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Edema (Fluid Retention)

 

Edema is swelling caused by the buildup of abnormal levels of fluid in the body. In edema, fluid collects under the skin within the tissues that are outside of the circulatory system. Edema is most common in the feet and legs, but it can occur in the hands, arms, face, abdominal cavity (ascites), and around the lungs (pleural effusion). Lymphedema is a type of edema where fluid builds up in an arm or leg due to a blockage in the lymphatic system.

Causes

Edema may be caused by the following factors:

  • Cancer itself, especially kidney, liver, or ovarian cancers
  • Some types of chemotherapy, including cisplatin (Platinol) and docetaxel (Taxotere)
  • Other medications, including steroids, corticosteroids, hormone replacement medications, nonsteroidal anti-inflammatory drugs, and some blood pressure medications
  • Low levels of protein in the blood caused by poor nutrition
  • Inactivity, which can cause fluid to collect in the feet and legs
  • Problems with functioning of the kidneys, liver, or heart

Symptoms

People with edema may experience the following symptoms:

  • Puffiness, swelling, or a "heavy" feeling
  • Clothes, shoes, rings, or watches that feel too tight
  • Decreased flexibility of the joints in the arms and legs, such as the ankles, wrists, and fingers
  • Skin that is shiny or feels tight or stiff
  • Skin that indents when pressed (in severe edema, the skin no longer indents)
  • Sudden or rapid weight gain
  • Decreased amount of urine

Diagnosis

To diagnose edema, your doctor may perform a physical examination to check whether the skin over the swollen area indents when pressed. Your doctor may ask you questions about recent weight gain, tightness of clothes or jewelry, and other symptoms. Your doctor may also order blood and urine tests and x-rays.

Management

Managing edema focuses on correcting the underlying cause of fluid accumulation. Edema caused by medications or poor nutrition is reversible in some patients. Edema caused by cancer itself or by kidney, heart, or liver problems may be more difficult to treat and may be permanent. The following suggestions may help reduce swelling and relieve symptoms:

  • Ask your doctor about prescription diuretics (medications that lower the amount of water in the body).
  • Eat a well-balanced diet.
  • Reduce the amount of salt in your diet.
  • Walk, or perform other exercises, to help pump fluids back into your circulatory system.
  • Elevate the affected area when sitting or lying down.
  • Avoid standing for long periods or sitting with your legs crossed.
  • Wear compression stockings or elastic sleeves to help push fluids back into your circulatory system.
  • Do not reduce amount of water or other fluids you drink without consulting your doctor.
  • Physical therapy and/or occupational therapy can help manage lymphedema.

More Information

PLWC Feature: After Treatment for Breast Cancer: Preventing Lymphedema

 

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