Lymphedema

Information for Physicians and Patients

What is Lymphedema?
Lymphedema occurs when the lymphatic system does not work properly and results in a long-term swelling of a part of the body.

If the lymph pathways become congested, blocked or damaged or if the lymph nodes are removed or irradiated, the lymphatic fluid (water, excess proteins, bacteria, long chained fats, cells, etc.) will build up in the tissues. Because the lymphatic load of fluid exceeds the system’s transport capacity, swelling occurs. This swelling usually will develop in an extremity first.

Untreated, the excess protein attracts more fluid and causes the condition to progress. This decreases the oxygenation of the tissues, interferes with normal wound healing and provides a breeding ground for bacteria. The extremity can become more swollen with changes in skin texture and appearance.

Causes of Lymphedema

Primary lymphedema has no known cause. Vessels can be either absent or very scarce, limiting drainage. Primary lymphedema can appear before birth, during puberty (the most common) or later in life.

Secondary lymphedema is a result of lost or obstructed lymphatic channels, generally due to the removal of lymph nodes during surgery for malignancy. Other causes include:

• radiation therapy
• accidental injury/trauma
• parasites
• chronic venous insufficiency.

The onset of secondary lymphedema can occur rapidly (immediately after surgery) or gradually (developing later in life).

Treatment of Lymphedema

Combined Decongestive Therapy (CDT) offers patients an effective treatment option in controlling lyphedema. The goal of CDT is to reduce swelling and facilitate the flow of lymph fluid to the venous circulation of the affected area. CDT consists of:

• Manual Lymph Therapy (MLD) - This massage technique helps drain the affected area, which stimulates lymphatic fluid flow.
• Compression Therapy - This is achieved by bandaging the affected extremity.
• Remedial Exercise and Breathing - This step helps promote venous and lymphatic flow.
• Skin Hygiene

Where to go for Treatment

Treatment for lymphedema using CDT is available by a certified therapist at the David C. Pratt Cancer Center. For more information, please call 314-251-6571.