What you need to know to stay safe
If you’ve had lymph nodes surgically removed as part of your cancer treatment, you are at an increased risk of developing a specific type of infection called cellulitis. This type of infection can develop rapidly and can be very serious if left untreated. As a result, it’s important to understand both how to reduce your risk and how to detect it early.
What is Cellulitis?
Cellulitis is a bacterial infection within the skin that can progress very rapidly into the lymphatic system and the bloodstream if left untreated. In serious situations, cellulitis has the potential to become a life-threatening condition, so early detection is important.
What Does Cellulitis Look Like?
Though the presentation of cellulitis can vary from person to person, there are several common symptoms to be aware of:
- A red “rash-like” area that spreads quite rapidly. This area can be warm to the touch.
- Progressive pain within the affected area
- Possible flu-like symptoms: fevers and chills
- Swelling in the affected area
Remember that these symptoms can come on very quickly and without warning.
Who is at an Increased Risk of Developing Cellulitis After Cancer Treatment?
Though anyone can develop cellulitis, there are certain factors that can increase your risk after cancer. These include the following:
1. Lymph Node Surgery
Because our lymphatic system is part of our immune system (i.e. infection-fighting system), anybody who has had lymph nodes removed as part of their cancer treatment is at risk of developing cellulitis. This includes anyone who has had a full or complete lymph node dissection as well as anyone who has had a sentinel node biopsy (i.e. only removed a few lymph nodes were removed)
2. Open Wounds
Any open wounds in the at-risk area, such as cracked skin, cuts or scrapes create an open area where the bacteria can enter.
3. Living with Cancer-Related Lymphedema
4. Repeated Episodes of Cellulitis
5. Obesity
Where in the Body Are You At Risk of Developing Cellulitis?
Thankfully the entire body is not at an increased risk of developing cellulitis after cancer surgery. The area(s) that are at increased risk, depend on where in your body your lymph nodes were removed.
To better explain where you’re at an increased risk of developing both cellulitis and lymphedema, it’s important to first understand the concept of watershed lines. These “imaginary lines” divide our body into sections, where each lymph node region drains fluid from an organized area of the body. For a more detailed explanation of watershed lines and lymphedema risk, I encourage you towatch the video below:
Cellulitis and Lymphedema
At this point in the blog, it’s important to talk about the two-way relationship between cellulitis and lymphedema. As I mentioned above, having lymphedema can increase your risk of developing cellulitis, but the same is true in reverse. In other words, having cellulitis can increase your risk of developing lymphedema, and this is backed in the literature. (1)
Because of this 2-way relationship between cellulitis and lymphedema, it’s really important to have a solid understanding of cellulitis risk and lymphedema risk as well as ways to reduce the risk of both. (Read to the end of this blog for a great resource about lymphedema risk reduction.)
How to Reduce Your Cellulitis Risk
First, when considering risk reduction, it’s important to mention that we can’t control whether or not you had lymph nodes removed (or how many) as a part of your cancer treatment; this was necessary for your cancer treatment. The purpose of the information in this blog is to understand what you DO have control over to manage moving forward.
The good news is there are some factors we can control.
Good Skin Care
Ideally, we want to reduce the risk of developing any cracks, cuts and scrapes in the areas that are at risk of developing cellulitis. Common-sense preventative measures like using gloves when gardening and keeping your skin moisturized to prevent cracking or hangnails can be helpful.
However, the reality is that we are all going to get cuts and scrapes from time to time. When this does happen, using common-sense first aid measures is important. These might include washing the area with soap and water, keeping the wound clean and monitoring carefully for any signs of infection.
Managing Your Lymphedema (if you have Lymphedema)
We know that there’s a relationship between lymphedema and tissue health, so keeping your lymphedema as stable and well-managed as possible is very important to keeping your tissues as healthy as possible. As such, well-managed lymphedema will further decrease your risk of developing cellulitis. Head here for more information about how to best manage your lymphedema.
Healthy Body Weight
What to do If You Suspect You Have Cellulitis
Sometimes, despite all of our best efforts to reduce our risk, cellulitis can still happen (remember how I said that we don’t have 100% control over this?) You’ve detected it early, but now what should you do?
First, if you develop a red rash with no other symptoms, and you’re unsure if it’s cellulitis, you can monitor for spread by drawing around the red area with a pen. If the red area begins to spread outside that line, this is a strong indicator that it’s more than “just a rash” and that medical attention is needed.
Second, if you clearly develop any of the symptoms mentioned earlier, you need to seek medical attention quickly. Remember that cellulitis can spread quite rapidly and become a very serious infection if left untreated; seeing a medical professional the same day you notice your symptoms is really important so it can be treated quickly.
Ongoing Swelling: The Difference Between Cellulitis and Lymphedema
Finally, if you do develop cellulitis and you’ve been treated successfully with antibiotics, but you’re still experiencing swelling after the treatment, there could be more going on. Remember that cellulitis is a risk factor for lymphedema, so if your swelling persists, early treatment from a certified lymphedema physiotherapist will offer you the best chance to reduce the risk of developing chronic cancer-related lymphedema. (2)
Lymphedema Risk Reduction Resource
As you might know, I’ve been working in cancer rehabilitation and lymphedema since 2009. For years I’ve witnessed clients feel confused, stressed, and overwhelmed about the risk of developing lymphedema after cancer. In addition, over the years, there has been an explosion of information on the internet, which unfortunately has shared a lot of misinformation, causing further stress and anxiety.
My solution to this was to create the Lymphedema Smart Workshop. This is a clear, evidence-informed workshop that gives you information about lymphedema risk reduction after cancer. Specifically, you will learn how the lymphatic system works, what lymphedema is, what your risk is, and how to reduce your risk. You’ll also learn the early, early symptoms that come before swelling so you can detect things early and get treatment quickly if you suspect you’re developing lymphedema.
Disclaimer – These blogs are for general information purposes only. Medical information changes daily, so information contained within these blogs may become outdated over time. In addition, please be aware that the information contained in these blogs is not intended as a substitute for medical advice or treatment and you should always consult a licensed health care professional for advice specific to your treatment or condition. Any reliance you place on this information is therefore strictly at your own risk.
