LYMPHEDEMA: AN OVERVIEW
Lymphedema is swelling in a region of the body that occurs because of a malfunction of the lymphatic system. The lymphatic system is critical in maintaining fluid balance, transporting fat soluble nutrients, and fighting infections. It is a very important system and when something goes wrong, the result can be increased swelling, known as lymphedema. It can also result in malnutrition, difficulty fighting infections, and managing inflammation. Symptoms can be very mild to very severe.
Lymphedema is either Primary (congenital malformation of the lymphatic system) or Secondary (resulting from injury to lymphatic system). Here in the United States, most lymphedema is secondary, and is often seen in people who have had treatment for cancer, specifically removal of lymph nodes and/or radiation, common treatments for solid tumor cancers such breast, gynecologic, head and neck, and skin cancers.
There are two systems that are involved in managing fluid balance in the body:
When a person has had surgery that removes lymph nodes, or radiation that damages the lymphatic system, this leads to a decreased transport capacity. Fortunately, the lymphatic system doesn’t work at full potential, creating a built-in buffer, otherwise known as a “functional reserve”, so even though the transport capacity is diminished, it still may be able to do its job, but will be tapping in to the functional reserve. If the normal lymphatic load is increased for some reason, such as chronic inflammation, acute injury, or infection, then the buffer or “reserve” gets smaller and smaller. Eventually, without a decrease in the load, and the transport capacity is lowered due to malfunction of the lymphatic system, the reserve is used up, the load exceeds the transport capacity, and swelling ensues.
To combat this excess fluid and stress on the lymphatic system, two things can help:
Lymphedema is either Primary (congenital malformation of the lymphatic system) or Secondary (resulting from injury to lymphatic system). Here in the United States, most lymphedema is secondary, and is often seen in people who have had treatment for cancer, specifically removal of lymph nodes and/or radiation, common treatments for solid tumor cancers such breast, gynecologic, head and neck, and skin cancers.
There are two systems that are involved in managing fluid balance in the body:
- Your circulatory system: Arteries transport blood loaded with oxygen and nutrients to all the cells in the body. The veins return the blood from the tissues back to the heart and the process starts all over again.
- Your lymphatic system: The lymph vessels return fluid from the tissues as well, but the lymphatic system takes the metabolic waste, toxins, pathogens, and other large molecules from the tissues and transports them via lymphatic fluid to lymph nodes. These fluids need to be filtered in the lymph nodes before returning to the blood system. Eventually the cleaned lymph fluid is returned to the circulatory system and the waste is processed out of the body.
When a person has had surgery that removes lymph nodes, or radiation that damages the lymphatic system, this leads to a decreased transport capacity. Fortunately, the lymphatic system doesn’t work at full potential, creating a built-in buffer, otherwise known as a “functional reserve”, so even though the transport capacity is diminished, it still may be able to do its job, but will be tapping in to the functional reserve. If the normal lymphatic load is increased for some reason, such as chronic inflammation, acute injury, or infection, then the buffer or “reserve” gets smaller and smaller. Eventually, without a decrease in the load, and the transport capacity is lowered due to malfunction of the lymphatic system, the reserve is used up, the load exceeds the transport capacity, and swelling ensues.
To combat this excess fluid and stress on the lymphatic system, two things can help:
- Raise the transport capacity of the lymphatic system
- Decrease the lymphatic load