It is a vital part of the body, but some people may not know about the lymph system.
Facts about the Lymph System
The lymph system contains lymph vessels, ducts, and nodes as well as organs that move the lymph into the bloodstream from the tissues. It is vital to the immune system. Lymph is “clear-to-white fluid” that contains white blood cells and fluid (chyle). The chyle has fats and proteins in it and “white blood cells, especially lymphocytes…attack bacteria”. The lymph nodes are “soft, small, round- or bean-shaped structures” found in the groin, armpit, neck, and inside the abdomen and chest. They make the immune cells that help fight infection, and the nodes “filter the lymph fluid and remove foreign material”, like cancer cells and bacteria. The nodes swell when infection is present. Sometimes lymph nodes can be felt in the neck, groin, and armpits. Other parts of the lymph system are the spleen, thymus, and tonsils and adenoids.1 There is “twice as much lymph fluid in (the) body as blood”. It is important to keep the lymph system healthy because it “drains away the detritus in the circulatory system”. Gut-associated lymphatic tissue (GALT) is the largest concentration of lymph tissue, and it is found around the intestines. The lymph system itself has no pump, but it relies on manual manipulation and muscle contraction to move its fluid. Elimination organs of the body (intestines, bladder, skin, kidney, and liver) need to work well so that the “lymph does not get overwhelmed with waste”.2
Impacts and Disorders
The lymph fluid backs up when the system is overloaded or blocked. This problem can occur due to toxic overload, surgery, or illness. Swelling, nausea, fatigue, and joint pain are symptoms of problems with the lymph system. Over time, this can lead to food sensitivities, worsening allergies, infections, headaches, joint pain, GI issues, mood disorders, skin breakouts, and many more problems. If the lymph is stagnant, the body cannot cleanse cancerous or diseased cells, and it cannot work to clear viruses and bacteria.3 Other disorders impacting the lymph system include lymphoma and lymphedema (discussed below), lymphangiomatosis , and Castleman disease. Castleman disease refers to “a group of inflammatory disorders that cause lymph node enlargement and can result in multiple-organ dysfunction”. It is similar to lymphoma and treated with chemotherapy. Lymphangiomatosis involves “multiple cysts or lesions formed from lymphatic vessels”, likely due to “a genetic mutation”. Lymphatic system disorders are often diagnosed when the nodes are swollen. Most of the time, swollen nodes are not a problem, as this occurs during the normal infection-fighting process, “but typically nodes that persist at larger than a centimeter are more worrisome”. Doctors may order scans or even biopsies, depending on the location of the problem. While chemotherapy, radiation, or surgery have been used for some time, doctors are now exploring medications, such as “ibrutinib, idelalisib, obinutuzumab, (and) lenalidomide” that work to “target the actual disease causing processes within cells”.4
Lymph Nodes and Cancer
Lymph nodes can swell up in the underarms, groin, or neck for a variety of reasons, such as injury, infection, or cancer. They enlarge because they are trying to “filter out the ‘bad’ cells”. A disease that infects the lymph nodes is called “lymphadenopathy”. Swollen lymph nodes indicate that there is a problem, typically in the region of the body where they are swelling. Sometimes, though, the lymph nodes may swell in more than one area, and this is called “generalized lymphadenopathy”. This could occur due to certain medications or infections, diseases of the immune system, or cancer. Leukemia and lymphoma can be the cause of swelling like this. There are two ways cancer can show in the lymph nodes. One way is if it originates there, and the other way is if it spreads there from somewhere else. Lymphoma is cancer that starts in the lymph nodes. There are two types of lymphoma: “Hodgkin Disease and Non-Hodgkin Lymphoma”. The more common form of cancer in the lymph nodes starts elsewhere. Cancer cells may break off from a tumor and travel through the lymph system or bloodstream. When it travels through the bloodstream it can impact other organs, but when it moves through the lymph system it can end up in the lymph nodes. Usually, cancer cells that escape die or are killed, but if they settle and grow, they can form new tumors. This is called “metastasis”. Generally, when cancer settles in the lymph nodes it is near the original tumor, but if it has spread further away, radiation or chemotherapy may be needed. If it is near the original site, surgery might be able to remove the mass. That surgery could trigger lymphedema.5
In some medical situations, lymph nodes can be damaged or removed as a part of treating cancer. This is the most common cause of lymphedema. Symptoms of lymphedema include swelling in the arms and legs due to the fluid buildup. The two types of lymphedema are primary (occurs on its own) and secondary (caused by another condition or disease). Secondary lymphedema is the more common type, and it is usually a result of surgery, radiation treatment, cancer, or infection. The causes of the rare and inherited primary lymphedema include Milroy’s disease (congenital), Meige’s disease (at puberty or during pregnancy), and late-onset (around age 35). The people most at risk of developing lymphedema from secondary causes are the obese, older patients, and those with arthritis (rheumatoid or psoriatic). Lymphedema can result in other complications, such as infections, including a bacterial skin infection called cellulitis, and lymphangitis, which is an infection of the lymph vessels. These infections may result from injuries to the legs or arms. A rare soft tissue cancer, Lymphangiosarcoma, is also possible, due to untreated, severe lymphedema. With this disorder, patients might develop purple marks on the skin. There is no cure for this lymphedema, but it can be managed. Typical treatment includes exercises, wrapping the affected limb(s), massage, pneumatic compression (with a special sleeve that pumps periodically to inflate), compression garments, and complete decongestive therapy (CDT), which incorporates lifestyle changes.6
Self-Massage and the Lymphatic System
Massage, whether from a professional or via self-care can be an important tool to use for the health of the lymphatic system. This type of therapy is called “lymph drainage”. Most of the lymph nodes are easy to reach and are in the front of the body. The work is meant to be gentle and the process only takes about 15 minutes. Detoxification, relaxation, and healing are the goals. Manual stimulation of the lymphatic system can “increase the carrying capacity of the lymph system…increase the flow through the lymph nodes…increase the production of lymphocytes…(and produce) a body-wide relaxation effect”. To perform this self-massage, it needs to be a gentle and slow stretching. The Chikly Method is one such way of going about this, and there are several steps to follow. Patients can start at the collarbone, move to the trapezius, perform a “neck hug”, work down the sides of the neck, stroke behind the ears, press in the armpit area, work on the abdominal region, and move on to the crease of the leg. There are certain procedures to follow, and some of the steps will need to be repeated.7
Learn more about lymphedema treatment.