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Lymphedema

(Primary Lymphedema; Secondary Lymphedema)

Definition

The lymph system helps your body fight illness. Lymph fluid travels throughout the body in lymph nodes and vessels. The fluid builds up if these nodes or vessels are blocked, damaged, or missing. 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
damaged lymph
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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
Planned Lymph Removal for Cancer Treatment
lymph nodes to be removed
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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 such as breast cancer surgery
  • Radiation treatment
  • Cancer
  • Infection
  • Parasites—tropical/subtropical regions
  • Overweight
  • Poor diet

Symptoms

Symptoms of lymphedema include:
  • 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.
Images may need to be taken of your body structures. This can be done with:
Other tests may include:
  • Measurement of your arms and/or legs—to assess the severity of fluid build-up
  • Lymphoscintigraphy—a test that uses dye to trace its travel through your lymph system

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 drain. 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.
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

In severe cases, surgery to remove extra tissue from your arm or leg may be considered.

Prevention

If you are at risk for developing lymphedema, there are measures you can take to help reduce your chance of getting the condition.
If you are at risk, you can prevent swelling and fluid if you:
  • Do not 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.
  • Avoid crossing your legs or carrying items on your shoulder if either area is at risk.
  • Maintain a healthy weight and eat properly.
  • Avoid ice packs or heating pads to the affected area.
  • If you had lymph nodes in your armpit removed during breast cancer surgery, participating in a physical therapy program may help to prevent lymphedema.
You can prevent side effects if you:
  • Keep your affected arm or leg clean.
  • Keep hands and feet protected by wearing gloves and shoes.
  • Use an electric razor to shave.
  • Use sunscreen when outdoors.

RESOURCES

National Cancer Institute http://www.cancer.gov

National Lymphedema Network http://www.lymphnet.org

CANADIAN RESOURCES

Canadian Cancer Society http://www.cancer.ca

Lymphedema Association of Quebec http://www.infolympho.ca

References

Lymphedema. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/patient . Updated March 6, 2013. Accessed May 16, 2013.

Lymphedema. Society for Vascular Surgery website. Available at: http://www.vascularweb.org/vascularhealth/Pages/lymphedema.aspx . Updated December 2011. Accessed May 16, 2013.

What is lymphedema? The National Lymphedema Network website. Available at: http://www.lymphnet.org/lymphedemaFAQs/overview.htm . Accessed May 16, 2013.

1/22/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010;340:b5396.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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