When your body builds up extra fluid in one place, it can lead to swelling, also known as edema. Swelling in different body parts — including the face — is common during cancer treatment.
Swelling in the face during cancer treatment can have several different causes. These include:
- Direct side effect of treatment for skin cancer, head and neck cancer, or oral cancer.
- Lymphedema.
- Superior vena cava syndrome.
- Allergic reaction.
- Cytokine release syndrome.
Some causes of facial swelling can be serious. If your face swells during cancer treatment, be sure to tell your doctor promptly.
Causes for Edema During Cancer Treatment
There are multiple reasons your face may swell during cancer treatment. Here’s a closer look at what causes facial swelling in cancer patients.
Direct effects of cancer treatment
Several kinds of cancer involve treatments focused on the face or nearby areas. These include:
Doctors generally rely on a combination of treatments to fight these cancers, including:
Depending on your cancer’s exact location, any of these treatments can cause facial swelling. During the planning stage, your doctor will discuss how likely your face is to swell from cancer treatment and what to do about it. Your doctor will also give you specific instructions about when to call if your face swells.
Lymphedema
Lymph fluid is a fluid containing salts and proteins that travels throughout the body’s lymphatic system. The lymph fluid passes through lymph nodes, which are small glands that help filter out foreign cells, including cancer cells. Lymphedema happens when lymph fluid builds up in the fatty tissues just under your skin.
When the lymph system is damaged, the normal flow of lymph fluid can become blocked, causing a buildup. Both cancer surgery and radiation therapy can damage nearby lymph nodes or lymph vessels.
If doctors use these treatments on or near your face, it might swell as a result.
Superior vena cava syndrome
Your superior vena cava is a large vein that carries blood from your upper body to your heart. When something blocks or presses on this vein, superior vena cava syndrome can result. Symptoms include:
- Swollen face or neck.
- Cough.
- Feeling of pressure or fullness in your upper body.
- Shortness of breath.
Cancer is the most common cause of superior vena cava syndrome. If a tumor presses on this vein, blood takes too long to get back to the heart. Lung cancer and non-Hodgkin lymphoma are the most likely cancers to cause this.
Symptoms may get worse when you lie down or raise your arms above your head.
Call your doctor right away if you suspect you might have superior vena cava syndrome.
Allergic reactions
Facial swelling can also occur as part of an allergic reaction, with or without hives. Angioedema is the collection of fluid in the deeper skin layers, including facial skin.
Allergies to foods or medications are common causes of angioedema. It’s rare to develop an allergy to cancer medications, but it does happen occasionally.
Allergic reactions can cause swelling of the:
- Cheeks
- Lips
- Eyelids
- Tongue
- Throat
These symptoms can be an early sign of a severe allergic response known as anaphylactic reaction. Seek emergency care if you feel your tongue, lips, mouth, or throat swelling.
Call 911 if you have facial swelling and are having trouble breathing.
Treatment may include:
- Epinephrine to prevent your airway from closing.
- Corticosteroids to reduce inflammation.
- Antihistamines to relieve symptoms.
Cytokine release syndrome
If your immune system reacts too aggressively to an infection or other stressor, it can release too many proteins called cytokines. In cytokine release syndrome, symptoms can be severe and affect many organs.
Cytokine release syndrome is most closely linked to two different types of cancer treatment: CAR T-cell therapy and checkpoint inhibitors. Severe COVID-19 infection may also cause cytokine release syndrome.
Cytokine release syndrome symptoms include:
- Edema, including facial swelling.
- Difficulty swallowing.
- Shortness of Breath.
- Dizziness.
- Fever.
- Chills.
- Nausea and vomiting.
- Headaches.
- Cough.
- Diarrhea.
- Muscle pain.
- Joint pain.
- Skin rash.
Call your doctor right away if you think you might have cytokine release syndrome. Call 911 if you can’t breathe well.
Treatment for cytokine release syndrome depends on which organs are affected and may include:
- Medications to reduce inflammation, including corticosteroids or drugs that target specific cytokines.
- IV fluids.
- Fever reducers.
- Electrolyte management.
- Blood transfusions.
Tips to Prevent Swelling During Cancer Treatment
Edema is a general term for excess fluid buildup in the body. The National Cancer Institute suggests several ways to prevent or lessen generalized edema during cancer treatment:
- Limit salt and sodium in your diet. Don’t add salt, soy sauce, or monosodium glutamate (MSG) to your food. Avoid salty, processed foods like chips, cured meats, and canned goods.
- Choose loose clothing. Wear clothes and shoes that aren’t too tight, with one exception: compression garments. If your doctor recommends compression garments, know that they are supposed to fit snugly.
- Prop up your legs when sitting or lying down. This helps when your legs, ankles, or feet swell. Keep your legs higher than your heart if you can.
- Exercise safely. Gentle movements of the swollen body part can help. Your health care team may be able to suggest safe exercises for you.
Your doctor may prescribe “water pills.” Also known as a diuretic, this medication helps your body pass excess fluid through your urine. Follow your doctor’s instructions exactly on when and how to take your diuretic.
Your doctor might want you to weigh yourself every day or two at the same time and then keep a record of your weight. If you gain more than five pounds in a week, that could be a sign that your body is holding too much fluid.
Call your doctor if you notice any new symptoms, including:
- Swelling in the face.
- Shortness of breath.
- Feeling of a racing heart.
- Feeling of heat, redness, or hardness in any swollen body part.