Lymph nodes

I was diagnosed with ovarian cancer, stage 1A (possibly 1C) in 11/07.  I had hysterectomy, staging, and chemotherapy.  I finished five rounds of chemo in 3/08.  

I think I now have lymphedema in arms, trunk and legs.  I have swollen thighs, armpits,arms and upper abdomen.    My CA-125 and CT scan is normal.

QUESTION: Is it normal to remove 30 lymph nodes during staging?  How many are usually removed during this procedure?  

[Annekathryn Goodman, M.D.]

Hi There,
It is not unusual to remove 30 lymph nodes as part of staging.
The description of your swelling does not immediately make me think of lymphedema

I have pasted a very nice description below from:
http://www.healthscout.com/ency/68/693/main.html#DefinitionofLymphedema

Your symptoms make me wonder about a metabolic problem such as low thyroid (hypothyroidism) or low cortisol (addison's disease) . Please see your primary care doctor for a careful evaluation
take care


Definition of Lymphedema
Lymph is a clear fluid that is carried through very small channels throughout the body (much like blood is carried through blood vessels). Blocking the flow of this fluid results in the build up of lymph in the surrounding tissues. It can occur any where on the body but commonly appears most notably in either the arms or the legs and is called lymphedema. It can be a primary or secondary disorder characterized by the accumulation of lymph in soft tissues, caused by inflammation, obstruction, or removal of lymph channels.


Description of Lymphedema
Lymphedema may be primary or secondary. The primary type can be present from birth (congenital lymphedema) or may occur during puberty mostly in women(lymphedema praecox), or less frequently later in life (lymphedema tarda).

Primary lymphedema is a result of missing lymphatic channels to carry the lymph. It occurs less often in men. The patient complains of swelling of the foot, leg, or entire extremity. On examination, the edema is diffuse, causes a typical mound on the dorsum (back part) of the foot or hand, and is only partially pitting (compressible). There are usually no skin changes in the acute period and the veins are not distended. When lymphedema is due to infection, the response to antistreptococcal antibiotics is rapid. If antibiotics are given for only a brief period (1 week), relapses are common. In chronic cases the swollen area can be very tender and the skin appears to be very thickened.



Secondary lymphedema is often a result of infection. In this setting, the onset is explosive, with chills, high fever, toxicity, and a red, hot, swollen leg. Red (Lymphangitic)streaks may be seen in the skin over a large area, and lymph nodes in the groin are usually enlarged and tender. These features may distinguish it from acute infection in the veins or thrombophlebitis (venous inflammation).


Secondary lymphedema in older persons may be due to a tumor or mass in the pelvis or groin. Obliteration of lymphatic tissue by excision or radiation therapy is another cause. In these cases, the swelling of the extremity may occur over a period of weeks or months.

[sawoea]

My Symptoms:  I have swollen and painful armpits and upper arms, swollen and painful mid-upper abdomen, and swollen and painful groin and thighs.  My ears are swollen and drain, and my neck gets swollen internally--if that makes sense.  I seem to be getting sicker.  Help!