Foot swelling is one of the most common complications for tumor patients, especially for advanced tumor patients. In severe cases, the whole lower limb is seriously swollen and painful, difficult to lift and unfavorable to move, which brings great pain to patients and seriously affects their quality of life.
How to detect foot swelling at an early stage? How to quickly identify the cause of foot swelling and treat it in a timely manner?
Swollen feet are not easily detected at the beginning, and some patients find swollen feet only when they wear shoes that squeeze their feet, or even when they wear socks with strangulation marks.
The severity of edema is usually determined by pressing on the back of the foot, the ankle or the medial side of the shin by the degree of indentation. In mild cases, the depression is shallow and recovers quickly; in severe cases, the skin is shiny and the swelling is obvious, even with fluid exudation.
So what are the common causes for tumor patients?
1. Hypoproteinemia
Decreased concentration of albumin in blood is the main criterion for diagnosis. It is common in prolonged eating difficulty, poor appetite, tumor depletion, hepatic occupancy protein synthesis disorder or protein loss caused by various reasons.
Manifestations are: bilateral, symmetrical swelling, or edema in lower body position, mostly seen in pubic edema.
2.Tumor compression
It is common that the tumor compresses the corresponding vein or lymphatic vessels, resulting in poor return of blood and lymphatic fluid to the distal end and edema.
If the tumor is located in one side of groin or distal end of limb and presses the blood vessels or lymphatic vessels on one side, edema of the distal end of the affected side will occur.
If the tumor is located in the abdominopelvic cavity and is large, edema may appear bilaterally, and such edema is often aggravated or relieved with the change of tumor size, and there is an obvious sequential relationship.
3.Deep vein thrombosis of lower limbs
Deep vein thrombosis of lower extremity is mostly due to hypercoagulation and slow flow of blood, which is common in patients who are bedridden, sedentary or combined with varicose veins of lower extremity.
Vascular ultrasound is mostly preferred for clinical diagnosis. Clinical mostly unilateral lower extremity edema is predominant, accompanied by pain, purple skin and dilated superficial veins.
4.Medically induced leg swelling
It commonly appears after taking drugs or undergoing certain treatments, and is partially insidious and difficult to detect early.
Common medication factors are: side effects and adverse reactions of hormonal drugs, some antihypertensive drugs and antidepressants, oral targeted drugs (proteinuria) and other related drugs.
Therapeutic factors include: pelvic, inguinal, and lower extremity tumors after radiotherapy and other radiation injuries. Among them, the former are bilateral symmetrical swelling, and the latter are mostly swelling on the affected side.
5. Other causes of edema
Cardiac and renal insufficiency, hypothyroidism, infection, foot fungus, gout, rheumatism, etc.
For the treatment of the above causes of edema, it is important to clarify the cause of the disease.
Among them, the biggest danger of deep vein thrombosis is “pulmonary embolism”, “heart attack” and “brain attack” caused by thrombus dislodgement, which is life-threatening, once it is diagnosed, bed rest is the main reason, and the affected limb can be elevated appropriately. The affected limb should be elevated appropriately, avoid strenuous activities, and elastic stockings should be worn, and treatment such as placement of venous filter, anticoagulation, thrombolysis or surgery can be used.
Except for edema caused by deep vein thrombosis, western medical treatment is mostly symptomatic correction of hypoproteinemia, anti-tumor, etc. The effect is relatively slow, and some edema (such as leg swelling after radiotherapy) does not even have particularly good targeted treatment.
”In Chinese medicine, leg swelling is mainly caused by the downward movement of cold and dampness and the obstruction of the meridians, or “blood is water when it is not favorable”.
In addition, Prof. Huang Jinchang advocates the combination of systemic and local treatment, and is good at finding nodules in the affected limbs to loosen the nodules, piercing blood cupping, etc. to open the meridians and dispel the evil out; for edema caused by tumor compression, he often combines tumor loosening, piercing blood cupping and fire acupuncture to suppress the tumor.
When edema occurs, there is no need to be overly anxious, and at the same time, pay attention to proper care, adequate rest, avoid getting cold, elevate the feet as much as possible, and avoid salty diet.