Lymphedema swelling is a long-term problem that requires daily support.
What is Lymphedema?
This condition concerns the swelling of the arms and legs due to a lymphatic system blockage. When the lymph fluid cannot drain well, the fluid continues building up, causing swelling. The most common cause of (secondary) lymphedema is cancer treatment, where damage to, or removal of, lymph nodes may occur. There is no cure, but daily care regimens can help patients cope.1 Affected tissues are at risk of getting an infection. Symptoms of this lymphatic condition, besides swollen limb(s) include discoloration of the skin, deformity, fluid accumulation in other places (i.e., head, neck), and fatigue. Radiation therapy or lymph node dissection or surgery can trigger damage to the lymphatic system. Breast cancer patients, in particular, are at risk. Lymphedema in the head and neck can be caused by radiation treatments for throat or tongue cancer. For ovarian, prostate, testicular, uterine, melanoma, and colon cancer patients, lymphedema can affect the groin and lower limbs. Sometimes the condition can be caused by diseases or accidents that interfere with the lymphatic system. In some tropical regions, filariasis, which is a type of parasiticinfection, can cause lymphedema. Cellulitis can also harm the lymphatic system. For some patients, their primary lymphedema may have started from birth, while others may develop it at puberty. Some vascular abnormalities may cause this lymphatic condition. Patients with lymphedema should also take care during air travel to wear compression garments to reduce swelling caused by the decreased cabin pressure. There are 4 states of this disease in the lymphatic system: latent (the lymphatic vessels are damaged), spontaneously reversible (tissue still bounces back), spontaneously irreversible (tissue is spongy and pitting), and lymphostatic elephantiasis (the tissue is hard, unresponsive, and the swelling is large and irreversible). This lymphatic condition is also rated by grades for its severity: mild, moderate, severe, massive, or gigantic.2 Besides cancer treatments, risk factors for lymphedema include obesity, slow skin healing after surgery, a tumor causing lymph node blockage, and scar tissue from surgery or radiation.3
Treatment and Prevention
The general medical treatment options for lymphedema include compression (i.e., garments, bandaging, pump therapy with a pneumatic sleeve), decongestive therapy or manual drainage of the lymphatic ducts, surgery (i.e., lymphatic vessel grafting, vascularized lymph node transfer, lymphaticovenous anastomosis, liposuction), and low level laser therapy.4 There are prevention options patients may want to consider. Before undergoing cancer treatments, patients can be taught to see the early symptoms of edema to get immediate treatment. Exercise may be helpful for cancer patients. Skin and nail hygiene can prevent cellulitis infection. Treating breaks in the skin with moisturizers or topical ointments, using sunscreen, keeping feet dry and clean, and being aware of infection can also help cancer patients avoid lymphedema problems. Keeping the affected arm or leg elevated, changing positions often, wearing loose clothing, and other positional considerations are useful practices.5 Complete Decongestive Therapy (CDT) is a non-invasive treatment option for the condition. This includes manual lymph drainage (MDL), a gentle massage technique, as well as compression therapy, exercise (while wearing bandages or compression garments), and taking care of the skin and nails to prevent infection.6 Patients may also want to lose weight, eat a healthy diet without processed foods and unhealthy oils, and consider some dietary supplements and herbs (i.e., bromelain, flax seed, fish oil, ginger tea, calcium and magnesium, colloidal silver, etc.) in order to strengthen the immune system and fight inflammation.7