Advanced Surgical Options for the Treatment of Lymphedema

Posted on Thursday, March 27, 2014

Vascularized lymph node transfer is an innovative new surgical procedure used to treat lymphedema, a common condition for patients who have had their lymph nodes removed during the course of cancer treatment.

Symptoms of lymphedema include fluid retention, tissue swelling and soreness of the extremities (arms, hands or legs). Research suggests that the frequency of upper extremity (arm) lymphedema in breast cancer patients can range from 8 percent to 56 percent Click [i]. Lymphedema in the lower-extremities (legs) can occur in 5 – 36 percent of patients after treatment for gynecologic cancers (vulvar, ovarian, uterine) [ii]. Thus, the procedure can benefit a wide range of patients and improve their quality of life after cancer surgery.

During the procedure, a surgeon transplants lymph nodes from one part of the body to another part of the body that is affected by lymphedema. The procedure ensures that the lymph nodes are “alive” by reestablishing blood flow to the transplanted lymph nodes. The transplanted lymph nodes can help divert the lymphatic fluid in the affected extremity to the venous circulation. Although there is a theoretical risk of developing lymphedema in the donor extremity (patient’s arms, hands or legs), with proper lymph node selection for transfer, this can be avoided. Recent evidence shows that very few cases of developing lymphedema in the donor extremity have been reported.

Any patient with lymphedema after cancer treatment is a potential candidate for this surgery. This procedure is now available at Fox Chase Cancer Center within the Division of Plastic and Reconstructive Surgery. Patients should always carefully review and discuss their options, including potential risks and benefits, with their doctor in order to make an informed decision regarding their care. To make an appointment or request a second opinion with Dr. Sameer Patel, please call 1-888-FOX-CHASE.

[i] Paskett ED, Naughton MJ, McCoy TP, et al.: The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiol Biomarkers Prev 16 (4): 775-82, 2007.

[ii] Beesley V, Janda M, Eakin E, et al.: Lymphedema after gynecological cancer treatment: prevalence, correlates, and supportive care needs. Cancer 109 (12): 2607-14, 2007.

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Sameer Patel, MD, FACS

About Sameer A. Patel, MD, FACS

Dr. Sameer Patel is a plastic and reconstructive surgeon within the Department of Surgical Oncology at Fox Chase Cancer Center. He specializes in breast and head and neck reconstruction, as well as melanoma, sarcoma and skin cancer reconstruction. In 2012, Dr. Patel was featured in Philadelphia magazine as a Top Doctor and a Rising Star Under 40. He received an MD from New Jersey Medical School at the University of Medicine and Dentistry of New Jersey. Dr. Patel also completed a residency in general surgery and plastic and reconstructive surgery at the Montefiore Medical Center at Albert Einstein College of Medicine in Bronx, NY, and a fellowship in microsurgical reconstruction at the University of Texas M.D. Anderson Cancer Center.

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