All You Need To Know About Lymphoedema And Cancer

Do you or someone you care about have lymphoedema or are you worried about getting it?

If you or someone you care about has been diagnosed with lymphoedema or are at risk or getting it, it's important to understand what the condition is and what causes it. Lymphoedema is a chronic condition that occurs when the lymphatic system, whose primary functions include combating infections and eliminating excess fluid from tissues, is damaged or blocked. This can lead to a buildup of fluid, causing swelling and discomfort in the affected area.

If you are at risk for lymphoedema, it's important to understand how to reduce your risk and manage your condition if it does develop. By knowing the potential causes and risk factors, you can take steps to protect your lymphatic system and prevent lymphoedema from developing. For those who have already been diagnosed, it's important to work with your healthcare provider to develop a comprehensive treatment plan to manage your symptoms and improve your quality of life. With proper care and management, people with lymphoedema can continue to lead fulfilling and active lives.

Causes of Lymphoedema

Lymphoedema arises due to a malfunction in the lymphatic system, an intricate network of vessels and glands present throughout the body.

There exist two primary types of lymphoedema:

Primary lymphoedema

Primary lymphoedema is a specific type of lymphoedema that arises as a result of genetic abnormalities that impact the normal development and functioning of the lymphatic system. Unlike secondary lymphoedema, which is caused by external factors or damage to the lymphatic system, primary lymphoedema is inherent and present from birth. It can manifest at any age, although it commonly becomes evident during specific periods of life, such as infancy, adolescence, or early adulthood.

Secondary lymphoedema

Secondary lymphoedema occurs as a result of an underlying condition or factor that damages or obstructs the lymphatic system. Some common causes of secondary lymphoedema are listed below and for the purpose of this article, we will be focusing on the first cause - Cancer treatment.

1. Cancer Treatment: Surgery, radiation therapy, or lymph node removal during cancer treatment can disrupt the lymphatic system, leading to lymphoedema.
2. Lymph Node Removal: Surgical removal of lymph nodes, often done during cancer treatment, can cause lymphoedema.
3. Infection: Certain infections, such as cellulitis, can damage the lymphatic system, resulting in lymphoedema.
4. Trauma: Physical injury or trauma that affects the lymphatic vessels can lead to the development of secondary lymphoedema.
5. Filariasis: This parasitic infection, caused by filarial worms transmitted through mosquito bites, can obstruct the lymphatic system and cause lymphoedema, commonly known as "elephantiasis."
6. Obesity: Excessive weight and adipose tissue can put pressure on the lymphatic system, impairing its function and leading to lymphoedema.
7. Chronic Venous Insufficiency: When the veins in the legs have difficulty returning blood to the heart, it can result in fluid buildup and secondary lymphoedema.
8. Congenital Disorders: Rare congenital conditions, such as Milroy's disease and Meige's disease, can cause abnormalities in the development or function of the lymphatic system, leading to lymphoedema.

Preventing lymphoedema

Preventing lymphoedema or minimizing its risk involves adopting certain practices and lifestyle choices. While not all cases of lymphoedema can be prevented, the following tips can help reduce the likelihood of developing the condition:

1. Practice Good Skin Hygiene: Maintaining proper skin hygiene is essential for preventing infections and skin-related complications that can contribute to lymphoedema. Cleanse the skin thoroughly with mild soap and warm water, paying attention to the folds and creases where moisture can accumulate. Moisturize the skin regularly to keep it hydrated and supple, using non-perfumed lotions or creams recommended by healthcare professionals. Avoid exposing the skin to extreme temperatures, as it can increase the risk of inflammation or skin damage.
2. Prevent Injuries: Take precautions to avoid injuries that can damage the lymphatic system and lead to lymphoedema. Be mindful of activities that may strain or stress the affected area, and use protective gear when engaging in sports or physical activities that pose a risk of injury. Avoid sharp objects that can cause cuts or punctures, and take care when handling sharp tools. If you have undergone lymph node removal or have an at-risk limb, consider wearing gloves or protective sleeves when gardening or performing tasks that may lead to skin abrasions or infections.
3. Maintain a Healthy Weight: Excess weight can put additional strain on the lymphatic system, making it more difficult for it to function properly. Maintain a healthy weight through a balanced diet and regular exercise. Focus on consuming nutrient-rich foods and avoiding excessive intake of salt, as it can contribute to fluid retention. If you are overweight, work with a healthcare professional or a registered dietitian to develop a personalized weight management plan that suits your needs and medical condition.
4. Gradual Exercise and Movement: Engaging in regular, low-impact exercises can promote lymphatic fluid circulation and help prevent lymphoedema. Start with gentle exercises and gradually increase intensity and duration. Focus on activities that involve rhythmic movements, such as walking, swimming, or cycling. If you have undergone cancer treatment or have other health conditions, consult with your healthcare provider or a lymphoedema therapist before starting an exercise program to ensure safety and appropriateness.
5. Avoid Excessive Heat and Sun Exposure: Excessive heat and sun exposure can increase the risk of inflammation and skin damage, which can disrupt the lymphatic system. Protect the skin by avoiding prolonged sun exposure, especially during peak hours, and using sunscreen with a high SPF. Additionally, take measures to stay cool in hot environments, such as seeking shade, wearing loose-fitting, breathable clothing, and staying hydrated.
6. Maintain Regular Healthcare Follow-ups: If you are at risk of developing lymphoedema, such as those who have undergone cancer treatment or have a family history of the condition, it is important to maintain regular follow-ups with your healthcare provider. They can monitor your condition, provide guidance on preventive measures, and detect any early signs of lymphoedema for timely intervention.

Remember that while these tips can help reduce the risk of developing lymphoedema, they may not guarantee complete prevention.

Symptoms and impact of lymphoedema

Lymphoedema presents with several common symptoms that can vary in severity and impact on an individual's daily life. The primary symptom of lymphoedema is swelling, which occurs due to the accumulation of lymphatic fluid in the affected area. This swelling may be mild, causing a sensation of heaviness or tightness, or it can become more pronounced, resulting in visible enlargement and a feeling of fullness in the affected limb or body part.

In addition to swelling, lymphoedema can cause discomfort and a range of physical sensations. The affected area may feel achy, tight, or tender. Some individuals experience a persistent feeling of heaviness or stiffness, which can make movement uncomfortable. Skin changes can also occur, including thickening or hardening of the skin, and in some cases, the skin may become red, warm, or prone to infections.

The impact of lymphoedema on daily life can be significant. The swelling and associated discomfort can restrict movement and impair mobility, making it difficult to perform daily activities or participate in physical exercise. Lymphoedema can interfere with one's ability to dress comfortably, as well as hinder the use of accessories or clothing that fit snugly around the affected area. It may also affect body image and self-esteem, leading to emotional distress or social anxiety.

Moreover, the chronic nature of lymphoedema requires ongoing management and self-care. Individuals with lymphoedema often need to incorporate specific measures into their daily routine, such as wearing compression garments, practicing skin hygiene, engaging in specialized exercises, and maintaining a healthy weight (all these are discussed below).

How lymphoedema is diagnosed

The diagnosis of lymphoedema involves a comprehensive evaluation that includes a combination of medical history, physical examinations, and, in some cases, imaging tests. The process aims to assess the characteristic symptoms, determine the underlying cause, and differentiate lymphoedema from other conditions presenting with similar symptoms.

During the medical history assessment, the healthcare provider collects information about the onset and progression of swelling, associated symptoms, past medical conditions, surgeries, infections, and family history of lymphoedema or related disorders. A thorough physical examination follows, involving visual inspection, palpation, and measurement of the affected area to assess swelling, skin condition, tenderness, and texture.

Lymphatic mapping techniques, such as lymphoscintigraphy, may be employed to visualize and evaluate the lymphatic system. This helps identify abnormalities, obstructions, or damage to the lymphatic vessels. Imaging tests like ultrasound and MRI can provide detailed images of the lymphatic system, aiding in the assessment of its structure, integrity, and potential complications.

Treatment options for lymphoedema

Treatment approaches for lymphoedema aim to reduce swelling, alleviate symptoms, improve limb function, and enhance overall quality of life. The following are some of the commonly used treatment options:

1. Compression Therapy: Compression therapy involves the use of specialized garments, such as compression sleeves, stockings, or bandages, to apply controlled pressure on the affected area. This pressure helps to reduce swelling, improve lymphatic fluid flow, and prevent the accumulation of fluid. Compression garments are usually worn throughout the day and should be properly fitted to ensure optimal effectiveness. They can be custom-made or purchased in standard sizes, depending on the individual's needs.
2. Manual Lymphatic Drainage (MLD): MLD is a specialized massage technique performed by trained therapists. It involves gentle, rhythmic movements and strokes that stimulate the lymphatic system, promoting the flow of lymphatic fluid and directing it towards healthy lymph nodes. MLD helps to reduce swelling, improve circulation, and enhance lymphatic drainage. It is often combined with other treatment modalities, such as compression therapy, to achieve optimal results.
3. Exercise: Regular exercise can be beneficial in managing lymphoedema. Physical activity promotes muscle contractions, which act as natural pumps to facilitate lymphatic fluid movement. It is important to engage in low-impact exercises that are appropriate for the individual's condition, such as walking, swimming, or cycling. Exercise can help reduce swelling, maintain limb mobility, and improve overall fitness and well-being. However, it is crucial to consult with a healthcare professional or lymphoedema therapist before starting an exercise program to ensure safety and effectiveness.
4. Skin Care: Proper skin care is essential in managing lymphoedema. It involves keeping the skin clean, moisturized, and protected to prevent infections or skin breakdown. Individuals with lymphoedema should practice regular washing, moisturizing with non-perfumed lotions, avoiding cuts or injuries, and protecting the affected area from extreme temperatures, sunburn, or insect bites. Maintaining good skin health helps to prevent complications and maintain the overall integrity of the skin.
5. Lifestyle Modifications: Making certain lifestyle modifications can support lymphoedema management. These may include maintaining a healthy weight, avoiding tight clothing or accessories that can constrict lymphatic flow, elevating the affected limb when resting or sleeping to encourage fluid drainage, and practicing good hygiene and self-care habits.
6. Education and Self-Management: Education plays a crucial role in lymphoedema treatment. Individuals with lymphoedema and their caregivers should receive comprehensive education on self-management techniques, such as skin care, compression garment use, exercises, and early signs of complications. Learning about the condition, its progression, and how to monitor and manage symptoms empowers individuals to take an active role in their own care and improve their quality of life.

It is important to note that treatment plans for lymphoedema are often individualized based on the severity of symptoms, underlying causes, and the specific needs and goals of the individual. Working closely with a healthcare team experienced in lymphoedema management is vital to developing a tailored treatment plan that best suits the individual's condition and lifestyle. Regular follow-up appointments with healthcare professionals help monitor progress, make adjustments to the treatment plan if needed, and provide ongoing support.

Our top 6 suppliers of lymphoedema sleeves

In the UK

• Lymphies - www.lymphies.com
• Pebble UK - www.pebbleuk.com/categories/24/lymphoedema-sleeves
• Juzo - www.juzo.com/en-uk/products/compression-garments/compression-therapy

In the US

• Lymph Divas - lymphedivas.com
• Ames Walker - www.ameswalker.com/collections/lymphedema-upper-body
• Bandages Plus - www.bandagesplus.com/compression-garments

Here's a video we found on youtube that explains a bit more about lymphedema

In conclusion, lymphoedema is a chronic condition that can have a significant impact on an individual's quality of life. By understanding its causes, recognizing its symptoms, seeking early diagnosis, and exploring appropriate treatment options, individuals can effectively manage lymphoedema and minimize its impact. Additionally, practicing prevention strategies, such as maintaining a healthy lifestyle, practicing good skin hygiene, and taking precautionary measures, can reduce the risk of developing lymphoedema.

With proper care, support, and education, individuals can lead fulfilling lives while effectively managing this condition.