Lymphoedema

What is lymphoedema?

Lymphoedema develops when too much protein-rich fluid (lymph) accumulates in the tissues. When the lymphatic drainage system is damaged, usually due to surgery or radiation treatment, it can't transport the fluid out of the tissues and return it to the bloodstream. This causes swelling, which can become permanent if left untreated. It might also lead to skin infections and cellulitis.

Lymphoedema can develop within months of treatment or years later. The onset is usually gradual.

Lymphoedema is a progressive, chronic condition that develops in stages:

• Stage 0 A stage where swelling isn't obvious, even though the lymphatic system has been damaged
• Stage I In this early stage, lymph fluid accumulates in the tissues, causing swelling that goes down with elevation. There may be some "pitting" (an indentation that remains after pressure is applied to a small area)
• Stage II Elevating the area doesn't reduce the swelling and pitting is obvious
• Stage III The tissue is hard and no longer pits. The overlying skin thickens, gradually becoming discoloured and increased fat deposits develop. At this stage the affected area is usually very swollen and the swelling is irreversible

It’s important to know the early signs and symptoms of lymphoedema:

• Swelling of the arm, hand, breast or trunk
• Infection
• Aching, heaviness, stiffness on the affected side or limitation of movement
• Tightness or temperature changes to areas of the body. Jewellery or clothing may feel tighter than usual.
• The swelling may be aggravated by heat, overuse and prolonged inactivity. It can be more obvious at the end of the day.

If diagnosed and treated early, lymphoedema can be controlled and reduced. Early treatment can prevent infection, improve range of movement and enhance your wellbeing.

Risk factors:

• The extent of surgery, lymph node removal, radiation treatment
• Skin infections on or near the affected area
• Injury such as sprains, fractures, cuts or wounds on the affected side
• Obesity and immobility
• Constriction from tight clothes, jewellery or blood pressure tests.
• Exposure to excessive heat including sunburn.

It's better to use your unaffected limb for blood pressure recording, blood tests, injections and IV drips.

Learn more about lymphoedema after breast cancer

A lymphoedema therapist makes all the difference. The sooner you are assessed and start treatment, the sooner you can take control.

In New Zealand the current treatment for lymphoedema is based on the five “cornerstones” of care:

• Light touch massage
• Compression bandages or garments
• Special care of the limb/area
• Exercise
• Medical taping.

If you've been diagnosed with lymphoedema following breast cancer surgery, or are at high risk, we can help fund lymphoedema treatment.

To get started, apply for funding today:

• Visit Lymphoedema NZ to find out more about lymphoedema therapy in New Zealand
• Head to the Australasian Lymphology Association website
• For lymphoedema support groups in New Zealand, visit the Lymphoedema Support Network