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What are the causes of Lymphedema?

Lymphedema is a condition that may occur after trauma or disease affects the lymphatic system. The lymphatic system is a network of organs, lymph nodes ( think spongy little balls usually found in clusters) and supporting structures that move fluids and other substances through the body acting like a transportation system. Chronic Swelling and Skin Changes are the main concerns of lymphedema. When lymphedema remains untreated, it will progress. Treatment of lymphedema focuses on halting this progression while also improving the symptoms. Lymphedema is categorized in two types. Primary, which means it is due to the presence of a gene OR it is secondary, which means it happens as a result of an issue with the lymphatic system. Cancer Related Lymphedema is a Secondary Lymphedema because he lymphedema occurs following cancer treatment. Radiation Therapy and Lymph Lode Dissections are typically the main cause of cancer related lymphedema.

Signs and symptom

In the early stages of the diseases mild skin discoloration and swelling are present. Over time, affected area can experience infections, thickening of the skin, discoloration and discomfort. The aforementioned issues can make limit mobility and make it difficult to wear regular clothing, shoes, gloves, jewelry etc. Many clients report that lymphedema can cause social isolation and issues of body acceptance.
 

Stages of Lymphedema

Stage 1 Lymphedema: (Spontaneously Reversible) The characteristics of Stage 1 include puffy appearance of the limb or affected region . There may be impressions from pushing on the skin—referred to as “pitting” edema. It may be more difficult to see veins. It is not unusual for swelling to improve at night but return during the day. Elevation of the affected area may temporarily help reduce the edema.

Stage 2 Lymphedema: (Spontaneously Irreversible):   In Stage 2 lymphedema, the swelling takes on a spongy consistency and “pitting” is less present. At this stage, lymphedema does NOT respond to elevation. This tissue consistency change is caused by the formation of fibrosis, or scar tissue, with gradual thickening of the tissues of the region as it increases in size.
 

Stage 3 Lymphedema: (Lymphostatic Elephantiasis): At this stage, the skin of the region has fixed skin creases and may become rough. There may be fluid leaking and skin infections such as cellulitis or fungal infections are common. Excess skin projections (including blisters) can form to attempt to contain the fluid, and these projections pose an even greater infection risk.   While these stages are all different, they are continuous.


 

Therapeutic Intervention

Lymphedema Prognosis varies greatly based on the individual experiencing it and his or her personal factors such as age, past medical history, radiation history, body size and activity levels. The most important factor in the success of lymphedema management is understanding the disease and the consistent application of management strategies.

common strategies used by lymphedema therapists

  • Education and Training on Disease and Prognosis

  • Teaching self massage , breathing and compression bandaging to reduce swelling

  • Advisement on Compression Garments, Sleeves, and Leg wear

  • Exercise Program that includes aerobic and strengthening activities

  • Performing of Manual Lymphatic Drainage, Soft Tissue Mobilization, Scar Management

Cancer Related Lymphedema often exists alongside other medical issues. Restoring the body to a state of homeostasis and into a healing phase is an important component to taking care of lymphedema or any other chronic condition. 


 

References

Zuther, J. E., & Norton, S. (2018). Lymphedema management: The Comprehensive Guide for Practitioners. Thieme.

and maintaining or enhancing the function of the limb. 

CANCER RELATED LYMPHEDEMA STAGES AND THERAPY

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