What causes lymphedema?Our lymphatic system is connected to our cardiovascular system and fulfils functions for our body that are just as important as the cardiovascular system itself. It plays a decisive role in our immune system. If we are healthy, our lymphatic system runs smoothly. We only become aware of the lymphatic system when it is impaired – in the case of lymphedema, for example.
What exactly is Lymphedema? Lymphedema occurs when the lymph fluid cannot flow towards the heart properly and accumulates in the tissues. It’s often compared to a traffic jam. The arms and legs swell up and edema forms, and with that, chronic swelling.
With the right treatment, it is possible to lead a normal and enjoyable life with lymphedema.
The body's "hazardous waste disposal" serviceThe lymphatic system can be compared to a “hazardous waste disposal”, because it transports waste products out of the body. These include proteins, metabolic breakdown products, inflammatory products or fat from the abdominal cavity. The lymphatic system runs alongside the blood vessels and covers our entire body like a net. Every day it transports up to four liters of purified lymph back into the blood circulation. Lymphedema can develop if lymphatic drainage is interrupted or impaired. There are so many different treatment options available today that allow those living with lymphedema to lead almost perfectly normal lives.
FormsThere are two forms of lymphedema:
Primary lymphoedema is congenital. It is usually caused by lymph channels or lymph nodes that have not been properly formed.
Secondary lymphoedema describes oedema that develops during a patient’s lifetime and is not congenital. The causes of this can be operations, infections or injuries, for example.
Signs and symptoms
Lymphedema after breast cancer surgeryBreast cancer is the most common form of cancer in women. Over 300,000 new cases are diagnosed every year in the US.*
On average, 20 to 30% of patients are affected by breast cancer-related lymphedema following removal of the axillary lymph nodes and adjuvant radiotherapy.**
Risk factorsPatients with cancer often go through radiotherapy of their lymph nodes or the nodes are removed altogether. Naturally, this influences the whole lymphatic system, so edema can develop. Other factors such as age or simply being female can favor the onset of lymphedema.
In many cases, lymphedema also develops from a previous venous disorder combined with too little physical exercise. There are many causes, but the good news is that there are efficient treatment options available to give lymph patients their quality of life back.
PreventionDo you have lymphedema? The small things in everyday life make a difference in keeping your edema in check. For instance, wear comfortable, non-constrictive clothes. Take good care of your skin and only use pH-neutral substances. At home, protect against injuries to your nails and skin. Avoid stress and extreme cold, because both constrict the vessels. Activities that dilate the vessels such as sunbathing for a long time, visiting the sauna or taking a hot bath are not recommended either. While manual lymphatic drainage has a positive effect on the lymph system, you should avoid kneading massages which could over-stress the affected part of your body. And finally, wear compression garments whenever you exercise.
Living with Lymphedema – Education, Therapy, Quality of Life
How can lymphedema be treated?Long-term treatment can achieve good results. Complex physical decongestive therapy (CPD) is particularly successful. The aim is to first decongest the affected limbs – as the name suggests.
Initially, the focus is on skincare and hygiene. You should clean and care for the affected areas. A therapist then performs manual lymphatic drainage before applying a compression bandage immediately afterwards. This encourages the return flow of lymph fluid during this phase. Without the bandages, the edema could return after about two hours. As part of the decongestion process, it is important to keep active – preferably directly after the manual lymphatic drainage and with the bandaging in place.
Once the decongestion phase is complete, the second phase will start, the maintenance phase. The four components are the same as in decongestion: hygiene, lymphatic drainage, compression and physical activity. The difference is that the compression dressing is replaced with a compression garment. Flat knit compression stockings, specifically seamed garments that are less elastic with a stiffer material than round-knit garments, are usually used for this. Round knit hosiery is used for venous diseases such as varicose veins.
The first phase of complex physical decongestion therapy lasts about three to six weeks. The individual duration depends on how successful decongestion is. Once the circumference of the affected regions of the body are no longer reduced any further, we then move to the maintenance phase.
Manual lymphatic drainage is a special form of massage given to increase the transport capacity of the lymphatic system. It is not only applied to the affected part of the body, but to the entire body.
The massage begins at the neck where the large lymph collector vessels open into the veins behind the collarbones. This stimulates the flow of lymph in the large lymph vessels to ease transport in the smaller vessels. Then the torso and limbs are treated.
Flat knit compression garments for maintenance
The measurements are taken by the DME retailer. It is important that you wear the garment regularly. Only then will the result remain constant and the edema will not spread. Medicines can be taken as add-ons to treat edema, but your doctor will decide whether these are needed.