Lymphedema

Lymphedema (or "Lymphoedema", "lymphatic obstruction") is a condition of localized fluid retention caused by a compromised lymphatic system. The lymphatic system (often referred to as the body's "second" circulatory system) collects and filters the interstitial fluid of the body. Lymphedema has been barely recognized as being a serious health problem; however, this is slowly changing due to education and awareness. Still, doctors and medical staff who practice in fields where this disease is uncommon may fail to correctly diagnose the condition due to the apparent lack of information regarding this disease. more...

Causes

Lymphedema may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). It was most frequently seen after surgery and radiation therapy, which may cause unintended damage to the lymphatic drainage system. It was especially common after surgery or radiation therapy were used in combination to treat breast cancer. Lymphedema may also be associated with accidents or certain diseases or problems that may inhibit the lymphatic system from proper function. Many cancer patients find this condition may develop after their therapy has concluded. The symptoms of Primary Lymphedema may not become apparent for many years. In the lower extremity it will be unilateral or bilateral.

Lymphedema affects both men and women. In women, it was most prevalent in the upper limbs after breast cancer surgery and lymph node dissection, occuring in the arm on the side of the body in which the surgery is performed, and in the lower limbs or groin after hysterectomy surgery. In men, lower-limb Lymphedema is most common, occuring in one or both legs or occasionally in the groin.

Aircraft flight has been linked to the onset of Secondary Lymphedema in patients who have had post-cancer surgery (likely due to decreased cabin pressure). Some cases of lower-limb Lymphedema have been associated with the use of Tamoxifen, which can also cause blood clots and deep vein thrombosis (DVT).

Symptoms

When the lymphatic impairment becomes so great that the lymph fluid exceeds the lymphatic system's ability to transport it, an abnormal amount of protein-rich fluid collects in the tissues of the affected area. Left untreated, this stagnant, protein-rich fluid causes tissue channels to increase in size and number, reducing the availability of oxygen. This interferes with wound healing and provides a rich culture medium for bacterial growth that can result in lymphangitis (infection).

Symptoms may include severe fatigue, a heavy swollen limb or localized fluid accumulation in other body areas, deformity ("elephantiasis"), discoloration of the skin overlying the Lymphedema, recurrent episodes of cellulitis, and in severe cases, skin ulcers and infections. Each case is different. In certain exceptionally-severe cases, prolonged, untreated Lymphedema can lead to a form of cancer known as Lymphangiosarcoma.

Lymphedema may also result in psychological distress. The normal, daily-living lifestyle can become severely limited.

Lymphedema should not be confused with edema arising from venous insufficiency, which is not Lymphedema. However, untreated venous insufficiency can progress into a combined venous/lymphatic disorder which is treated the same way as Lymphedema (see Treatment below).

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