Naturopathic Approaches to Post-Cancer Treatment of Lymphedema

National Breast Cancer Awareness Month comes each October and though there continue to be many people diagnosed with cancer, there are also a whole lot of survivors, 3.8 million to be exact. Sometimes the very treatments that are lifesaving leave a long lasting impact, such as lymphedema. 

Lymphedema is a challenging problem and can negatively impact many aspects of a person’s physical capabilities and quality of life. Conventional and naturopathic approaches used together can offer relief even for those who have had lymphedema for a very long time. Whether this is a new condition for you, or you have been diagnosed previously, the following article offers solutions that you may not have considered. 

Please consult with a naturopathic doctor before trying any of these remedies. If you are in need of a naturopathic physician, please see our Find and ND directory. For more information on naturopathic oncologists, please check out our partners from Oncology Association of Naturopathic Physicians (OncANP), a professional association of naturopathic physicians who offer supportive healthcare for people who have been diagnosed with cancer. 

What is Lymphedema?

Lymphedema causes swelling and fullness from too much fluid.

There are numerous kinds of cancers and respective treatments that can potentially lead to lymphedema. The actual tumor, trauma to the area from surgery, radiation or infection can all lead to a lymphedema diagnosis. The most common complaint from patients with lymphedema is fullness and swelling due to the increased volume of fluid. Skin changes include itching, a tendency for infections, a sense of heaviness of the limb, changes in strength and range of motion, along with varying degrees of discomfort and pain. 

Breast cancer treatments are the most familiar cause of upper extremity lymphedema. Risk factors for lymphedema include axillary (armpit region) or sentinel lymph node dissection (location can vary) and/or radiation to the breast or armpit area. Additional contributors include having more than eight cancer-positive nodes, being overweight, or having larger breasts. 

Lower limb lymphedema can also happen often after gynecological or prostate cancer treatments. Head and neck cancers can also lead to lymphedema in the jaw, neck, and chest areas. Also, internal lymphedema is possible. There are other conditions that can cause some of these same symptoms, thus accurate and early diagnosis is always best. If you suspect you are having symptoms and are not under medical supervision and were not assessed for risk factors before any cancer or surgical treatment, please get help right away. 

Risk of Infections is Higher 

When swelling occurs, the area contains higher concentrations of protein in the fluid buildup. The high protein environment creates a welcome space for bacteria to multiply and a higher-risk environment for bacterial skin infection (cellulitis) and inflammation of the lymphatic channels (lymphangitis). As such, infection can be both a cause and a result of lymphedema. It is important to keep your nails short and filed and address any breaks in the skin right away to reduce the risk of infection.  Likewise, being sure your skin does not become too dried out from stretching due to swelling is paramount. I recommend coconut oil or other low-chemical moisturizers. It’s also important to work on creating a robust and diverse microbiome to reduce the risk of infection. Taking probiotics and eating cultured and fermented foods can help. 

State of the Art Treatment of Lymphedema

Wherever the lymphedema takes place, the care approaches are similar, though they should be tailored to the person and the presenting symptoms. The main treatment for lymphedema is non-invasive, complete decongestive therapy (CDT), which consists of manual lymphatic drainage, compression therapy, a daily exercise program, along with skin and nail care. Some lymphedema specialists use Kinesio Taping to decrease fluid volume as well. Surgery may be performed for those who do not respond well enough to CDT, though CDT approaches should be continued before and after surgical procedures. 

Compression garments limit the build-up of lymphatic fluid and encourage fluid to move to areas where there is better drainage by helping local muscles pump the fluid away. These recommendations can be beneficial, though not everyone says they are beneficial. In addition, they take significant time to put on because they are so tight and they can be expensive. Because of this, many people want a fresh perspective and new ideas about how to augment treatment. The following may be just what you’ve been looking for. 

Naturopathic and Integrative Medicine Adjunctive Treatment of Lymphedema

As natural and integrative medicine approaches are studied, there are a number of treatment options that should be considered: Exercise and yoga shows are helpful for lymphedema because they help with overall blood and lymph flow. But before you decide to go all out, your exercise and yoga routines may need to be modified based on lymphedema symptoms. Ask your doctor or physical therapist for advice. One kind of exercise, resistance training, previously thought to possibly worsen lymphedema, has in fact been shown to help build muscle, which in turn helps pump excessive fluid away without creating further risk of developing or worsening lymphedema. Obesity is another risk factor for developing lymphedema and can complicate treatment. It can be difficult to take up an exercise routine and change your diet when you don’t feel well because of lymphedema. Consult with your physician about how to get the support you need to safely lose excess weight. 

Research confirms that acupuncture may reduce swelling
  1. Botanical medicine, optimal nutrition, and nutritional supplements each have a role to play.  The herbs Astragalus (Astragalus membranaceus) and Peony (Paeoniae rubra), when administered orally, have been put to the test in clinical trials and have shown positive results. Consult with a medical professional, please do not self prescribe. 
  2. An anti-inflammatory diet is important because it helps to reduce overall inflammation in the body. One should also monitor salt intake, as excessive sodium may add to swelling. 
  3. Ensuring you are replete with folate and B vitamins makes good sense, as being deficient in these will lead to further capillary fragility and more swelling. Bioflavonoids like quercetin and hesperidin may prove useful as they help stabilize capillary membranes. Selenium has also been shown to reduce the risk of developing lymphedema. Another supplement, pycnogenol, derived from French maritime pine bark, has helped people with chronic venous insufficiency (CVI). While these diagnoses are different, lymphedema and CVI share certain features, especially in the lower extremities. It is possible to have a combination of CVI and lymphedema, called phlebolymphedema. Taking the supplement pycnogenol may well reduce the sensation of heaviness and the fluid volume. And, as always, consult with your doctor about these supplements. 
  4. Acupuncture is another approach to consider; research confirms it helps with swelling and improves quality of life related to lymphedema. Of note, when getting acupuncture for lymphedema, no needles should be placed in the affected side. And, when you receive blood draws, finger pricks, and blood pressure measurements, make sure they are taken on the non or less-affected side. Likewise, ensure properly fitted undergarments, no restrictive clothing or jewelry in the area of swelling. 
  5. Low Level Laser Therapy (LLT) may be a good option. This therapy is defined as  “…. low intensity light therapy. The effect is photochemical, not thermal.” The light works by triggering biochemical changes within cells, similar to the process of photosynthesis in plants. The treatment has shown good results. Consult your doctor on which device to purchase for home use and which local health professionals offer treatments. 
  6. Localized hyperthermia, the application of heat to a specific area of swelling and fluid accumulation can be effective with few side effects. This is a therapy that requires special equipment so ask a licensed naturopathic doctor about this type of treatment. 
  7. Sauna use is contraindicated for those with lymphedema. While a sauna may sound relaxing and have other beneficial attributes, it can aggravate lymphedema, so please avoid sauna treatments. 
  8. Aquatherapy, basically exercises or a gentle aerobics class in a pool, can reduce swelling and improve range of motion for some people with lymphedema even many years after the difficulties begin. 
  9. Hydrotherapy or balneotherapy is another beneficial approach. Hydrotherapy is when water, hot, warm, cold and/or ice, is applied to the lymphedema site by a trained naturopathic physician. Hydrotherapy has been around since the beginning of time and has many uses for health conditions. An example is alternating hot and cold hand or “baths” or soaking tubs to encourage circulation to, and most especially away from, the areas in question. Naturopathic doctors have extensive training in hydrotherapy and can help design a tailored hydrotherapy program as part of a plan to treat cancer-related lymphedema. Learn more about hydrotherapy in this video. 

In conclusion, lymphedema should never be ignored. Lymphedema, when left unchecked can cause permanent fibrosis, which is a hardening of the affected tissue. The natural medicine approaches listed above aim to keep tissues oxygenated and reduce fluid build up that can lead to further complications. 

This article is excerpted from Dr. Rothenberg’s upcoming book, You Finished Treatment, Now What? Natural Medicine Approaches for Cancer Survivors/Thrivers. Amy Rothenberg ND, DHANP is a contributor to INM and practicing licensed naturopathic doctor in Northampton, Massachusetts. Dr. Rothenberg is the American Association of Naturopathic Physicians 2017 Physician of the Year. Dr. Rothenberg’s writing can be found on, Better Nutrition’s Naturopathic Health Hub, Medium, Thrive Global, andThe Huff Post. She is the proud mother of 3 adult children.

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.