Lymphoedema
Lymphoedema is a condition where the accumulation of excessive amounts of protein-rich fluid in the tissue results in swelling of one or more regions of the body.
This can impact a person in many physical and psychological ways. Lymphoedema cannot be cured but it can be improved and managed with appropriate intervention. Best practice management has a holistic multidisciplinary approach and is provided by qualified lymphoedema therapists.
What is the Cause of Lymphoedema?
Primary Lymphoedema is due to a genetic malformation of the lymphatics. Onset of swelling may not present until adolescence or adulthood.
Secondary Lymphoedema is due to damage or destruction of lymph nodes or lymphatic vessels. This may occur with surgery and/or radiotherapy related to cancer treatment, recurrent cellulitis, or following injury (trauma or surgery to other organs or structures in the body).
Symptoms of Lymphoedema
Symptoms of Lymphoedema:
Aching in the limb
Heaviness of the limb
Limited movement of the limb
Tightness or temperature changes of the limb
Clothing, jewellery or shoes may feel tighter
Increased skin folds
Skin changes: redness, heat, staining, thickening of skin, warty overgrowth.
Noticeable difference in limb size
How do we Treat Lymphoedema?
The aims of lymphoedema physiotherapy are to prevent progression of the condition, to reduce oedema and then maintain the improvement.
This is achieved through:
Education
Skin care
Exercise
Massage - known as Manual Lymphatic Drainage (MLD)
Compression therapy
Prescription of off-the-shelf or custom-made compression garments
Intensive program of multilayer or Compri2 bandaging for a decongestive
Early Diagnosis and Prevention
The Australasian Lymphology Association (ALA) states that early diagnosis and early intervention are the primary means of limiting the impact of lymphoedema on patients. Early detection in the subclinical stage of lymphoedema (before obvious symptoms develop) can allow time for intervention with a Lymphoedema Therapist, which can then prevent or reduce progression of lymphoedema.
Every cancer patient who undergoes lymph node dissection, treatment with taxane based chemotherapy or any form of radiation therapy lives with an increased risk of developing clinical lymphoedema. While initially proposed for breast cancer rehabilitation, the importance of early diagnosis and early intervention is now more widely applied in oncology rehabilitation in general.
The Restore Clinic aims to establish a prospective surveillance model of care for all cancer patients living with the risk of lymphoedema progression. Part of this program involves screening with bioimpedance spectroscopy (BIS) every 3 months over the first 2 years following cancer diagnosis.