What Are Lymphedema And His Treatment

By Peter Henderson, MD

Lymphedema is when lymph fluid builds up in the fat cells under your skin. This buildup could lead to swelling and pain. It usually happens in the arms or legs but can also occur in the face, neck, trunk, abdomen, or genitals.

Doctor examining a patients foot

It’s important to know that lymphedema can sometimes get very bad and cause serious problems. It’s also often a long-term or chronic condition. This is why it’s essential to treat it early and carefully so that symptoms get better and it doesn’t get worse.

What causes lymphedema?

Lymphedema can happen when there is damage to the lymph system, which stops lymph fluid from returning to the blood. When lymph fluid builds up in people with cancer, it can be because:

Doctor bandaging a patients legs

What are the signs and symptoms of lymphedema?

It’s important to know what lymphedema looks like and how it feels so it can be treated immediately.

Some of the most common signs and symptoms of lymphedema are:

What are the stages of lymphedema?

diagram showing stages of Lymphedema

The stage of lymphedema is often used to describe how bad it is:

Stage 0: There is no swelling, but you may feel like the area is entire or heavy or that the skin is tight.

Stage 1: The affected area gets swollen. The arm, leg, or other affected area is getting bigger or stiffer. When the arm or leg that is projected is raised, the swelling goes down.

Stage 2: Swelling worse than stage 1 and doesn’t get better when the arm or leg is raised. The hurt area is challenging and more significant than in stage 1.

Stage 3: The swelling is much worse than in stage 2. The swelling might be so bad that you can’t lift or move the arm or leg on your own without using your other arm. The skin can become thick and very dry. When the skin swells, fluid leaks or blisters can form.

Lymphedema can’t be cured. But treatment can help lessen the pain and swelling.

Treatments

Complex decongestive therapy (CDT) begins with an intensive therapy phase where the patient gets treatment and training every day. This is followed by a step called “maintenance,” in which the patient is encouraged to take care of themselves using their learned skills.

These are the four parts of CDT:

These light exercises help move the lymph fluid out of the limb.

Skincare: Taking good care of your skin lowers the risk of skin infections like cellulitis.

Manual lymphatic drainage (MLD): The lymphedema therapist uses special massage techniques to move fluid into working lymph nodes, where it is drained. During the maintenance phase, the lymphedema therapist also teaches massage techniques that can be used.

MLB stands for multilayer lymphedema bandaging. Wrapped around the lymph vessels and lymph nodes to help move the fluid through the lymphatic system.

There is no central pump for blood flow (heart). The goal is to use bandages and compression clothing to support the muscles and encourage them to move fluid out of the affected body. Patients will also be taught how to correctly put on their bandages and compression garments so that MLLB can continue during maintenance. You can buy different kinds of compression stockings online.

Historically, surgery for lymphedema hasn’t worked as well as other treatments that don’t involve surgery. But a new type of surgery called liposuction has been more successful. It takes fat away from the affected limb, which makes the swelling go down.

four stages of lymphedema

Complications

Lymphedema can cause other problems if it comes back often or is not treated. These things are:

skin infection 

Cellulitis is a skin infection that often happens in people with lymphedema. Cellulitis is a bacterial infection of the deeper layers of skin and the fat and soft tissue layers under the skin.

Lymphangitis

Lymphangitis is an inflammation of the lymph vessels, usually caused by a Streptococcus bacterial infection when it is contagious. If you don’t treat it, it can spread to the skin and nearby soft tissues, called cellulitis, or to the bloodstream, which is called bacteremia.

Psychological effects:

Lymphedema can change your look, affecting your mind, especially if you’ve been living with cancer. Lymphedema makes it more likely that it is a Dependable Source of getting depressed.

Prevention

Because fewer lymphocytes (which fight infections) in the affected limb, it is more likely to get skin infections.

If the patient takes steps to keep their skin from getting cuts and scrapes, their infection risk may go down a lot. The following steps may be able to help:

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