Lymphoedema, Bladder Cancer & Lymph Node Removal Blog :

1. What is Lymphoedema?

Lymphoedema is the accumulation of excessive amounts of protein-rich fluid resulting in swelling of one or more regions of the body. This is due to a mechanical failure of the lymphatic system and occurs when the demand for lymphatic drainage exceeds the capacity of the lymphatic circulation. The condition usually affects the limb(s) although it may also involve the trunk, breast, head and neck or genital area. The lymphatic system is a network of vessels and nodes throughout the body that transports fluid (lymph) from the body tissues back to the bloodstream. The functions of the lymphatic system are to maintain the volume and protein concentration of the extracellular fluid in the body and to assist the immune system in destroying pathogens and removing waste products from the tissues.

2. What causes lymphoedema?

Lymphoedema may arise because the lymphatic vessels or nodes have been damaged or were not formed correctly. Secondary lymphoedema is the most common type developing following damage to the lymphatic system. The damage may occur as a result of some cancer treatments including the removal of lymph nodes, following radiotherapy to lymph node groups or with the progression of malignant disease. The onset of lymphoedema may be at any time. It may occur within months of the damage or it may appear years later.

Lymphoedema is understood to be a progressive disease and early intervention is recommended to minimise time and age related changes. The swelling may progress without treatment. The skin is prone to thickening and the development of fibrosis and other secondary changes. When the lymphatic impairment causes the lymph fluid to exceed the lymphatic system's ability to transport it, an abnormal amount of protein-rich fluid collects in the tissues of the affected area. Left untreated, this stagnant, protein-rich fluid causes tissue channels to increase in size and number, reducing the availability of oxygen. This interferes with wound healing and provides a rich culture medium for bacterial growth that can result in infections: cellulitis, lymphangitis, lymphadenitis, (in severe cases sepsis) and skin ulcers. It is vital for lymphoedema patients to be aware of the symptoms of infection and to seek treatment at the first signs, since recurrent infections, in addition to their inherent danger, further damage the lymphatic system and set up a vicious cycle. The ALA has developed best practice guidelines in relation to cellulitis - The Management of Cellulitis in Lymphoedema available here.