerary.
