Lymphedema
(Primary Lymphedema; Secondary Lymphedema)
Pronounced: lim-fah-DEE-ma
Definition
The lymph system helps your body fight illness. Lymph fluid travels throughout the body in lymph nodes and vessels. If these nodes or vessels are damaged or missing the fluid builds up. Fluid build-up in the arms or legs is called lymphedema. There are two types of lymphedema:
- Primary lymphedema is uncommon and occurs because people are born without lymph nodes and vessels.
- Secondary lymphedema occurs when there is injury to the lymph nodes or vessels.
Damaged Lymph Nodes
While there is no cure for lymphedema, it can be controlled. If you suspect you have this condition, contact your doctor promptly for treatment.
Causes
Lymphedema can be caused by a variety of factors:
-
Primary lymphedema
- Born without lymph vessels and nodes
- Milroy’s disease
- Meige disease
- Late-onset lymphedema
-
Secondary lymphedema
- Surgery for cancer
- Radiation treatment for cancer
- Burns
- Liposuction
- Surgery on blood vessels
- Infection
- Trauma
Planned Lymph Removal for Cancer Treatment
Risk Factors
These factors increase your chance of developing lymphedema. Tell your doctor if you have any of these risk factors:
-
Surgery that removed lymph nodes
- Breast cancer surgery (eg, lumpectomy , mastectomy )
- Radiation treatment
- Cancer
- Infection
- Parasites—tropical/subtropical regions
- Overweight
- Poor diet
Symptoms
If you have any of these symptoms do not assume it is due to lymphedema. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
- Swelling in arms, legs, fingers, or toes
- Loss in range of motion
- Infection
- Aching, pain, or discomfort
- Heaviness or tightness of skin
- Your clothes, shoes, or jewelry feel tight
- Hardening of the skin
- Redness of skin
Diagnosis
Cases of lymphedema can vary from mild to severe. Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:
- Measurement of your arms and/or legs—to assess the severity of fluid build-up
- Lymphoscintigraphy—test that uses dye to trace its travel through your lymph system
- MRI scan —magnetic waves are used to make pictures of body structures; used to look at tissue affected by lymphedema
- CT scan —type of x-ray that uses a computer to make images; used to look at tissues affected by lymphedema
- Duplex ultrasound or Doppler ultrasound —test that uses sound waves to make images; used to look at blood flow and rule out blood clot
Treatment
Talk with your doctor about the best plan for you. Options include the following:
Drainage
Your doctor or physical therapist may show you exercises to drain fluid out of your arm or leg. Massage may also be used to help fluid draining. Sometimes external pumps are used to help drain the fluid build-up.
Compression
Compression stockings, sleeves, or bandages are often used to direct fluid away from your affected arm or leg. You may be shown how to apply a compression device.
Medicine
Areas of lymphedema are at risk for infection. Your doctor may prescribe an antibiotic to prevent or treat infection. If the condition is painful your doctor may suggest or prescribe a pain reliever.
Surgery
Surgery to remove extra tissue from your arm or leg may be considered in severe cases.
Prevention
If you are at risk for developing lymphedema, there are measures you can take to help reduce your chance of getting the condition:
- Don’t allow anyone to take blood or your blood pressure on your affected arm or leg.
- Wear a medical bracelet warning of your risk for developing lymphedema.
- Keep your affected arm or leg clean.
- Avoid crossing your legs or carrying items on your shoulder if either area is at risk.
- Keep hands and feet protected by wearing gloves and shoes.
- Maintain a healthy weight and eat properly.
- Use an electric razor to shave.
- Use sunscreen when outdoors.
- Avoid icepacks or heating pads to the affected area.
RESOURCES:
The National Cancer Institute
http://www.cancer.gov
The National Lymphedema Network
http://www.lymphnet.org/
Society for Vascular Surgery
http://www.vascularweb.org/index.html
CANADIAN RESOURCES:
Canadian Cancer Society
http://www.cancer.ca/
Lymphedema Association of Quebec
http://www.infolympho.ca/
Lymphovenous Canada
http://www.lymphovenous-canada.ca/
References:
Lymphedema. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/lymphedema/DS00609 . Accessed November 3, 2008.
Lymphedema. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/patient . Accessed November 3, 2008.
Lymphedema. Society for Vascular Surgery website. Available at: http://www.vascularweb.org/patients/NorthPoint/Lymphedema.html . Accessed November 3, 2008.
What is lymphedema? The National Lymphedema Network website. Available at: http://www.lymphnet.org/lymphedemaFAQs/overview.htm . Accessed November 3, 2008.
Last reviewed November 2008 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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