Swelling in the arms and legs during treatment

Fluid retention or swelling is a common side effect of many breast cancer treatments. When fluid builds up in the body's tissues, the result is swelling or ‘oedema’.

Swelling is most common in the feet and ankles, because gravity pulls the fluid to the lowest point in the body. You may also have swelling in your arms.

Causes of swelling

Treatments that are most likely to cause swelling or make it worse include:

• surgery (which can cause seroma or lymphoedema)
• some chemotherapy drugs, particularly paclitaxel (Taxol), docetaxel (Taxotere) and gemcitabine
• radiation therapy.

Treatments for swelling

Mild swelling

Usually mild swelling does not need treatment. Swelling caused by treatment is different from lymphoedema (swelling after lymph nodes are removed from the armpit).

Severe swelling

If the swelling is severe, your treating team may recommend a steroid premedication (e.g dexamethasone). When you take this with some chemotherapy drugs, it helps minimise fluid retention. It’s important you follow the directions on how to take it.

Ways to reduce swelling

Some of the general things you can do are:

• Stay active. This helps any excess fluid in your legs and feet return to your circulation.
• Keep swollen areas lifted when you sit down, for example, put your feet up on a stool.
• Try to avoid standing or sitting still for long periods. Make sure you walk around or at least move your toes and legs regularly.
• Wear loose clothing so you’re not putting pressure on areas of swelling.
• Try to limit how much salt you eat. Avoid salty foods such as chips and try not to add salt to your meals.
• Keep drinking water as normal, unless your treating team tell you to drink less. Staying well-hydrated can help your kidneys work better and make you wee out the excess fluid. It’s important not to reduce your fluids without speaking to your treating team as this can cause other problems.

When to contact your doctor

• You need to contact your treating team if you experience any of the following:
• you are suddenly short of breath
• the swelling is sudden or gets worse
• you have an irregular heartbeat
• you gain weight suddenly
• you pee (‘urinate’) less often, even though you are drinking the same amount
• you have swelling in your arm on the same side as your breast cancer (but not the other arm or your legs). This could be lymphoedema and requires different treatment.