Your lymphatic system plays an important role in keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste products. The wastes are then filtered out by lymphocytes (infection-fighting cells that live in your lymph nodes) and are ultimately flushed from your body
Lymphedema is an accumulation of this protein-rich fluid (lymph) in the tissues caused by a transport failure of the lymphatic system. Lymphedema refers to swelling that generally occurs in one of your arms or legs. Sometimes both arms or both legs swell.
Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid build up leads to swelling.
.Lymphedema can be either primary or secondary. This means it can occur on its own (primary lymphedema) or it can be caused by another disease or condition (secondary lymphedema). Secondary lymphedema is far more common than primary lymphedema.
Primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in your body. Specific causes of primary lymphedema include:
- Milroy’s disease- present at birth
- Meige’s disease- appears around puberty or during pregnancy, though it can occur later, until age 35.
- Late-onset lymphedema- adult onset. Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema. Causes include:
- Surgery- Removal of or injury to lymph nodes and lymph vessels may result in lymphedema. For example, lymph nodes may be removed to check for spread of breast cancer. Lymph nodes may be also injured in surgery that involves blood vessels in your limbs.
- Radiation treatment for cancer– Radiation can cause scarring and inflammation of your lymph nodes or lymph vessels.
- Cancer- Lymphedema may result if the cancer cells themselves block lymphatic vessels. For instance, a tumor growing near a lymph node or lymph vessel could enlarge and block the flow of the lymph fluid.
- Infection- An infection of the lymph nodes or presence of parasites can restrict the flow of lymph fluid. This type of infection-related lymphedema is most common in tropical and subtropical regions and is more likely to occur in developing countries.
Lymphedema signs and symptoms, which occur in your affected arm or leg, include:
- Swelling of part or all of your arm or leg, including fingers or toes
- A feeling of heaviness or tightness
- Restricted range of motion
- Aching and discomfort in the limb
- Recurring infections
- Hardening and thickening of the skin (fibrosis)
- Lymphedema treatments include:
- The swelling caused by lymphedema ranges from mild, hardly noticeable changes in the size of your arm or leg to extreme changes that make the limb difficult to use. Lymphedema caused by cancer treatment may not occur until some time after treatment.
- Exercises- Light exercises in which you move your affected limb may encourage lymph fluid drainage. Pump exercises to facilitate active muscle pumping shouldn’t be strenuous or tire you but should focus on gentle contraction of the muscles in your arm or leg.
- Bandaging your arm or leg- Bandaging your entire limb encourages lymph fluid to flow back toward the trunk of your body. The bandage should be tightest around your fingers or toes and loosen as it moves up your arm or leg. It must not cut into the skin or cause pressure sores.
- Massage- A special massage technique called manual lymph drainage may encourage the flow of lymph fluid out of your arm or leg. And various massage treatments may benefit people with active cancer. However, massage isn’t for everyone and massage should be avoided if you have a skin infection or blood clots.
- Compression garments- Long sleeves or stockings made to compress your arm or leg encourage the flow of the lymph fluid out of your affected limb. Obtain a correct fit for your compression garment by getting professional help. Ask your doctor or physiotherapist where you can buy compression garments in your community. These can also be custom made if need be. The following steps may help reduce the risk of developing lymphedema and assist in preventing further complications:
- Keep affected limb elevated above the level of the heart, when possible. May be useful to elevate on pillows.
- Avoid tight/ constricting garments or jewellery or clothing
- Do not apply heat packs to the affected area and avoid hot tubs/steam baths etc
- Keep yourself adequately hydrated Do not carry your handbag on the affected arm
- Practice careful skin hygiene
- Avoid insect bites and sunburn.
Health care professionals may be able to recommend further management of your condition.