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Lymphedema is an abnormal accumulation of protein-rich fluid in the interstitium or fluid-filled spaces existing between different structures in the body, such as cells or skin. This causes chronic inflammation and active fibrosis of the affected tissue and can present in different parts of the body due to different medical reasons and with different severities.
Specialists with Spaulding Outpatient Rehabilitation at Kent Hospital are here to help alleviate discomfort and pain and work to create an individualized approach for each patient. They see varying patients suffering from different forms of lymphedema in addition to those who may be recovering from breast cancer. Proper lymphedema management can reduce the build-up of lymphatic fluid in the arms, legs, head, and neck.
Spaulding Outpatient Center of Kent Hospital | East Greenwich
A Kent Hospital Facility
1351 South County Trail, Building 2, Suite 200A
East Greenwich, RI 02818
P: (401) 886-4650
F: (401) 886-7084
Our team is dedicated to patient-centered care and individualizing every plan with patients. Some treatments may include:
Our trained clinicians are committed to helping you manage this complex disorder through education, training, counseling, and recommended support groups to meet your needs.
Lymphedema is a condition that results in an accumulation of protein-rich fluid. This causes swelling, usually in the arms and legs. Some cancer treatments can put a person at risk for lymphedema. It can occur immediately after treatment or many years later. Lymphedema can develop after surgery or radiation for any type of cancer that affects the lymph nodes or the lymph drainage.
But it most often occurs after treatment for patients with breast cancer, pelvic cancers (such as prostate or uterine cancers), lymphoma, or melanoma.
Lymphedema is a condition that can be treated, not cured. If left untreated, this protein-rich fluid can cause the lymphatic system’s channels to grow larger. It can also reduce the amount of oxygen that is transported in the body. This affects the healing of wounds and encourages bacteria growth that may lead to infection.
It is unclear why some patients develop lymphedema, and others do not.
Axillary Web Syndrome is also known as “cording syndrome” and commonly occurs following breast cancer surgery that involves the removal of axillary lymph nodes. This causes the lymphatic vessels connected to removed nodes to undergo fibrosis and harden, creating rope-like tendons that can run down the arm. The hardening of these lymphatic vessels causes increased pain, restricted range of movement of the affected extremity and can greatly impact function.
It’s unclear at this time as to what exactly causes axillary web syndrome. Fortunately, trained therapists use manual techniques including soft tissue mobilization, myofascial release, manual lymph drainage of the affected extremity as well as stretching and flexibility exercises to promote movement, reduce pain/discomfort. This condition can materialize after incidences of breast cancer that result in mastectomies, lumpectomies, and lymph node removal.
Typically, lymphedema has been most prevalent in women who have had breast cancer treatment in the United States. However, research is now linking human papillomavirus (HPV) directly to Oropharyngeal (tongue and throat) cancers with men. This accounts for the majority of the cases, and currently has the highest prevalence, in men between the ages 40- 55 years old.
With increased instances of Oropharyngeal cancer, the incidence of lymphedema following lymph node removal, glossectomy (removal of tongue cancers), as well as radiation treatment is also increasing.
Lymphedema can develop as a direct result of any lymph node removal and/or injury to lymphatic vessels, traumatic injuries/ blunt trauma to all extremities, chronic venous insufficiency, orthopedic surgeries resulting in lymphatic edema (common with knee replacements), or infections related to damage of lymphatic vessels.
Although rare, lymphedema can also be inherited. This is called primary lymphedema. It is a result of abnormalities in the development of lymph vessels in the body from birth. A trained therapist will utilize the same interventions (complete decongestive therapy) to manage primary lymphedema as they do for secondary.
Manual lymph drainage can be utilized for open wounds to promote the healing process, enhancing fat-soluble nutrient absorption/ immune system function (Infections must be under control to prevent spread), chronic inflammation, acute inflammation, rheumatoid arthritis, reflex sympathetic dystrophy, and cyclic idiopathic edema.
For lymphedema, fluid is moved by a therapist from the swollen area into a place where the lymphatic system is working normally using certain skin movements to clear the area that they want the fluid to drain into. A patient is usually lying down or sitting up, depending on the location of the fluid.