SECONDARY LYMPHOEDEMA

Secondary Lymphoedema is caused by damage or trauma to the lymphatic system or body but mostly from cancer treatment (radiotherapy), lymph node removal or surgery. It usually presents as swelling of one or more areas of body, but can affect one of the areas of the body such as head, neck, torso, genitals, breast and abdomen.

ARE YOU AT RISK OR HAVE SIGNS OF LYMPHOEDEMA?

Have you has surgery with removal of lymph nodes from axilla (armpit), abdomen, groin or neck?

Have you experienced an injury/trauma to your lymphatic system or your effected limb?

Manual lymphatic drainage, skin care, exercise, compression garments,
self MLD and education, advice on lymphoedema and after care support.

1. Treat subtle underlying causes to tissues
2. Breakdown scar tissue, fibrotic tissues inhibiting the lymphatic drainage
3. Improve skin healing after radiotherapy scarring
4. Reduction of oedema and stimulation of lymphatic system
5. Education on risk reduction and self – treatment with management

  • Have you has radiotherapy, chemotherapy or hormone medications as an addition therapy for cancer
  • Do you have scar formation, fibrosis or dermatitis following radiotherapy treatment
  • Are you overweight or are obese
  • Have an inactive lifestyle
  • Swelling and recovery following cosmetic surgery

Secondary Lymphoedema can help with:

Swelling in legs & ankles

Promotion of scar tissue healing

Post-operative healing

Deep relaxation and stress relief

Signs of lymphoedema

1.The affected limb or area that has had surgery or radiotherapy just doesn’t feel right – it could be achy, unusual, tingling, shooting sensations or pins and needles or different temperature
2. Gradual swelling of the affected area or limb. Usually this affects only one limb but occasionally both limbs have swelling
3. The area may feel heavy, full or tight
4. Skin may dimple or pucker or have a pitting look to it
5. Skin folds at the joints become deeper and more noticeable
6. A positive “stemmers sign” test – when the skin on the second toe or finger of the affected limb is pinched, the skin cannot be lifted and feels taut and hard.

Diagnosis and treatment:

If you notice any of the above changes, visit your oncology team, breast care nurse, lymphoedema therapist, or your G.P.
Diagnosis in the first instance use palpation, observation and measurement of affected limb and comparison to other limb, family history and medical history. There are certain scans that can be done using medical imaging including lymphoscintigraphy if confirmation is required. Prompt treatment by lymphoedema specialist is important to provide a full assessment of the limb or torso. If you are at high risk, then a treatment and management plan can be started and education for self-care will be given.

Manual lymphatic drainage, skin care, exercise, multi-layer bandaging, compression garments measured and fitted, self MLD and education, breathing exercises, advice on lymphoedema and after care support.

1. Reduction of the volume of limb (arm or leg) so maintain a limb that
does not fluctuate in volume/size.
2. Improve tissue health of the affected limb.
3. Reduce pain symptoms, discomfort and heaviness of limb.
4. Improve mobility
5. Improve quality of life

Stages of lymphoedema

Stage 0:

  • Lymph vessels are damaged, but no swelling is visible. Body Lymph drainage is normal
  • No swelling exists yet

Stage 1:

Oedema reduced overnight after limb raised. Swelling occurs during the day and
reduces when limb raised. When pressure in applied to the limb/tissues a dent is
made which can remain for some time. This is called pitting oedema.

  • Impaired lymph drainage
  • Oedema occurs during the day
  • Reduction of the oedema after lying down with affected area elevated or
    overnight when in bed.
  • Visible dent after pressing into issues with finger

 

 

Stage 2:

Oedema that is not resolved by limb elevation.

The swelling remains even during longer periods of rest. The skin hardens, becomes tougher and raising arms or legs does not bring any reduction or relief from swelling.

  • No reduction in swelling of limb on elevating limb
  • Difficult or impossible to press the skin and leave an impression In skin
  • Skin changes develop and occur – the texture becomes uneven and skin bubbles can appear which may leak fluid.

Stage 3:

 

Elephantiasis

If the swelling remains untreated the limb shape becomes distorted in shape with bigger skin folds. The skin condition texture will continue to get worse and the bubbles harden up and continue to leak fluid (lymph). This stage is called elephantiasis.

  • The shape of the limb(s) become distorted
  • Hardening of skin happens
  • Wart like growths and lymph can ooze from them
  • Complications: skin infections (cellulitis), deep wounds which don’t heal easily or quickly.