Secondary Lymphedema is usually seen as a swelling of an arm or leg because of damage to one or more lymph nodes. In the United States, and other developed countries, the main cause of lymphedema is from cancer treatment, including surgery and radiation therapy. The body has about 650-700 lymph nodes, which are the filtration system that helps the protein-rich lymph fluid break down and distribute it throughout the body. In many cases, if some lymph nodes are removed or irradiated, there are others nearby that can help out. However, if one or more are damaged in cluster areas (under the armpit, in the groin, and in the neck), a person is at a life-long risk for lymphedema. Biopsy and surgery often permanently remove lymph nodes, and radiation therapy can destroy them. Once damages, they do not regenerate. Lymphedema may also be caused by a tumor, infection or injury. The most visible lymphedema is in the arm, and is precipitated by lymph nodes removed or radiation therapy in women with breast cancer. Approximately 90% of women develop lymphedema within 3 years of treatment. Lymphedema in the legs is more common, but easier to conceal with trousers/slacks. Early detection is important to slow progression and maximizes treatment.
Massage modified for lymphedema risk, including a lighter pressure for the affected area, and proper direction of massage stroke, allows a person at risk to still enjoy and benefit from a full-body massage. Improper massage technique, including chair massage or a deep tissue massage to the at-risk area, can trigger lymphedema and cause already damaged lymph systems to malfunction and or become obstructed. If you are at risk for lymphedema, we urge you to find an Oncology Massage Therapist (OMT), and if you have developed lymphedema, the OMT can still see you, or in more serious cases, see someone trained in MLD (Manual Lymph Drainage) or CDT (Complete Decongestive Therapy).
Treatment recommendations consist of exercise, pressure gradient dressings, massage, decongestive therapy, and sometimes surgery. Cure is unusual, but treatment may lessen symptoms, slow progression, and prevent complications. Patients are at risk of cellulitis, lymphangitis, and, rarely, lymphangiosarcoma. Common problems of perpetual discomfort and feeling handicapped on a daily basis. For more information please visit the National Lymphedema Network webpage: www.lymphnet.org