Lymphatic fluid circulates throughout the body and is essential to keep our tissues healthy and plays a major role in fighting off infections. Disruption to the lymphatic system, made up of a network of vessels, tissues, and organs, can make filtering out these protein molecules harder.
Damage or disruption in lymphatic drainage can lead to lymphedema, the swelling caused by excess lymphatic fluid. Primary lymphedema is caused by genetic mutation due to which the lymphatic system is improperly developed and its ability to effectively drain fluids is compromised.
What is secondary lymphedema?
Secondary lymphedema results from a damage leading to an obstruction of normally functioning lymph vessels or lymph nodes and it may occur in the extremities, trunk, head and neck, abdomen, and external genitalia. The causes that obstruct the lymph nodes or lymph vessels may include tumor, surgery, post-irradiation fibrosis, infection, filariasis, thyroid disease, obesity, and chronic venous insufficiency.
Filariasis is the most common cause of secondary lymphedema globally. India has more cases of lymphoedema than any other country on the planet because of the high numbers of cases of lymphatic filariasis.
In mainland India, Wuchereria bancrofti transmitted by the ubiquitous vector, Culex quinquefasciatus, has been the most predominant infection (over 95%) and the remaining infection by B. malayi, and they are commonly called Bancroftian and Brugian filariasis respectively. Chronic infection causes lymphatic dysfunction, resulting in progressive, irreversible swelling of the limbs and genitals.
W. bancrofti, Brugia malayi or Brugia timori infect the lymphatic system of humans, who are the definitive host. Following filarial infection, the body generates an inflammatory immune response that results in lymphatic obstruction leading to lymphedema.
Cancer and related treatments
The highest incidence of secondary lymphedema is observed following surgery and radiation for malignancies, particularly among those individuals affected by breast cancer. Lymphedema often occurs in patients who had all, or part of their breast removed and axillary (underarm) lymph nodes removed. Various studies in women with Lymphedema following breast cancer treatment has reported the incidence to be in a wide range between 2% – 40%.
It is also common with related treatments for uterine cancer, prostate cancer, lymphoma, or melanoma and malignancy of head and neck.
Clinical studies have also revealed that obesity and postoperative weight gain are significant risk factors for lymphedema.
Why does lymphedema develop after cancer treatment?
Any kind of surgery that requires the removal of lymph nodes can lead to the onset of lymphedema. Breast conserving (lumpectomy) surgery or the more extensive breast surgery (mastectomy) involve the dissection (removal) of lymph nodes and subsequent damage to the lymph vessels. The condition may get further aggravated with radiation therapy that follows the procedure.
The cancer treatment done with an aim to eliminate the cancer cells and save the patient’s life can result in lymph nodes removal and damage of lymphatic vessels. It leads to the disruption in the transport of lymphatic fluid. Following surgery, if the remaining lymph vessels are unable to compensate for the damaged vessels, it may lead to the accumulation of lymphatic fluid in the tissues. This causes abnormal swelling in the upper and lower extremities; however, other areas might also be affected at times.
Other lesser common causes of secondary lymphedema include surgeries other than for the treatment of cancer or trauma that disrupts the lymphatic system. Sometimes large tumors grow in the soft tissues which can cause a physical block on lymphatic structures subsequently blocking the normal flow of lymphatic fluid.
Patient education about the possibility of developing secondary lymphedema, combined with appropriate observation and prompt symptom reporting following cancer treatment, can reduce the occurrence and progression of secondary lymphedema.
Though Lymphedema is incurable, an early start of treatment will ensure that the swelling and associated pain is under control. Our doctors at Avis vascular center can help you to effectively manage the condition.
Lymphedema Treatment In Hyderabad
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