Lymphedema

What is Lymphedema?
Lymphedema refers to swelling that generally occurs in one of your arms or legs. It is caused by a blockage in your lymphatic system, which prevents lymph fluid from draining well. As the fluid builds up, the swelling continues.

There is no cure, but it can be managed. It is most commonly caused by the removal of or damage to lymph nodes as a part of cancer treatment.

Symptoms

The swelling can range from mild changes to extreme enlargement that makes using the limb difficult. Symptoms include:

• Swelling: Part or all of your arm or leg, including fingers or toes.
• Heaviness: A feeling of tightness or weight in the limb.
• Restricted Motion: Difficulty moving the arm or leg.
• Skin Changes: Hardening and thickening of the skin (fibrosis).
• Infections: Recurring infections in the affected limb.

⚠️ WHEN TO SEE A DOCTOR
If you notice persistent swelling in your arm or leg, especially after cancer treatment, see a doctor. If you already have lymphedema and the limb becomes red, hot, or painful, seek immediate help as this may be a serious infection.

Causes

Lymphedema occurs when lymph vessels cannot adequately drain fluid. It is classified into two types:

1. Secondary Lymphedema (Most Common)

Caused by another disease or condition that damages the lymph nodes/vessels:

• Surgery: Removal of lymph nodes (e.g., during breast cancer surgery).
• Radiation Treatment: Can cause scarring and inflammation of lymph nodes.
• Cancer: Tumors can physically block lymphatic vessels.
• Infection: Parasites (Filariasis) can block lymph vessels, common in tropical regions.

2. Primary Lymphedema (Rare)

Caused by inherited problems with the development of lymph vessels:

• Milroy's Disease: Begins in infancy; lymph nodes form abnormally.
• Meige's Disease: Usually appears around puberty.
• Late-onset Lymphedema: Begins after age 35.

Complications

• Infections (Cellulitis): The trapped fluid makes the limb a breeding ground for bacteria. Even a small injury can lead to serious infection.
• Lymphangiosarcoma: A rare form of soft tissue cancer that can result from severe, untreated cases.

Diagnosis

If you have had recent cancer surgery, diagnosis is often based on symptoms. For other cases, imaging helps visualize the blockage:

• Lymphoscintigraphy: Injecting a radioactive dye to track fluid movement.
• MRI & CT Scans: To see the tissue structure and identify blockages.
• Doppler Ultrasound: To rule out blood clots as the cause of swelling.

Treatment: Complete Decongestive Therapy (CDT)

Treatment focuses on moving the trapped fluid back into circulation. It usually involves a combination of techniques:

• Exercises: Light exercises to contract muscles and push fluid out of the limb.
• Wrapping: Bandaging the limb tightly at the fingers/toes and looser moving up, encouraging fluid to flow toward the trunk.
• Massage (Manual Lymph Drainage): A special technique using light hand strokes to move fluid to healthy lymph nodes. (Avoid if you have an active infection or blood clots).
• Pneumatic Compression: A sleeve connected to a pump that intermittently inflates to push fluid away.
• Compression Garments: Wearing special sleeves or stockings to maintain the reduced size of the limb.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.