Lymphedema is a chronic condition in which the lymphatic system is not effectively draining lymph fluid, causing edema. Although the edema can occur anywhere lymph nodes are located--near the underarm, pelvis, neck, groin or abdomen--lymphedema most commonly occurs in the arms and legs. The leading cause of lymphedema is cancer treatment in which lymph nodes have been removed. While no cure exists for lymphedema, the condition can be effectively managed to guard against potential problems such as infection and decreased function.
Combined Therapy
The initial step at the first sign of lymphedema is usually combined therapy, also known as complex decongestive therapy, under the guidance of a certified therapist. Combined therapy involves manual lymph drainage--light massage--in which the therapist manually shifts the fluid to a noncompromised space, bandaging the affected area with a firm elastic bandage, light exercises, and skin care to prevent infection. The individual will typically meet with the therapist several times each week for two to three weeks before becoming independent in his own care.
Pressure Garments
During combined therapy, the individual will be fitted for a pressure sleeve or stocking, which is to be worn daily and taken off only at night. This garment helps move fluid and keep it from building up. According to the National Cancer Institute, it is particularly important to wear a pressure garment during air travel, as high altitudes can worsen lymphedema.
Compression Devices
Compression devices are pumps with sleeves that fit around the affected limb. Intermittent pressure is exerted progressively up the limb, moving fluid out of the affected area. A certified therapist makes the initial settings, and the device should be monitored periodically to ensure that too much pressure is not being placed on lymph vessels.
Exercise
Until recently it was believed that exercise could be harmful for individuals with lymphedema. However, it is now known that light exercise and aerobics help move lymph fluid and reduce swelling. A pressure garment should always be worn during exercise, and any exercise program should be started under the guidance of a certified therapist. Individuals should begin with light exercise and progress slowly; if they stop exercising at any time, they should again start with light exercise, advancing activity slowly. If they notice at any time that their symptoms are worsening, they should consult their therapist.
Surgery and Drug Therapy
Only in rare cases are surgery and/or drug therapy used to treat lymphedema. According to the National Lymphedema Network, surgery is considered only in severe cases that have not responded to combined therapy and the use of pressure garments. Surgery may be indicated to reduce the weight of the limb, to reduce frequency of infections, or to prevent a secondary cancer. There are significant risks to surgery, and individuals will still require pressure garments afterward. Antibiotics may be used to prevent or treat infections, but diuretics and anticoagulants--blood thinners--have been shown to be ineffective and can actually worsen the condition.
References
- National Cancer Institute: Treatment of Lymphedema
- National Lymphedema Network: Position Statement of the National Lymphedema Network: Topic: Treatment
- Lymphedema Treatments: Everything About How to Treat Lymphedema
- American Cancer Society: Lymphedema: What Every Woman With Breast Cancer Should Know
- Vascular Disease Foundation: Lymphedema: Treatment
