Lymphoedema is swelling that occurs due to the build-up of protein-rich fluid called lymph fluid. The lymphatic system is part of the body’s immune system, and one of its jobs is to carry lymph fluid. Lymph fluid contains white blood cells that help fight infection.
Lymph nodes are another important part of the lymphatic system. They receive, filter, and send lymph fluid to and from lymph vessels. Lymphoedema often occurs when the lymph nodes are blocked or damaged, causing lymph fluid to build up. However, lymphoedema can occur if any part of the lymphatic system is unable to drain lymph fluid. As a result, swelling most often appears in the arms or legs, but it can affect any area of the body.
There are an estimated 1.3 million people in South Africa living with the disease. The number of South Africans living with lymphoedema is expected to increase over the next few decades. Lymphoedema can become severe over time, and good treatment and management is important to ensure that people with lymphoedema stay as healthy as possible.
The most visually obvious symptom of lymphoedema is swelling of the arms, legs, and other areas of the body. However, there are other symptoms that occur as lymphoedema becomes worse. These include:
It’s important to seek medical attention if you notice swelling that won’t go away. If you already know that you are living with lymphoedema, seek help if one of your arms or legs suddenly swells a lot.
The most common causes of lymphoedema include cancer, radiation treatment for cancer, surgical removal of lymph nodes to prevent cancer from spreading, and parasites that accumulate in the lymph nodes.
Risk factors for lymphoedema include:
A medical professional often makes a lymphoedema diagnosis based on recent symptoms and a physical exam, especially if you’re at risk of developing lymphoedema. If the diagnosis of lymphoedema isn’t as obvious, a doctor may order imaging tests, like an MRI, computerised tomography scan (CT), or an ultrasound.
A doctor may also ask for a lymphoscintigraphy. This test involves radioactive dye being injected into the lymphatic vessels so that a medical professional can see the lymph fluid moving through the body with a machine that detects radioactive material. It’s a safe way for a doctor to better see what’s happening in the body.
Complications of lymphoedema include:
While there is no cure for lymphoedema, it can be managed with a combination of medication, therapy, and if it’s right for you, surgery.
Common therapies for lymphoedema include gentle exercises, compression socks or bandages to help lymph fluid move, and manual lymph drainage. Manual lymph drainage is a non-invasive technique that involves a trained professional encouraging blocked lymph fluid to move toward a part of the body where there are working lymph vessels.
People living with lymphoedema can also try compression socks and sleeves with attached pumps for additional pressure on the area of the body where fluid is trapped. This encourages the flow of lymph fluid.
Surgical treatments for early lymphoedema include connecting lymphatic vessels to new blood vessels. The hope is that trapped lymphatic fluid will drain into the new blood vessels. Another option in early lymphoedema is lymph node transplant. In more severe cases of lymphoedema, surgical removal of scarred tissue in the affected area of the body can help.