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Ask Dr. Weil : Forget lymph drainage unless nodes were removed

Q: What is your take on lymphatic drainage for general health?

A: Lymphatic drainage, also called lymphatic massage or manual lymph drainage, is a technique developed in Germany. It is most useful in treating lymphedema, an accumulation of fluid that can occur after lymph nodes are removed during surgery, most often a mastectomy for breast cancer. Up to 25 percent of breast cancer patients whose surgery includes removal of lymph nodes in the area of the armpit eventually develop this uncomfortable condition in the arm. Lymphedema also can develop in the legs or other parts of the body if lymph nodes are removed in the course of other types of surgery — for melanoma, colon, prostate or bladder cancer, for example — or are damaged by radiation treatment, infection or trauma. Symptoms are swelling, pain and, sometimes, infection. Lymphedema can occur immediately after radiation or surgery, or weeks, months and even years later.

If you don't have lymphedema, you don't need lymphatic drainage, no matter what glowing claims are made for it. I've seen Internet sites that warn of the health consequences of "sluggish lymphatic flow" and promote lymphatic drainage for all manner of supposed benefits ranging from detoxification of the body, regeneration of burned, injured or wrinkled tissue, anti-aging effects, and relief of sinusitis, bronchitis, ear infections, chronic pain, fibromyalgia, constipation, insomnia, memory loss, cellulite and obesity. Lymphatic drainage is even being promoted as a beauty treatment. This is ridiculous.

Manual lymphatic drainage is not a necessity for general health. Lymph fluid circulates as a result of muscular contraction, including the muscles used in breathing that support normal physical activity.

You don't have to worry about drainage as long as your lymphatic tissues or lymph nodes have not been damaged or removed.

If you do have lymphedema, however, the procedure is worthwhile.

Q: My friend, female, age 60, had surgery for a malignant brain tumor a year ago. She is now cancer-free, but soon she will discontinue the steroids she has been on since the surgery. Are there alternative foods, vitamins or herbs that simulate the benefits of steroids?

A: I'm glad to hear that your friend is doing well. After brain surgery, steroids are prescribed to counteract swelling that can result from surgery, the tumor or treatment.

Typically, the steroid dose is reduced when physicians are confident that swelling no longer will be a problem. The drug most often used is dexamethasone (Decadron), which may help relieve headache and other symptoms that occur due to increased pressure caused by swelling. Patients frequently need another drug to prevent seizures — also a risk after brain surgery.

Given that the steroids are not needed long term, don't worry that your friend will be off them. As a matter of fact, she should feel better, because these powerful drugs have many side effects: weight gain and water retention, increased appetite, diabetes, sleeping problems, mood changes, stomach irritation, skin thinning, an acne-type rash, flushing and night sweats.

As far as natural alternatives, licorice root has steroidlike effects and can help patients transition off the drugs, but steroids should not be stopped suddenly, and she should follow the tapering-off plan prescribed by her doctors.

Your friend also should follow these lifestyle strategies, which can enhance cancer treatment:

• Get plenty of antioxidants through foods or supplements (be sure to discuss any dietary changes with your health-care practitioner).

• Eat generous amounts of vegetables and moderate amounts of fruit (preferably organic to minimize exposure to pesticide residues).

• Drink green tea several times a day.

• Eat foods rich in omega-3 fatty acids (walnuts and flaxseed, and cold-water fish such as salmon and sardines). Take fish-oil supplements if you can't get these foods into your diet.

• Limit alcohol consumption.

• Take cancer-protective supplements including Asian mushrooms, CoQ10, selenium and vitamin D.

Readers who want to ask Dr. Weil a question can do so by going to his Web site, www.drweil.com, and clicking "Ask Dr. Weil" and then "Ask Your Question." Because Weil receives so many questions, it's impossible for him to personally respond to every one. If your question is selected, look for Weil's response in an upcoming Q&A article.

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