Treatment for Lymphedema

Patients who have been treated at Fred Hutchinson Cancer Center can be seen in the Physical Therapy department by one of our Certified Lymphedema Therapists, who are trained in teaching patients how to manage lymphedema. While there is no cure for lymphedema, patients can be taught self-care techniques that can avoid the most severe complications of lymphedema. Located at the South Lake Union Clinic, Physical Therapy is open Monday through Friday, 8 am to 5 pm and can be reached by phone at 206.606.6373.

In addition, our therapists can prescribe compression garments to manage the buildup of fluid in the arms, legs, and other parts of the body affected by lymphedema. Compression garments for legs, arms, breast and trunk are available at Shine, a specialty gift and oncology service store located at South Lake Union House (formerly SCCA House). The staff at Shine are trained in fitting compression garments for patients and providing advice. 

And for some patients, surgery at the UW Medical Center - Montlake may be appropriate to help alleviate the most severe symptoms of lymphedema.

Treatment Types

Treatment looks different for different people depending on your diagnosis. We tailor your treatment plan to you.

Complete Decongestive Therapy

Fred Hutch’s physical therapists may recommend Complete Decongestive Therapy (CDT) to treat lymphedema. CDT is a non-invasive approach to treating lymphedema. CDT typically has two phases— the first phase happens at Fred Hutch with our physical therapists who teach patients how to treat themselves. In the second phase, the patient themselves take the techniques they’ve learned to manage swelling on their own.

CDT includes compression, lymphatic massage, lymphatic exercises and skin care. Compression helps to decrease swelling and prevents it from getting worse. Lymphatic massage is a type of light self-massage that’s intended to get the lymphatic vessels to pump faster. Massage also helps to reroute the fluid to a lymphatic pathway that’s not blocked or damaged. In addition, patients are counselled on the importance of skin care and avoiding and managing situations that can cause swelling and overload the lymphatic system, for example, insect bites, cuts and burns in the arms and legs. Specific lymphatic exercises which cause the contraction of muscles can also help the movement of lymphatic fluid as well.


For patients who have undergone CDT and continue to have difficulty managing lymphedema, surgery at the University of Washington may be an option. Until recently there have not been any good surgical options for treating lymphedema. However, in recent years several new procedures have been developed. These procedures don’t cure the lymphedema, but they may provide relief from swelling and discomfort and they generally make the lymphedema easier to manage.

The following procedures are done by plastic surgeons at UW Medical Center for women who develop lymphedema after breast cancer treatment:

  • Lymphovenous bypass (LVB), also called lymphaticovenular anastomosis (LVA)
  • Vascularized lymph node transfer (VLNT)

Your care team can help you decide whether surgery is an appropriate option for you.

Lymphovenous Bypass

This procedure was developed by Dr. Isao Koshima, one of the pioneers of modern microsurgery, in Tokyo. It involves making several small skin incisions (cuts) in the affected arm. Just under the skin are the lymphatic channels. The surgeon joins several of these channels to nearby veins so lymph can drain into the venous system without having to go through the axilla. LVB is done under an operating microscope and requires a high level of skill. It takes about four hours. Because the incisions are not deep, there is very little post-operative pain, and the patient can go home the same day.

Vascularized Lymph Node Transfer

Lymph node transfer involves taking lymph nodes from other parts of the body (the groin or the neck) and moving them to the axilla. These lymph nodes are transferred along with the blood vessels that supply them with blood, and these vessels are attached to other blood vessels in the axilla. After the procedure, the transferred lymph nodes start to drain lymph from the affected arm. Lymph node transfer is more complex than LVA. It involves a four-to-five-hour operation and a three-to-five-day hospital stay. Recovery is fairly fast, and patients can expect to be back to normal in three to four weeks. With this procedure and with LVB, the reduction in swelling takes some time; it happens over a period of about one year after the surgery.

Preventive Surgical Methods

For some patients and types of cancer, our reconstructive surgeons may be able to use techniques to prevent lymphedema. These include axillary reverse mapping (ARM) and microsurgery to restore lymph flow (known as LYMPHA), which is done at the same time as lymph nodes are removed.

Learn more about Reconstructive Surgery

Meet the Lymphedema Care Team