Kathy Bates Discusses Her Struggle with Lymphedema

Academy Award winning actress Kathy Bates has had more than her share of health issues. In 2003, Bates was diagnosed and treated for ovarian cancer. In 2012, she underwent a bilateral mastectomy to treat breast cancer.

Today, in an interview on CBS Sunday Morning, she invited correspondent Lee Cowan to join her for her doctor’s visit to deal with a complication of her breast cancer treatment. During her mastectomy, doctors removed 19 lymph nodes from her underarms. This has left her with a condition called lymphedema, where extra fluid builds up in her arms. She must wear a special compression sleeve on her arms to minimize the swelling. As she told Cowen, at the time of this diagnosis, “I went berserk, I went nuts, and for a long time after that, I was really, really angry. I just turned into another person. I just felt betrayed, I felt enraged.”

But now, she’s turning that anger into something more constructive, becoming a spokesperson for the Lymphatic Education & Research Network so she can help others.

“I didn’t know what I was saying yes to and the more I learn about it, the more angry I am,” Bates says. “I feel I have to do something about it. If I can use my celebrity for something real, then that’s what I want to do.”

First, a few words about the lymphatic system…

The lymph system is a network of lymph vessels, tissues, and organs that carry lymph throughout the body.

The parts of the lymph system that play a direct part in lymphedema include the following:

• Lymph: A clear fluid that contains lymphocytes (white blood cells) that fight infection and the growth of tumors. Lymph also contains plasma, the watery part of the blood that carries the blood cells.
• Lymph vessels: A network of thin tubes that helps lymph flow through the body and returns it to the bloodstream.
• Lymph nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.

When the lymph system is working as it should, lymph flows through the body and is returned to the bloodstream.

What is lymphedema?

Lymphedema is the build-up of fluid in soft body tissue when the lymph system is damaged or blocked. It is a common problem that may be caused by cancer and cancer treatment. Lymphedema usually affects an arm or leg, but it can also affect other parts of the body.

Lymphedema can occur after any cancer or treatment that affects the flow of lymph through the lymph nodes, such as the removal of lymph nodes or radiation therapy. Lymphedema often occurs in breast cancer patients who have had all or part of their breast removed and axillary (underarm) lymph nodes removed.

Lymphedema may develop within days or it can only occur many years after treatment. Most often, it develops within three years of surgery.

Possible signs of lymphedema include swelling of the arms or legs.

Other symptoms can include:

• Swelling of an arm or leg, which may include fingers and toes
• A full or heavy feeling in an arm or leg
• A tight feeling in the skin
• Trouble moving a joint in the arm or leg
• Thickening of the skin, with or without skin changes, such as blisters or warts
• A feeling of tightness when wearing clothing, shoes, bracelets, watches, or rings
• Itching or burning feeling in the legs or toes
• Trouble sleeping

What can be done for patients with lymphedema?

The goal of treatment is to control the swelling and other problems caused by lymphedema.

Damage to the lymph system cannot be repaired. Treatment is given to control the swelling caused by lymphedema and keep other problems from developing or getting worse. Physical (non-drug) therapies are the standard treatment. Treatment may be a combination of several of the physical methods.

The goal of these treatments is to help patients continue with activities of daily living, to decrease pain, and to improve the ability to move and use the limb (arm or leg) with lymphedema. Drugs are not usually used for long-term treatment of lymphedema.

Treatment of lymphedema may include the following:

Pressure garments

Pressure garments are made of fabric that puts a controlled amount of pressure on different parts of the arm or leg to help move fluid and keep it from building up. Some patients may need to have these garments custom-made for a correct fit. Wearing a pressure garment during exercise may help prevent more swelling in an affected limb. It is important to use pressure garments during air travel, because lymphedema can become worse at high altitudes. Pressure garments are also called compression sleeves and lymphedema sleeves or stockings.

Exercise

Both light exercise and aerobic exercise (physical activity that causes the heart and lungs to work harder) help the lymph vessels move lymph out of the affected limb and decrease swelling.

Talk with a certified lymphedema therapist before beginning exercise.

Wear a pressure garment if lymphedema has developed.

Patients who have lymphedema should wear a well-fitting pressure garment during all exercise that uses the affected limb or body part.

When it is not known for sure if a woman has lymphedema, upper-body exercise without a garment may be more helpful than no exercise at all. Patients who do not have lymphedema do not need to wear a pressure garment during exercise.

For Breast Cancer Survivors:

Breast cancer survivors should begin with light upper-body exercise and increase it slowly.

Some studies with breast cancer survivors show that upper-body exercise is safe in women who have lymphedema or who are at risk for lymphedema. Weight-lifting that is slowly increased may keep lymphedema from getting worse. Exercise should start at a very low level, increase slowly over time, and be overseen by the lymphedema therapist. If exercise is stopped for a week or longer, it should be started again at a low level and increased slowly.

If symptoms (such as swelling or heaviness in the limb) change or increase for a week or longer, talk with the lymphedema therapist. It is likely that exercising at a low level and slowly increasing it again over time is better for the affected limb than stopping the exercise completely.

Bandages

Once the lymph fluid is moved out of a swollen limb, bandaging (wrapping) can help prevent the area from refilling with fluid. Bandages also increase the ability of the lymph vessels to move lymph along. Lymphedema that has not improved with other treatments is sometimes helped with bandaging.

Skin care

Protect your skin. Use lotion to avoid dry skin. Use sunscreen. Consider wearing plastic gloves with cotton lining when working in order to prevent scratches, cuts, or burns. Keep your feet clean and dry. Keep your nails clean and short to prevent ingrown nails and infection. Avoid tight shoes and wear your jewelry loose.

Resources for more information:

Lymphatic Education & Research Network

National Cancer Institute