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What is Lymphedema?
Lymphedema is swelling, generally of the arms or legs (and occasionally of other parts of the body), caused by obstruction or damage in the lymphatic system. The lymphatic system is a network of vessels and organs situated in several areas of the body. They produce cells of the immune system that are vital in fighting bacteria and viruses, and they distribute fluid and blood cells throughout the body. Usually uncomfortable and sometimes painful, lymphedema is disfiguring and can interfere with your ability to use your arms, hands, legs or feet. Untreated, or undertreated, it can lead to serious complications, such as skin breakdown, infections or the rare life-threatening lymphangiosarcoma.
In the United States and other developed countries, lymphedema most often affects people who have undergone surgery or radiation treatment for breast cancer, melanoma, prostate cancer or other pelvic cancers or who have suffered severe trauma to a limb. In developing countries, parasitic worms that infest the lymph system cause millions of cases of filariasis; this usually leads to an extreme form of lymphedema known as elephantiasis. Cases arising from other causes, such as surgery, injury or infection, are known as secondary lymphedema.
In addition, through increased awareness, doctors see more cases of primary idiopathic (without a known cause) lymphedema, which may be present at birth or develop during puberty (called lymphedema praecox) or in adulthood (called lymphedema tarda).
Lymphedema can occur in acute and chronic forms. The acute form includes the mild, immediate, short-term swelling that accompanies all surgery and many injuries, such as a sprained ankle; the chronic swelling that often occurs after surgery due to axillary or pelvic lymph node dissection, phlebitis (inflammation of a vein) or other surgical complications; and swelling from insect bites and infections. Acute cases generally respond within days to such simple remedies as elevating the affected area or taking anti-inflammatory medication or antibiotics. Chronic lymphedema, defined as lasting longer than six months, is much more difficult to treat, particularly as it becomes advanced.
Left untreated, lymphedema tends to get worse and become more difficult to treat. The fluid and protein that accumulates (causing the swelling), along with the infections that they encourage, further damage the already-impaired lymph vessels and surrounding tissues. This, in turn, encourages more fluid and protein accumulation, and so on in an ever-worsening cycle.
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