Usually caused by a removal of the lymph system or damage to it, lymphedema generally happen in the framework of a cancer treatment : the lymphatic system, part of the general immune system, experiences a blockage preventing lymph fluids from draining well. This results in a fluid buildup, leading to swelling, usually in arms or legs. There is no present cure for lymphedema, although it can be managed quite well thanks to an early diagnosis and appropriate care of your affected limb.
What are the symptoms?
Symptoms of lymphedema are quite obvious. They include a partial or total swelling of arms and legs, including fingers and toes, along with a feeling of heaviness and / or tightness. It may also imply a restricted range of motion, as well as aching and / or discomfort. Other more severe complication may occur, such as recurring infections and a hardening and thickening of the skin, called fibrosis.
When to see a doctor?
Although lymphedema caused by cancer treatments may not occur until months or years after the beginning of the treatment, it can quickly lead to extreme changes. For that reason, it is important to see a doctor as soon as first symptoms appear in order to be cared for quickly when there is an increase in the size of the involved limb.
What are the causes?
Being part of the general immune system, the lymphatic system is necessary to one’s good health by collecting bacteria, viruses and waste products through lymph vessels up to lymph nodes, where infection-fighting cells called lymphocytes flushed these harmful substances from the body. A body affected by lymphedema will see its lymph vessels no more able to drain lymph fluid properly, usually in arms and / or legs.
There are two levels of lymphedema affection : primary and secondary. The primary level of affection occurs on its own, as the secondary level is caused by another disease or condition, such as cancer. The second version of the most common.
Primary lymphedema’s causes
Cases of primary lymphedema infection are rare. They generally occur in the framework of inherited conditions including development problems of lymph vessels, such as patients affected by Milroy’s disease, in which case we call it a congenital lymphedema. This specific condition begins in infancy and leads lymph nodes to develop abnormally.
Another common cause of primary lymphedema is Maige’s disease, scientifically called lymphedema praecox, a disorder leading to lymphedema around puberty or during pregnancy. Finally, the late-onset lymphedema, called lymphedema tarda, occurs very rarely and usually begins after the age of 35.
Secondary lymphedema’s causes
Secondary lymphedema happens in the framework of another disease or treatment, which damages the lymphatic system. It can occur after a surgery implying the removal of or injury to lymph nodes or vessels. For instance, lymph nodes may be removed to check for spread of breast cancer, or injured in surgery that involves blood vessels in the limbs.
Cancer radiation treatments may also cause scarring and / or inflammation of the lymphatic system. Cancer cells themselves may block lymphatic vessels, for instance when a tumor growing near a lymph node or vessel enlarges enough to block the lymph fluid to flow properly.
Finally, an infection or parasites of the lymphatic system can also restrict the lymph fluid from flow normally. These infection-related cases of lymphedema are most common in tropical regions in developing countries.
What are the risk factors?
Secondary lymphedema is subject to a few factors that can increase the risk of appearance of the affection, such as an older age, excessive weight or obesity and rheumatoid or psoriatic arthritis.
What complications may occur?
Most severe complications caused by lymphedema are infections. Indeed, as the immune system is down, the smallest injury to an affected part of the body represents an entry point for infections, such as bacterial infection of the skin (cellulitis) or of the lymph vessels (lymphangitis).
Another notable complication is called lymphangiosarcoma, a rare form of soft tissue cancer resulting of untreated lymphedema. Its symptoms include blue-red / purple marks on the skin.
How to prevent lymphedema?
In order to remain aware of possible risks, for instance if you are going to have cancer surgery, make sure to ask your doctor if the surgical procedure or your potential radiation treatment will involve your lymphatic system.
Additionally, take extra care protecting your arms and legs form sharp objects to avoid any injury such as scrapes and burns, which are risks factors for infection. For instance, shave with an electric razor and wear gloves as often as possible, when gardening and cooking for example. Also, make sure to keep doctors posted of your affection during medical procedures such as blood straws and vaccinations.
Note also that heat and cold are to be avoided. Although they may seem good ideas to reduce swelling and / or heaviness, it will actually have the opposite effect and worsen your condition. The best you can to is to elevate the affected part of your body in order to facilitate fluids flow.