Almost 11,000 women in Spain undergo a mastectomy each year, and in many of these operations, because they are affected, they have to remove some lymph nodes. This has the consequence that almost 30% of these women suffer from lymphedema, swelling and discomfort due to accumulation of liquids in some extremity. Controlling it in its early stages is crucial so that it affects the quality of life of patients as little as possible.
What is lymphedema and why does it occur?
Lymphedema is caused by a buildup of fluid in tissues under the skin, such as consequence of a malfunction of the lymphatic system, which is responsible for collecting and transporting lymphatic fluid (lymph) through the tissues to the blood. If this process is not done well, the fluid cannot be drawn into the blood, it cannot be expelled, and it accumulates in the tissues causing swelling, a feeling of heaviness or tightness, limitation in movement or even recurrent skin infections. By causing, in some cases, a profound transformation in the image of the affected people, as well as their lifestyle, this pathology can have, in addition to physical, many psychological consequences.
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The malfunction of the lymphatic system can be caused by the removal of the nodes due to cancer treatment. The types of cancer that most favor the appearance of lymphedema are breast, prostate, pelvic area, lymphoma, melanoma and head and neck cancers. Depending on the area where the tumor is, lymphedema may appear in some parts of the body or others. Thus, breast cancer can cause lymphedema in the area of the breast, chest, armpits and arms, those of the abdominal or pelvic region, in the same abdomen, the genitals or in the legs and those of the head and neck. have been linked to the appearance of lymphedema in the face and neck.
In addition to cancer, there may be others such as:
• Radiotherapy.
• Genetic changes or mutations that affect the lymphatic system.
•Injuries or traumas in certain parts of the body.
•Some parasitic infections, which clog the lymph nodes, such as Filariasis.
•Other health conditions, such as cardiovascular diseases, arthritis, eczema, tuberculosis…
How is lymphedema treated?
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Lymphedema is a chronic disease that can progress, so it requires constant care, both to alleviate symptoms and to prevent progress. The treatment consists, on the one hand, of drugs, and on the other, of different therapies, especially physiotherapy.
As for drugs, antibiotics can be used occasionally to treat possible infections, medicines to treat eczema, etc.
As for therapies, they are very useful:
•Do specific exercises. These exercises will be prescribed by a specialist and one or the other should be performed depending on the affected area.
•Manual lymphatic drainage. It is one of the most effective therapies, and consists of a specific massage designed to displace the fluid trapped in the swollen extremity towards an area with functioning lymphatic vessels. To be effective, it must be done regularly.
•Bandages or other compression garments. The use of these bandages, sleeves, stockings, etc. It encourages the lymphatic fluid to flow again.
•Presoterapia. This technique, also widely used in aesthetics, consists of placing a pump on the affected limb that inflates it intermittently. The pressure exerted pushes the lymphatic fluid away from the fingers or toes.
•Special cares. The affected limb must receive special care, plenty of hydration, avoid bumps and scratches… because wounds in this area can worsen symptoms and cause complications, such as fibrosis or infections.
In some cases, as indicated in Mayo Cliniccertain interventions may be helpful, such as
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•Lymph node transplant, that are taken from a different area of the body and join the network of lymphatic vessels in the affected limb. It is most effective when the lymphedema is not severely affected.
•New secretion pathways. Create new connections between the lymphatic network and blood vessels. It is also recommended in early stages.
•Removal of fibrous tissue. Removing some of the hardened tissue can improve function of the limb. It is performed especially in severe and advanced cases.
To avoid complications in people with lymphedema, from Cancer.org, from the American Cancer Society, recommend:
•Avoid obesity.
•Exercise regularly.
•Avoid wearing very tight clothing or jewelry.
•Do not lift a lot of weight (if the arm is affected).
•Wear loose clothing.
•Avoid sandals (closed shoes are better) in case of lymphedema in the legs or feet.
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