Lymph is the fluid flowing throughout the body that removes waste substances from the tissues and edema is the term used for the accumulation of excess fluid. The fluid accumulation results in the swelling of the arms or legs and commonly develops from the damage or the removal of the lymph nodes with cancer treatment. In addition, these individuals may also experience an inflammatory reaction that creates scar tissue known as fibrosis which further makes it difficult for the proper drainage of the fluid from the affected area. This can disrupt the normal delivery of oxygen and nutrients to the affected area which can result in infections of the skin called cellulitis and delay wound healing.
Causes
Individuals with the primary lymphedema present genetic or congenital abnormalities of the lymphatic system. Examples of primary lymphedema include various diseases such as Milroy’s disease and Klippel-Trenaury syndrome. The common form of primary lymphedema is lymphedema praecox which develops particularly among the girls during puberty. The secondary lymphedema develops as the result of damage to the lymphatic system and some of the common causes of this include the radiation exposure, an infection or surgery. Some individuals can also develop this condition as the result of cancer treatment immediately or within months. Lymphedema can also occur from infections such as lymphangitis, filariasis and elephantiasis.
Symptoms
Some of the symptoms of lymphedema include swelling of the limbs including the fingers or toes, skin hardening (fibrosis), restricted range of motions, recurrent infections and pain or discomfort. The swelling of the limbs can vary from mild to severe depending on the cases making it difficult to use the affected limb. Lymphedema is staged from 0 to 3 based on their severity. The stage 0 is non-visible, stage 1 is spontaneously reversible, stage 2 is spontaneously irreversible and stage 3 is lymphostatic elephantiasis.
Diagnosis
The diagnosis may be made based on the symptoms particularly if a surgery was done for cancer involving the lymph nodes. In some cases, tests may be required to evaluate the lymph system. The tests include MRI scan, CT scan, Doppler ultrasound and lymphoscintigraphy which produce images that help determine the location of blockages in the lymphatic system.
Treatment
There is no cure for lymphedema and the treatment is based on reducing the swelling and the pain. Some of the treatment options include exercises of the affected limb to help the proper drainage of the lymph fluid and wrapping the affected limb with a bandage to help lymph flow back to the trunk. A massage or the compression garments can also encourage the flow of the lymph fluid out of the limb. In the case of a severe condition, a surgery may be considered to remove the excess tissue of the affected limb to reduce the swelling.
References
http://www.mayoclinic.org/diseases-conditions/lymphedema/basics/treatment/con-20025603
http://www.breastcancer.org/treatment/lymphedema
http://www.lymphnet.org/le-faqs/what-is-lymphedema/signs-and-symptoms
https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/lymphedema.html
