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Cancer-related lymphedema affects an estimated 350,000 Canadians and can develop after cancer surgery, radiation therapy, or other treatments damage the lymphatic system. This article summarizes emerging research into why only some cancer survivors develop lymphedema despite receiving similar treatments. Gibson and Gomes describe evidence that radiation can impair lymphatic vessel repair and drive lymphatic endothelial cells into senescence, a damaged but living state in which cells stop dividing and release inflammatory signals. Their research found elevated inflammatory factors in people with cancer-related lymphedema years after radiation treatment, and animal studies showed that radiation increased swelling, immune cell invasion, fibrosis, and lymphatic cell senescence. Senolytic drugs that selectively remove senescent cells reduced swelling by approximately 50% in a mouse model, suggesting a potential future therapeutic direction. These findings provide new insight into radiation-induced lymphedema and may help guide treatments targeting inflammation, fibrosis, and lymphatic repair.