Lymphoedema

What causes lymphoedema?

Lymphoedema happens when there’s a blockage in the lymphatic system, part of the immune system that fights infection and manages excess fluid.

When the lymphatic system is blocked, it stops lymph fluid from draining, leading to a build-up of fluid and causing swelling.

There are two main types of lymphoedema caused in different ways:

• Primary lymphoedema – When faulty genes affect how the lymphatic system develops. This type is rare and often starts in childhood or early adulthood

• Secondary lymphoedema – When the problem with the lymphatic system is caused by another condition or procedure. For example, if the lymph nodes are injured or removed during surgery or radiation treatment for cancer, if cancer cells block lymphatic tissues, or if an infection has restricted the flow of lymph fluid

Lymphoedema symptoms

The main symptoms of lymphoedema are:

• Swelling in some or all of a limb, usually the arms or legs (including fingers and toes)

• An aching, heavy feeling in the affected part of the body

• Difficulty moving

• Skin problems, including infections, wart-like growths, folds in the skin and hardening and thickening of the skin (fibrosis)

These symptoms can cause discomfort in day-to-life, making it difficult to fit into clothes and make wearing shoes and jewellery uncomfortable.

How is lymphoedema diagnosed?

If you’re having cancer treatment, the treatment team will talk to you about any risks linked to lymphoedema. They will monitor your condition after your treatment.

If you develop swelling in your arms or legs, whether you’ve had cancer treatment or not, get it seen by a doctor as soon as possible. They may be able to diagnose lymphoedema based on an examination and your medical history. They may also measure how much you’re swelling using a tape measure, water displacement or infrared light.

If you need further tests, these might include:

• Bioimpedance testing – Looking for the presence of fluid in your body’s tissues by measuring electrical charges with a handheld device

• Imaging tests – Producing images of the inside of your body with a radioactive dye (lymphoscintigram), magnetic fields and radio waves (MRI), high-frequency sound waves (ultrasound) or X-rays (CT scan)

Lymphoedema treatment

There’s no cure for lymphoedema, but a range of treatments, collectively known as Decongestive lymphatic therapy (DLT), can help manage and reduce the swelling, ease discomfort and reduce the build-up of fluid.

Decongestive lymphatic therapy (DLT)

DLT consists of the following types of treatment:

• Skincare – Keeping your skin in good condition and avoiding skin damage, like cuts and scrapes, bites and burns

• Compression treatment – Used alongside exercise, compression garments, bandages or pumps can help to move fluid out of your affected limb and reduce the build-up

• Exercise – It’s essential to exercise the muscles in your affected limb to improve the flow of lymph fluid and encourage it to move away from the swollen area. Keeping active is also a positive way to maintain a healthy weight and reduce lymphoedema swelling, and boost your mental wellbeing

• Massage – A special type of massage called lymphatic drainage helps the lymph fluid drain away from the affected limb and control swelling. This will be done by a professional, but they may teach you some simple self-massage techniques that you can do at home on your own

Other treatments

DLT is the main treatment for lymphoedema, but in some cases, other treatment may be recommended, like:

• Surgery – Procedures include: debulking, where the doctor removes excess skin and tissue, liposuction, where they remove fat from your affected limb; and lymphaticovenular anastomosis, where surgery corrects the flow of fluid in the lymphatic system

• Laser therapy – A newer treatment that isn’t widely available, this uses lasers to target cells in the lymphatic system

Lymphoedema prevention and care

Taking the following steps can help to reduce your chances of getting lymphoedema or stop it from getting worse:

• Care for your skin by moisturising regularly, avoiding very hot baths and showers, using high factor skin protection, and using insect repellent to prevent insect bites

• If you have lymphoedema, avoid injections or other medical interventions in the affected limb if possible

• Care for cuts and scratches immediately

• Avoid jewellery, watches and tight-fitting clothes

• Eat a healthy, balanced diet

• Keep active and exercise regularly

• Try to keep a healthy body weight