What causes lymphedema?
Our lymphatic system is connected to our cardiovascular system and fulfills functions for our bodies that are just as important as the cardiovascular system itself. It plays a decisive role in our immune system. If we are healthy, our lymphatic system runs smoothly. We only become aware of the lymphatic system when it is impaired – in the case of lymphedema, for example.
What exactly is Lymphedema? Lymphedema occurs when the lymph fluid cannot flow towards the heart properly and accumulates in the tissues. It’s often compared to a traffic jam. The arms and legs swell up and edema forms, and with that, chronic swelling.
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With the right treatment, it is possible to lead a normal and enjoyable life with lymphedema.
There are two forms of lymphedema:
Primary lymphedema is congenital. It is usually caused by lymph channels or lymph nodes that have not been properly formed.
Secondary lymphedema describes edema that develops during a patient’s lifetime and is not congenital. The causes of this can be operations, infections, or injuries, for example.
Breast cancer-related lymphedema or BCRL
Breast cancer is the most common form of cancer in women. Over 300,000 new cases are diagnosed every year in the US.*
Women treated for breast cancer are facing a life-time risk of developing lymphedema, a chronic condition that occurs in up to 40% of this population and negatively affects breast cancer survivors’ quality of life.
What are the risk factors for developing lymphedema after breast cancer?
Breast cancer-related lymphedema results from obstruction or disruption of the lymphatic system associated with cancer treatment (removal of lymph nodes and radiotherapy). Naturally this influences the entire lymphatic system, so edema can develop. In addition, patient personal factors [obesity or higher body mass index (BMI)] can increase the risk of lymphedema, and infections or trauma can trigger lymphedema.
In many cases, lymphedema also develops from a previous venous disorder combined with too little physical exercise. There are many causes, but the good news is that there are efficient treatment options available to give lymph patients their quality of life back.
Do you have lymphedema? The small things in everyday life make a difference in keeping your edema in check. For instance, wear comfortable, non-constrictive clothes. Take good care of your skin and only use pH-neutral substances. At home, protect against injuries to your nails and skin. Avoid stress and extreme cold because both constrict the vessels. Activities that dilate the vessels, such as sunbathing for a long time, visiting the sauna, or taking a hot bath, are not recommended either. While manual lymphatic drainage has a positive effect on the lymph system, you should avoid kneading massages which could over-stress the affected part of your body. And finally, wear compression garments whenever you exercise.
How can lymphedema be treated?
Long-term treatment can achieve good results. Complex physical decongestive therapy (CPD) is particularly successful. The aim is to first decongest the affected limbs – as the name suggests.
Initially, the focus is on skincare and hygiene. You should clean and care for the affected areas. A therapist then performs manual lymphatic drainage before applying a compression bandage immediately afterwards. This encourages the return flow of lymph fluid during this phase. Without the bandages, the edema could return after about two hours. As part of the decongestion process, it is important to keep active – preferably directly after the manual lymphatic drainage and with the bandaging in place.
Once the decongestion phase is complete, the second phase will start, the maintenance phase. The four components are the same as in decongestion: hygiene, lymphatic drainage, compression and physical activity. The difference is that the compression dressing is replaced with a compression garment. Flat-knit compression stockings, specifically seamed garments that are less elastic with a stiffer material than round-knit garments, are usually used for this.