Lymphoedema is a chronic and permanent swelling of one or more body parts. It’s more than just a physical condition as it can be debilitating and disfiguring, affecting people both emotionally and psychologically.
It is caused by problems with the lymphatic system, which results in the accumulation of fluid. Lymphoedema is characterised by swelling of mainly the arms or legs, although it can happen to any part of the body.
It is conservatively estimated that around 70,000 people in Australia are living with lymphoedema. (The reason it’s only “estimated” is because the condition is often unreported or confused with other conditions in its early stages.)
People at the greatest risk of developing lymphoedema are those with conditions such as:
- Cancer-related risk of lymphoedema (e.g., breast, melanoma, gynaecological, prostate, sarcoma, head, and neck)
- Venous surgeries (e.g., varicose veins) or venous insufficiency
- Deep vein thrombosis (DVT)
- Hereditary Lymphoedema
Lymphoedema needs to be diagnosed professionally to exclude other causes of oedema such as:
- New cancer
- Heart, kidney, or liver failure
- Thyroid disease
- Medication side effects
- Venous causes (e.g., DVT, insufficiency, chronic ulcers)
- Surgery or trauma
Symptoms of Lymphoedema
Common symptoms of lymphoedema include:
- A feeling of heaviness in the affected area
- The skin feels tight and close to bursting point
- The skin is hotter than other areas of the body
- Pins and needles
- Painful joints
- Darting pain
Types of Lymphoedema
There are two types of lymphoedema.
Primary lymphoedema is caused by congenital or inherited structural problems of the lymphatic system. The lymph vessels may be sluggish when they pump, or there may be an insufficient number of vessels. Or it could be both.
It usually presents in childhood, but it can also appear in early and later adulthood.
In this case, lymphedema occurs due to something else, such as an infection, injury, obesity, trauma, or cancer that affects the lymphatic system. Lymphoedema may be a side effect of cancer treatment, such as radiation therapy or removing some lymph nodes, which can damage the lymphatic system.
There are three stages of lymphoedema
Stage 0: This is where there is impaired lymph transport but no evidence of swelling. This stage may exist for months or years before any oedema becomes evident.
Stage 1: This stage represents the early onset of lymphoedema. There is an accumulation of tissue fluid that subsides with limb elevation. Oedema may be pitting (swollen skin remains indented after being pressed) at this stage.
Stage 2: Swelling is rarely reduced by limb elevation alone, and pitting is present.
Late Stage 2: Tissue fibrosis becomes more evident.
Stage 3: Tissue is hard without any pitting. The skin becomes thick, with hyperpigmentation, increased skin folds, fat deposits and warty overgrowths.