Lymphedema is a condition characterized by the swelling of the arms, legs, or both, resulting from poor lymph drainage caused by blockage, injury, or abnormal development of the lymphatic vessels. Lymph is a light yellow, cloudy fluid that originates from body tissues and flows through tiny vessels called lymphatic vessels, eventually leading to lymph nodes (glands) where infection-fighting cells filter out waste from the body. When the lymphatic system encounters issues with proper drainage, it can lead to the accumulation of lymph, causing swelling and discomfort.

Types and Causes of Lymphedema:

Lymphedema can be classified into primary or secondary types. Primary lymphedema is rare and caused by developmental abnormalities of the lymphatic system. It is more commonly observed in people under the age of 20, with a higher prevalence among females than males.

Secondary lymphedema is a result of an underlying condition or injury that affects the lymphatic system. Causes of secondary lymphedema include infections, such as those caused by streptococcus bacteria or filarial worms. Injuries from trauma or radiation therapy, particularly in cancer treatment, can also lead to secondary lymphedema. Some of the most common cancers associated with lymphedema are breast and prostate cancers, as well as lymphoma.

Symptoms of Lymphedema:

The primary symptom of lymphedema is persistent swelling or edema in the legs. In cases where individuals have received radiation therapy for breast cancer, arm swelling can occur. Men with prostate cancer that has spread (metastasized) may experience swollen legs. The swelling is typically painless but constant, and in some cases, other parts of the body, such as the genitals and face, can also become affected. An affected foot may resemble a buffalo hump, and a swollen leg can appear like a tree trunk due to ankle swelling. In severe cases, the toes may become swollen, giving the foot a square-like appearance.

Diagnosis of Lymphedema:

Healthcare providers diagnose lymphedema through a combination of medical history, physical examination, and X-ray studies known as lymphoscintigraphy. Additional tests such as blood tests and computed tomography (CT) may be performed to rule out other diseases. In some cases, the healthcare provider may order lymphangiography, where a dye is injected into a lymph vessel to identify blockages.

Treatment of Lymphedema:

The treatment for lymphedema depends on its underlying cause. Primary lymphedema may be managed through leg elevation, leg massage, and the use of elastic compression stockings. These stockings must be properly fitted and have the appropriate pressure to be effective. They are available in various types, including knee-high, thigh-high, and pantyhose.

For long-standing lymphedema cases, surgery may be considered in cases where leg size continues to increase despite treatment, legs do not function well, recurring leg infections occur, or there are cosmetic appearance concerns. A vascular surgeon experienced in surgical lymphedema treatment should be consulted in such cases.

In secondary lymphedema, addressing and treating the underlying cause, such as prostate or breast cancer, is essential for effective management.