What is Lymphedema


Lymphedema

Lymphedema is a chronic disease that results in a build-up of lymph fluid (swelling) that occurs when the lymph system is either faulty or damaged. There are many causes, but the most common is cancer treatments that remove or damage lymph nodes or lymph vessels. There is no cure for lymphedema, but it can be effectively treated.


What does it mean?

Every one of us has a lymphatic system. In 2012 researchers at USC made the statement that “…the lymphatic system is no less essential than the blood circulatory system for human health and well-being.” The lymphatic system is similar to our cardiovascular system in that it circulates fluid throughout the entire body. It forms a web-like network of channels and nodes throughout our body.

The fluid it circulates is ‘lymph’. Lymph begins in our blood as plasma. Plasma is the fluid component that makes our blood liquid. At the ends of our cardiovascular vessels are capillaries. As blood flows through the blood vessels, plasma leaves the capillaries and moves into tissues to deliver oxygen and nutrients to our cells. Then it picks up waste and other substances, such as bacteria’s and viruses, from the cells and returns to the blood vessel.

Some plasma (usually around 10%) is left behind along with some larger “junk” cells picked up along the way. That plasma is now called LYMPH. The lymph then travels along the lymphatic system and passes through at least one of our lymph nodes.

The nodes then filter out the waste before returning it to the blood vessels. Each of us has around 600-700 lymph nodes, each one working as a filter. This is why it is such a major part of our immune system. This is also how cancer cells can metastasize to lymph nodes. It is the nodes job to collect these cells.

Another important point worth noting is that the lymphatic system has no pump to help it run the way that the cardiovascular system has your heart to do the work. Lymph fluid circulates through the lymphatic channels by pressure created in your legs when you move. This stimulates a contractible rhythmic movement of lymphatic system. This motion is called a calf-pump or joint-pump.


The Stages of Lymphedema

Because we have certain compensatory mechanisms at our disposal, lymphedema does not develop overnight. In fact, it can take years after initial cause of damage before symptoms are noticed. Lymph fluid is very high in protein so as it accumulates over time in the tissues it causes the cells to activate the production of new connective tissue, causing fibrosis.

  • The affected area becomes increasingly hard; this is known as sclerosis.
  • These altered conditions weaken the immune system in the affected area.
  • As severity increases, skin is more susceptible to bacterial infections.
  • The infections then affect the lymphatic system, worsening the lymphedema, causing a vicious cycle.

This is the situation in which the lymphatic system is already functioning inadequately, but is it still coping (by means of compensatory mechanisms) with the lymph produced. No edema is present.
The lymphatic system is overburdened; a protein-rich soft swelling develops in the affected area. It can be indented by applying pressure. When the affected arm or leg is raised, the swelling reduces on its own.
The swelling is already characterized by the presence of excess connective tissue; fibrosis and sclerosis have developed. Indentions can only be produced by applying strong, deliberate pressure; raising the limb no longer reduces the swelling.
The swelling is extreme; the skin is hardened and shows wart-like growths. Sometimes large bulges are present. The risk of inflammation is high and the skin is vulnerable to the development of deep, poorly healing wounds.

Am I at Risk?

Only 10% of Lymphedema cases are PRIMARY

  • There are over 40 rare genetic disorders that can cause lymphedema.

90% of cases are SECONDARY

22% of SECONDARY cases are Non-Cancer related:

  • Trauma
  • Burns
  • Radiation
  • Surgeries
  • Infections
  • Paralysis
  • Arthritis
  • Obesity
  • Untreated Wounds
  • Ileo-femoral Bypass

68% of Secondary cases are Cancer related:

  • Surgery- vessels and nodes are cut or removed.
  • Radiation – causes scarring and inflammation of lymph nodes and vessels.
  • Infection – inflammation of nodes restricts flow.
  • Cancer- tumor itself may be growing near a vessel or node and back up flow.

 


Most physicians in the United States are taught about the lymphatic system for one hour or less during their 4 years of medical school.

Millions of Americans go undiagnosed and untreated for lymphedema. Unbelievably, Medicare and most insurances do NOT cover supplies and long-term treatments, even if prescribed by a physician, increasing incidence of complications and disabilities.

The Lymphedema Treatment Act (LTA) is a federal bill that aims to improve insurance coverage for the doctor-prescribed, medically necessary compression supplies that are the cornerstone of lymphedema treatments.

For more information on the Lymphedema Treatment Act click here:
www.LymphedemaTreatmentAct.org