Lymphoedema is a swelling caused by failure of the lymphatic system to remove a normal load of protein and fluid from the body tissues.
Lymphoedema can occur because of some malformations or poor development of the lymphatic system, which may be present at birth (genetically inherited) or arise later around puberty or age 30-40. These are referred to as primary lymphoedemas, which according to most research accounts for 5-10% of all lymphoedemas.
The lymphatic system may also fail as a consequence of surgery or radiotherapy which removes or destroys lymph vessels and nodes, or because tumours or other structures are pressing on the delicate vessels. This is known as secondary lymphoedema. Research indicates that around 30% of women (though this may vary) who have treatment of breast cancer, which involves removal of lymph nodes and radiation, will develop this swelling as will about 30% of men and women who have lymph glands removed during treatment for the reproductive system or bowel cancers.
Signs and symptoms of lymphoedema
Some of the symptoms that can occur are:
• A swelling that comes and goes with exercise or other physical activity;
• Feelings of heaviness, pain or tension in the limb;
• A “bursting” feeling (tightness and fullness) in the limb;
• Pins and needles;
• Redness and a sensation of heat.
Some of these symptoms might be a natural after effect of surgery or radiotherapy, and lymphoedema may not develop. They do, however, warrant a consultation with a health professional who is knowledgeable about the diagnosis and treatment of lymphoedema, or with a breast care or other specialist nurse.
Recent research from America (Stout et al 2008) indicated that lymphoedema diagnosis could be obtained on average at 6.9 months (if present) when an initial measurement of fluid was done prior to surgery. Currently this initial measurement is not practiced but it does highlight that lymph oedema does occur early and usually starts in the forearm area post breast cancer surgery. Early intervention at this stage is important and can have a significant impact on the course of lymphoedema.