Lymphedema: A primer on the identification and management of a chronic condition in oncologic treatment


  • Brian D. Lawenda MD,

    Corresponding author
    1. Assistant Professor, Radiology/Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD, Department Head, Breast Health Center, and Clinical Director, Radiation Oncology, Naval Medical Center, San Diego, CA, Adjunct Assistant Professor, Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
    • Radiation Oncology Department, Naval Medical Center, 34800 Bob Wilson Drive, San Diego, CA, 92134
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  • Tammy E. Mondry DPT, MSRS, CLT-LANA,

    1. New Horizons Physical Therapy, San Diego, CA
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  • Peter A. S. Johnstone MD

    1. Chair and William A. Mitchell Professor, Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
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  • DISCLOSURES: The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government. The authors report no conflicts of interest.


The primary goals of oncologic therapy are the compassionate care of cancer patients, eradication of disease, and palliation of symptoms. Advances in various targeted therapies such as highly conformal and image-guided radiotherapy techniques, sentinel lymph node dissection, and molecularly targeted agents hold the promise of allowing those goals to be reached with fewer treatment-related complications. Unfortunately, certain side effects remain problematic due to the inability to completely avoid injuring normal tissues. Lymphedema, a chronic condition that occurs as a result of the body's inability to drain lymph fluid from the tissues, is a common treatment-related side effect experienced by cancer patients. In this review, many of the important aspects of lymphedema with which clinicians who treat cancer patients should be familiar are outlined, including the anatomy, pathophysiology, diagnosis, and management of this condition. The authors also identify some of the resources available both to cancer patients with lymphedema and to the clinicians who treat them. It is hoped that this review will convey the importance of the early identification and management of this incurable disorder because this is essential to minimizing its complications. CA Cancer J Clin 2009;59:8–24. © 2009 American Cancer Society.