Lymphoedema - reducing the risk.

For anyone who has had a node clearance as part of their cancer treatment, the risk of developing lymphoedema can be a major cause of concern.  Typically lymph nodes are surgically removed from the armpit or the groin in an attempt to fully remove any cancer cells from the body.   To be extra sure, sometimes radiotherapy is also used, and this can further impact on the already depleted lymphatic system.   The lymphatic system is the body’s own ‘waste disposal’ system.  It transports fluid and molecules from the tissues to the venous circulation whereby waste products can then be eliminated.  Lymphoedema is an abnormal collection of fluid, proteins and fat within the tissues as a result of a dysfunctional lymphatic system.   The lymph nodes are a vital component of this system, and in order to fully understand the importance of reducing the risk of developing lymphoedema we need to have an understanding of how the body would normally utilise the lymphatic system.  Imagine getting a bee sting on the back of your hand.  You would probably feel pain, see redness developing around the area, and then see swelling occur around the site of the sting.  This redness and swelling is an indication that the body has recognised that the protective barrier of the skin has been breached and that its own defence system has been deployed to the area to breakdown and remove any infection or foreign particles that should’nt be there.  The local swelling, which includes the nasty bits of the sting, will then be transported to the lymph nodes in the armpit where they will then be emptied into the central lymphatic system, which will ultimately remove them to the circulatory system where they can be disposed of.  In a person who has had their axillary (armpit) nodes removed, the body will respond in exactly the same way to a bee sting on the hand, but it is  the removal of the local swelling that is now going to be much reduced, resulting in the fluid staying in the hand, which can be the onset of lymphoedema.  It is therefore vitally important for anyone who has had lymph node removal to take precautions every day for the rest of their life to try and minimise the risk of getting lymphoedema in the first place.  Avoiding any kind of breaks to the skin on the affected limb is really important, and a break to the skin that is intentional, for example the introduction of a hypodermic needle for the taking of blood of the giving of drugs can be every bit as dangerous as a bee sting, cut, scratch, or burn.  It is also important to avoid any kind of compressive forces which may produce a tourniquet effect, for example, tight fitting clothing and jewellery or the pressure cuff used when taking blood pressure.   Looking after the affected limb by keeping the skin well moisturised and exercising regularly are hugely beneficial.  It is also important to be vigilant of any changes in the limb, including changes in shape and volume, feelings of tightness or heaviness, pain and reduced range of movement and discuss these with a lymphoedema practitioner at the earliest opportunity.  Lymphoedema can be an extremely debilitating condition, but if it is recognised and treated in its very early stages, it will be a lot easier to manage it in the long term.