EDEMA

What is edema?

Edema (uh-DEE-muh) is swelling caused by the buildup of abnormal amounts of fluid in your body. Edema may also be called fluid retention. Fluid may collect in your legs, arms, feet, hands, lungs, heart, or abdomen. Severe edema can cause your kidneys, heart, and lungs to be overworked or damaged. Symptoms of edema include swelling or puffiness of your face, hands, feet, legs, or around your eyes.

Ascites (uh-SIE-tees) is a related problem where abnormal amounts of fluid collect in your stomach or abdomen. Symptoms of ascites include swelling or puffiness of your abdomen or stomach, tight or shiny skin over your stomach, feeling full sooner than normal during meals, or being able to see the veins on the skin of your stomach.

Why would I have edema?

People with cancer are at an increased risk for edema for several reasons, including the following:

  • Cancer - changes in your body can cause edema.
  • Poor nutrition or malnutrition - if your body may not have enough protein to function normally, fluid may collect.
  • Medications - some types of cancer treatment cause changes in your body that make you retain more salt and fluid than usual. Other cancer medications shift around the fluid in your body, making fluid collect in places it usually does not.

Chemotherapy drugs that often cause edema include aldesleukin, anagrelide, arsenic trioxide, bexarotene, cyclosporine, liposomal cytarabine, denileukin diftitox, docetaxel, gemcitabine, imatinib, leuprolide, muromonab CD3, rabbit antithymocyte globulin, temozolomide, and thalidomide.

Other medications that are used in cancer patients can also cause edema, including anastrozole, bicalutamide, darbopoetin, oprelvekin, sargramostim, corticosteroids (prednisone, methylprednisolone, hydrocortisone), anabolic steroids (fluoxymesterone, testosterone, methyltestosterone), progestins (megestrol, medroxyprogesterone), and nonsteroidal antiinflammatory agents (ibuprofen, indomethacin, naproxen, rofecoxib, celecoxib).

Edema caused by cancer may be permanent. Edema caused by medications or poor nutrition is usually temporary and goes away after you stop treatment and your nutrition improves. However, edema can be permanent in patients with heart, lung, or kidney problems.

When should I call my doctor?

Call your doctor, pharmacist, or nurse if you are worried or have questions about edema.

Call your doctor at once if you have any of the following symptoms:

  • Wheezing, shortness of breath, or trouble breathing
  • Chest pain or tightness
  • Swelling or weight gain so that your clothes do not fit
  • Rapid weight gain or gaining over 5 pounds in a single day
  • Urinating smaller amounts than usual or not passing any urine

What can I do to relieve symptoms of edema?

Diet

  • Reduce the amount of table salt that you eat. Ask your doctor if you can use salt substitutes.
  • Reduce the amount of salt that you use while cooking. Cook with other seasonings like lemon juice, vinegar, herbs, and pepper.
  • Eat small, frequent meals if you have swelling in your stomach or abdomen.
  • Eat a diet that gives you enough protein, calories, and carbohydrates. Ask your doctor or dietician for help choosing the right combination of foods.
  • Continue to drink the same amount of water and fluids as normal. Your doctor may have you limit this amount if you have severe edema.

Supportive Care

  • Use pillows or cushions to raise your feet and legs above your heart when you are sitting or lying down.
  • If you have severe edema, lie down and rest for several hours each day.
  • Wear elastic compression stockings during the daytime, after you get out of bed in the morning. The compression stockings will help push fluid back into your system. Normal stockings or pantyhose will not work. However, you can buy compression stockings at medical supply stores and pharmacies.

What things should I AVOID while I have edema?

  • AVOID eating foods that are high in salt or sodium. These foods may make your body retain even more water. Many convenience and snack foods contain lots of salt, including canned soups, dry soup mixes, canned meat or fish, ham, bacon, sausage, salted nuts or peanut butter, instant cooked cereals, salted butter or margarine, processed meats (like deli meats or hot dogs), prepared food mixes (like pancake, muffin, or cornbread mix), prepackaged frozen dinners that contain more than 400 mg of sodium in one serving, preseasoned mixes (like taco, gravy, chili, rice, or sauce mix), snack foods (like pretzels, potato chips, olives, cheeses, pickles), salad dressings, and fast foods.
  • AVOID cooking with monosodium glutamate (MSG), baking soda, baking powder, or salty seasonings like bouillon cubes, cooking sherry, cooking wine, chili sauce, meat tenderizer, seasoned salts, soy sauce, steak sauce, or Worcestershire sauce. These products contain lots of sodium and may worsen edema.
  • AVOID strenuous or vigorous exercise if you have severe edema.
  • AVOID sitting with your feet on the floor for long periods of time. Elevate your feet whenever you can.

What should I know about medicine for edema?

Medicine for edema is used to increase the amount of water you pass in your urine and can be swallowed by mouth. Ask your doctor or pharmacist which type of medicine you need.

Take the dose of medicine your doctor prescribes. Ask your doctor, nurse or pharmacist before changing your dose if you need more or less medicine.

These patient information materials should be used in conjunction with verbal counseling. They are not intended as the sole source of information patients receive about managing cancer therapy complications.

From the Cancer Chemotherapy Manual, © 2001, University of Utah Hospitals and Clinics, Salt Lake City, UT. Published by Facts and Comparisons, St Louis, MO, www.drugfacts.com