Diagnosing and treating lymphatic diseases

Lymphoedema is persistent swelling of certain body parts caused by damaged or abnormal lymphatic vessels.

It occurs where damaged lymph nodes (glands) and/or vessels drain into that part of the body, and requires ongoing monitoring and management.

There are two types of lymphoedema:

  1. Primary – this is due to abnormal lymphatics. It can occur at any age from infancy to old age.
  2. Secondary – this is most commonly caused by cancer treatment to the lymph nodes, but can also be caused by other trauma.

Lymphoedema has a significant impact on a person's social life, family, work and finances.

At MQ Health, we're dedicated to researching the causes of lymphoedema and developing more effective treatments that help improve your quality of life.

Symptoms

The most common lymphoedema symptom is swelling.

This can occur in the arms, legs, fingers and toes, and can be mild or severe. If you have severe swelling, you may not be able to use the affected body part.

Other symptoms of lymphoedema can include:

  • pain or discomfort
  • recurring infections
  • fibrosis
  • a feeling of heaviness.

When to see a doctor

Make an appointment with your healthcare professional if:

  • you notice a sudden onset of swelling in any body part
  • you already have lymphoedema and your symptoms suddenly get worse.

Lymphoedema is commonly caused by:

  • cancer – a tumour growing near a lymph node can block fluid from flowing
  • cancer treatment – inflammation and scarring caused by radiation therapy can damage the lymphatic system
  • surgery – lymph nodes can be damaged during surgical procedures
  • infection – an infection of the lymphatic system could block the flow of fluid.

Little is known about the causes of lymphoedema and there is no complete cure.

However, our research has revealed that the lymph fluid that circulates throughout the body can back up after treatment to the lymph glands. This fluid then spills into the tissues and causes inflammation, stimulating fat stem cells to grow. Once this happens, compression sleeves and bandaging will no longer be effective treatments.

To diagnose lymphoedema, your healthcare professional will consider your health history, symptoms and lymphoedema risk factors.

You might also need some tests, such as scans and ultrasounds, that can show blockages in your lymphatic system.

Treatment of lymphoedema aims to prevent swelling from getting worse, reduce swelling, and maintain improvement.

To treat lymphoedema, your healthcare professional will also address any associated symptoms, aim to prevent infection and develop a treatment plan that improves your function and quality of life.

Conservative management: complex lymphoedema therapy

Complex lymphoedema therapy is the most effective way to treat lymphoedema and includes the following five areas:

  1. Education and psycho-social support – to help you understand your lymphatic system and how to best manage and live with lymphoedema.
  2. Skincare – well-nourished skin can better protect itself against the effects of chronic oedema.
  3. Exercise – is safe, helpful and protective for those at risk of or living with lymphoedema.
  4. Manual lymphatic drainage (MLD) massage –a personalised MLD plan can be devised based on how your lymphatic system is working and can be used in combination with the four other strategies.
  5. Compression therapy – is the most effective strategy to keep the tissue fluid moving and keep the swelling well controlled.

All five areas are important, so a combination of options that works for the individual is optimal rather than just focusing on a single aspect of management.

Surgical management

You may be referred for surgical assessment if necessary. The assessment will determine the presence and extent of lymphoedema, and your suitability for surgical intervention using specific criteria.

Surgical treatments include lymph node transfer and lymphovenous anastomosis for management of early lymphoedema, and liposuction for management of advanced lymphoedema.

People who are most at risk of lymphoedema are those who have had:

  • lymph node surgery
  • multiple lymph nodes removed
  • radiation therapy
  • chemotherapy
  • infection or injury.

Being overweight or obese can also increase your risk of lymphoedema.

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