Many people are familiar with how blood flows in the body: rich blood travels outward from the heart via the arteries, then returns inwards through the veins.
Excess body fluid also needs to return to the heart to be recirculated. This fluid is picked up from body tissues by a network of microscopic tubes called lymphatics. These run parallel with the blood vessels towards the centre of the body. Along the way, the fluid is filtered by the immune system in small organs called lymph nodes.
Lymphoedema is a condition caused by fluid collecting and stagnating in body tissues, due to back-pressure from blocked or non-functional lymphatics. In “primary lymphoedema”, people are born with faulty lymphatic systems. However, most adult lymphoedema is “secondary lymphoedema”, due to damage sustained to previously-normal lymphatics.
The most common cause in New Zealand is secondary lymphoedema, as a consequence of cancer treatment. Breast, gynaecological, and skin cancer are most typical. However, limb trauma and parasite infections are also recognised causes.
Symptoms, which may manifest months or even years later, typically worsen over time. These include:
Lymphoedema often goes unrecognised until visible limb swelling occurs. This only happens once the problem is more firmly established. In contrast, recognising the other symptoms of lymphoedema allows earlier, more effective treatment.
The understanding of lymphoedema and its treatment has come a long way since the turn of the millennium. Different strategies are needed depending upon your specific situation. The most important determinants of treatment success are how early intervention begins, to what degree the lymphoedema has advanced, and the motivation of a patient to actively shape their own journey.
