Reducing the risk of lymphoedema in the lower limb and genital area

Lymphoedema is swelling in a part of the body caused by a build-up of fluid (lymph) in the tissues. This can happen if the lymphatic system isn’t working properly. Cancer treatment, such as surgery and/or radiotherapy can affect the way your lymphatic system works. 

Not all swelling is lymphoedema. Swelling following surgery and/or radiotherapy is common and usually gets bets better within a few weeks. If the swelling persists or if you are worried, talk to your GP or other healthcare professionals.

The lymphatic system is an important part of your immune system. It is made up of lymphatic organs, lymph nodes (glands) and lymph vessels that run through your body.

The lymphatic system helps to:

• fight infection 
• maintain a balance of fluids in your tissues and bloodstream 
• monitor for foreign materials and bacteria in the body.

Lymphoedema does not affect everyone and there is no way to know if you will develop lymphoedema. This is because each person’s lymphatic system is unique and recovers from the cancer treatment in its own way.

You may be at risk of developing lymphoedema if you have had one or both of the following:

• your lymph nodes removed from your groin or pelvis. This can affect the way lymph drains and cause fluid to build up in the tissues. 
• radiotherapy as part of your cancer treatment. 

Lymphoedema can occur in the foot, leg, genitals and/or abdomen (tummy) on the side of your surgery. 

Signs to look out for include: 

• tightness, heaviness, fullness or ache in the lower limb or genitals 
• change in the shape of the affected limb 
• tightness of clothing and/or shoe 
• swelling or puffiness at the end of the day or after specific activities.

Skin care

It’s important that you care for your skin around the treated area to reduce the risk of skin infection (cellulitis). Please follow the tips below: 

• Keep the skin in and around the treated area in good condition and moisturised. This will help to prevent the skin from becoming dry and cracked.
• Use an insect repellent to minimise bites.
• Protect your skin from sunburn. Use sun cream with a factor 30 or above on the area you have had radiotherapy.
• Look after your nail beds and cuticles. Damage to nail beds and cuticles may trigger infection.

You could be at increased risk of developing cellulitis in your lower limb and genital area if you had: 

• lymph nodes removed from your abdomen and/or groin
• radiotherapy in the pelvic area.

Any skin damage in these areas may lead to cellulitis. This can then trigger the development of lymphoedema.

Avoiding cellulitis

If you cut or scratch your skin, or notice any skin damage, wash the affected area carefully with soap and water. Look out for signs and symptoms of cellulitis which include: 

• skin redness 
• increasing swelling 
• skin feeling hot and painful to touch 
• flu-like symptoms or raised temperature.

If you notice any of these symptoms, please contact your GP without delay. If your GP surgery is closed, go to your nearest walk-in centre or Emergency Department (A&E). If you have cellulitis, you will need a course of antibiotics to treat it. 

The British Lymphology Society recommends antibiotics for at least 14 days if: 

• you are at risk of lymphoedema, and 
• you have been diagnosed with cellulitis in ‘the area at risk’. 

You can find the Guidelines on the Management of Cellulitis in Lymphoedema on the Lymphoedema Support Network (LSN) website. 

It may be helpful to download them and show them to your GP 

or an A&E doctor if they suspect you have cellulitis. 

Please note: 

• It’s important that you always finish the course of antibiotics you have been prescribed. 
• Tell your doctor if you don’t start to feel better after 48 hours of taking antibiotics.

Exercises

Try to keep active. Regular exercise helps with lymphatic drainage 

and can reduce the risk of developing lymphoedema. There are some useful exercise videos on our website. 

Visit Lymphoedema Service page. 

It’s important that you slowly increase your exercise level. If you need advice on this, speak to your healthcare team.

General advice

• There is no evidence that air travel triggers lymphoedema. But many people choose to wear flight socks to reduce the risk of swelling during a flight.
• Eat a balanced diet to help maintain a healthy body weight.
• Be aware that extreme heat, which may include saunas and steam room, can trigger swelling for some people.

The Macmillan Support and Information Service offers emotional support, practical advice and information to anyone affected by cancer or a blood condition.

You don’t need an appointment to visit and the team will see you as soon as they can.

Address: University College Hospital Macmillan Cancer Centre, Ground Floor, Huntley Street, London WC1E 6AG

Opening hours: 9am to 4.45pm

Telephone: 020 3447 8663

Email: uclh.supportandinformation@nhs.net 

X (formerly known as Twitter): @supportandinfo

Website: uclh.nhs.uk/msis

Lymphoedema Service 

University College Hospital Macmillan Cancer Centre, Huntley street, London WC1E 6AG

Telephone: 020 3447 3925

Lymphoedema Support Network (LSN)
The LSN is a patient organisation providing advice and a range of information about lymphoedema. It also holds support groups around the UK and can advise on local lymphoedema services. 

Address: St Luke’s Crypt, Sydney Street, London SW3 6N1T Information and support: 020 7351 0990
Email: adminlsn@lymphoedema.freeserve.co.uk 

Macmillan Cancer Support
Provides helpful information about cancer-related lymphoedema. Telephone: 0808 808 00 00

Cancer Research UK
Funds research to help beat cancer sooner and provides information about cancer. Telephone: 0808 800 4040 

NHS Website

University College London Hospitals NHS Foundation Trust cannot accept responsibility for information provided by external organisations.