How much do you know about lymphedema? Many people living with this condition aren’t loading up on fried chicken or polishing off blocks of chocolate on the regular – some eat healthily and exercise every day, yet still struggle with that characteristic swelling of their arms and legs. Here’s why.

Our lymphatic system is made up of a network of drainage pathways which move fluids around our bodies, playing a vital role in filtering out pathogens and disease-causing free radicals. Lymphatic drainage is the key to a robust immune system and a healthy circulatory system – but sometimes things get a little stuck. Lymphedema is one such instance – let’s dive into what it is, why it happens and what you can do about it.

What is lymphedema?

Lymphedema involves the dysfunction of our lymphatic system where excess fluid collects around the body. The resulting symptoms include the following:

• Swelling of parts or all of the arms and legs
• Swelling of fingers and toes
• A heavy or tightening feeling
• Restricted mobility and motion range
• Frequent or recurring infections
• A hardening of the skin

Some of the risk factors for the condition include obesity, older age and psoriatic or rheumatoid arthritis.

The causes of lymphedema

The major contributors to the development of this condition include obesity and lymph node surgery. The latter could have occurred for cancer, chemotherapy or radiation treatment – often time when preparing for cancer surgeries, the discussion is mainly centred around the cancer itself, and there is little consideration into future risks for conditions like lymphedema. While this is understandable as the focus is on beating the cancer, it can mean that some vital conversations are left on the back burner, with many unaware of the risks at hand.

Cancer patients will often have surrounding lymph nodes removed during surgery, which can have a knock-on effect on their lymphatic drainage system by reducing flow and circulation. This can result in swelling and inflammation, which may affect the arms, legs, and even the head, neck and stomach. Many will also experience associated skin issues like sores, cellulite and “orange-peel” skin, which is exactly what it sounds like – skin that has the dimpled appearance of orange peels, usually with large pores and fine lines.

Often during invasive breast cancer, an axillary node dissection may be performed – this is where up to 30 nodes will be removed, and this alone spikes your risk for lymphedema by around 30%.

That’s not the only breast cancer treatment which can skyrocket your risk for developing the condition – radiation treatment is another risk factor. Often the underarm lymph nodes are affected during radiation, which can negatively impact the lymphatic drainage network of vessels. The result? For many women, they’ll have a higher risk of lymphedema not just after the surgery, but for the rest of their years. This is because the treatment can cause scarring which impedes the lymphatic flow, along with creating blockages where excess fluid would otherwise be drained.

Cancer itself is another cause of lymphedema, and this is due to the cancerous cells blocking the vessels in our lymph drainage system.

Busting common lymphedema myths

1. Lymphedema is caused by lifestyle choices alone: While our lifestyle choices like diet and exercise play a major role in our lymphatic health - including the reduction of risk of blockages, along with reducing the severity of symptoms, the vast majority of cases stem from the effects of cancer, cancer treatment, surgeries or even parasites.

2. Lymphedema exists in a vacuum: Many people with the condition are at an elevated risk for a range of other debilitating conditions – some of which can be life-threatening. Lymphedema can greatly increase your chances of developing the following:

• Cellulitis: Skin infections are far more likely for lymphedema sufferers and this all comes down to that fluid trapped – which would have been cleared out with a properly functioning lymphatic system. Even small injuries can become infected as the fluid creates a hospitable breeding ground for pathogens. If your skin is infected, it will likely be warm and appear red and swollen.
• Sepsis: If the cellulitis remains untreated, it may move into the bloodstream, potentially setting off sepsis. This is where the body responds to infection in a self-destructive manner.
• Cancer: Untreated and severe cases of lymphedema can result in the development of soft tissue cancer.
• Blistering: If the swelling from your lymphedema is severe, it may leak through the skin and case a blistering rash.

3. There’s no treatment for lymphedema: This disheartening myth is one we’re most relieved to bust – there are a range of treatments to improve the symptoms of lymphedema, including the following:

• Surgery: Surgical intervention has developed extensively in recent years and, as such, we’re now seeing a range of options available like liposuction, microsurgical vascularised lymph node transfer and lymphovenous bypass surgery. Studies have shown surgery can be particularly effective in fighting the cellulitis that often accompanies lymphedema, with rates of infection at around 58% before surgery, and down to just 15% after surgery.
• Compression therapy: A range of compressive tools can be used to stimulate lymphatic drainage – this includes bandages and clothing items like sleeves, stockings ad gloves which promote the movement of fluids.
• Massage: Lymphatic massage is a useful technique which may help reduce the swelling, along with helping get stagnant fluids flowing.
• Decongestive lymphatic therapy: This incorporates a few of the above treatments into an intensive program – usually provided by a specialist therapist – and includes

Note: Be sure to get in touch with your doctor to work out a specialised treatment plan.

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