Lymphedema

Lymphedema, a swelling in certain areas of the body, usually the arms and legs, occurs from a blockage within the lymphatic system. The lymphatic system helps to fight infection and disease by carrying lymph, a colorless fluid containing white blood cells, through the body. Acute lymphedema, which is often brought about by cancer treatment, usually goes away after six months. Chronic lymphedema, however, has no cure, although there are certain ways to manage it and keep it from getting worse. No matter the type, untreated lymphedema may result in decreased function and mobility in the affected part of the body and can result in chronic infections and various illnesses.

Causes of Lymphedema

Lymphedema is divided into two categories, primary and secondary, both of which have a number of causes.

Primary Lymphedema

A rare, inherited condition, primary lymphedema is caused by lymph-vessel-development issues and occurs most frequently in women. Causes of primary lymphedema often include:

Milroy‘s disease

Also called congenital lymphedema, Milroy's disease causes lymph nodes to form abnormally. This condition usually begins in childhood.

Meige‘s disease

Also called lymphedema praecox, Meige's disease causes lymph vessels to form without the valves that prevent the backward flow of lymph fluid. As a result, the body cannot drain lymph fluid from the limbs. Meige's disease usually manifests itself in childhood or puberty but can occur in those in their early twenties or thirties.

Late-onset lymphedema

Also called lymphedema tarda, late-onset lymphedema occurs rarely and usually manifests itself in those 35 and older.

Secondary Lymphedema

Secondary lymphedema arises from any condition or procedure that damages lymph nodes or lymph vessels. Causes of secondary lymphedema may include:

Surgery

If lymph nodes and lymph vessels are removed or cut during surgery, lymphedema may result. Lymph nodes are often removed in the underarm, groin or pelvic areas to treat breast cancer, gynecologic cancers, prostate cancer, testicular cancer, bladder cancer and melanomas, and lymphedema is often a side effect.

Radiation treatment

Radiation treatment can cause scarring and inflammation to lymph nodes or lymph vessels, which affects the flow of lymph fluid, causing lymphedema.

Cancer

Tumors from cancer that has metastasized may grow large enough to block lymph vessels, and restrict the flow of lymph fluid, resulting in lymphedema.

Infection

Lymph-node infections, either bacterial or fungal, can restrict the flow of lymph fluid. Infection may also be caused by parasites. Filariasis, which is caused by roundworms, is one such parasitic infection. Infection-related lymphedema is usually found in tropical and subtropical regions, and in developing countries.

Treatment of Lymphedema

There is no cure for primary lymphedema. Treatment for both primary and secondary lymphedema focuses on reducing swelling and controlling pain, and on keeping symptoms from getting worse. Drugs are usually not used to treat lymphedema unless to fight a resulting infection. Diuretics and blood thinners usually do not help and may only exacerbate symptoms. Lymphedema treatment often includes:

  • Compression sleeves or stockings
  • Exercise that incorporates gentle contraction of muscles in the affected limb
  • Compression bandages that encourage lymph-fluid drainage to the center of the body
  • Pneumatic-compression devices
  • Massage that helps to drain lymph fluid

Several of these treatments may also be combined. To reduce severe swelling, lymphedema may be treated with surgery that removes excess fluid and tissue from the affected limb.

  • Compression sleeves or stockings
  • Exercise that incorporates gentle contraction of muscles in the affected limb
  • Compression bandages that encourage lymph-fluid drainage to the center of the body
  • Pneumatic-compression devices
  • Massage that helps to drain lymph fluid

Several of these treatments may also be combined. To reduce severe swelling, lymphedema may be treated with surgery that removes excess fluid and tissue from the affected limb.

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