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Do you have lymphedema?

Rekha Singh, M.D. [January 27 2011]

If you've had cancer treatment that involved removal of lymph nodes or vessels and now have swelling in an arm or leg, ask your doctor to check for lymphedema.

Lymphedema is a common condition affecting the body's lymphatic system. Part of the immune system, the lymphatic system consists of lymph glands, or “nodes”, and a network of lymphatic vessels (similar to veins and arteries) throughout the body. The vessels carry lymph, a fluid containing protein, white blood cells and other substances. Lymphedema occurs when lymph vessels in an area stop pumping and lymph accumulates in body tissues. Swelling results, usually in an arm or leg, but sometimes in the chest, face, neck or genitals.
There are two types of lymphedema:

• Primary lymphedema results when a person is born without lymph vessels or nodes.
• Secondary lymphedema occurs when lymphatic vessels or nodes are damaged or removed, most often after surgery and radiation therapy to treat breast, prostate or pelvic area cancers, lymphoma or melanoma.

Untreated, lymphedema can lead to further swelling, skin changes and infection, and can be life-threatening. While the condition can't be cured, lymphedema therapy can significantly reduce swelling, discomfort and risk of infection.

One commonly used treatment is called Complete Decongestive Therapy, which includes a technique called manual lymph drainage (MLD). During MLD, specially trained lymphedema therapists use massage-like techniques to re-route lymph around damaged nodes or vessels.

Compression therapy is used between MLD treatments. Patients wear special bandages or garments on the affected area to prevent re-accumulation of lymph fluid. Different wrapping materials and techniques are used depending on each patient's condition. When patients reach a maintenance phase of treatment, they learn how to use bandages and compression garments themselves and perform self-MLD.

They also learn special exercises for the affected area and deep-abdominal breathing techniques to increase lymph circulation. Because lymphedema patients are more prone to infection, treatment also includes extensive education on meticulous skin and nail care.

Rekha Singh, M.D., is a general surgeon at The Hospital of Central Connecticut. Learn more about lymphedema therapy at HCC