Innovative Microsurgery Advances Treatment of Cancer-Related Lymphedema

Lymphedema is long-term swelling in an arm, hand, leg, or foot that can follow cancer treatment when lymph vessels are damaged. It causes pain, restricts mobility, and increases infection risk, with lasting effects on body image and mental health. As more cancer survivors live longer, this complication remains common and burdensome. To help address this challenge, surgeons have refined lymphatic microsurgery that aims to relieve symptoms quickly and restore function in appropriately selected patients.

Microsurgeons at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) are advancing specialized lymphatic microsurgery to treat—and in some cases help prevent—lymphedema. The program uses papercut-size incisions, with patients potentially experiencing rapid pain relief and improved movement. The team’s goal is to expand access so more eligible patients can be evaluated and treated at centers with the necessary expertise.

The lymphatic system is a network of tiny vessels that drain excess fluid and help clear pathogens. Cancer surgery that removes lymph nodes increases the risk of disrupting this network, and studies suggest up to 30% of people treated for certain cancers may develop lymphedema. In the United States, an estimated 3 to 5 million people live with long-term lymphedema after cancer care. Historically, management relied on medical massage, physical therapy, and compression garments, which often left patients with persistent limb asymmetry that complicated daily life.

OSUCCC – James is among a small number of U.S. centers with deep experience offering newer microsurgical options, including lymphatic bypass and lymph node transfer. The team also applies ultra-high-frequency ultrasound to visualize very small lymph vessels, which may help determine who is most likely to benefit from surgery. Until about a decade ago, many survivors had to accept lymphedema as a lasting consequence of treatment; the availability of these operations now provides additional options. The center recently hosted the 11th World Symposium for Lymphedema Surgery to advance education and treatment strategies globally.

“Think of the lymph system as the body’s sewer system. If there is a blockage in your home’s sewer pipes, the back-up can cause damage and trouble. The same thing is true when lymph vessels are damaged as a side effect of cancer. If there is a build-up of lymph fluid, patients experience painful, chronic swelling that can take a major toll on physical and mental health” said Min-Jeong Cho, MD, a plastic and reconstructive surgeon and director of the Lymphatic Education & Research Network (LE&RN) Center of Excellence at the OSUCCC – James.

“These advances through research and surgical techniques are truly changing the lives of patients, and they are going home with an incision the size of a papercut,” said Cho. “We want more people to know there is hope and help in dealing with their lymphedema.”

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