If you are suffering from lymphedema caused by cancer or cancer treatments and are unable to afford the proper care please inquire about our assistance program.
Understanding the importance of early and consistent treatment of lymphedema
Going through the diagnosis, treatment, and recovery of cancer, is one of the most challenging experiences a person will have. But survivors often say that the disease was “only the beginning.” Just when they feel like they have successfully beaten this demon, lymphedema appears, seemingly out of nowhere, and presents a whole new set of challenges.
Lymphedema (LE) is an accumulation of high protein fluid in the tissues surrounding the lymph vessels, resulting from a malfunction of the lymphatic system (LS). Two of the most common causes are cancer related surgeries and radiotherapy. When the LS becomes blocked by scar tissue from the necessary surgery, or by alteration of healthy tissue during radiation, the lymph fluid pools, causing a change in fluid pressures. As a result the accumulated fluid enters the tiny spaces between the cells, and collects there. It is not able to get back into the lymph vessels because of this mechanical malfunction.
In the face, neck and chest areas, for example, there may be areas of swelling, which will make one side appear larger than the other. Glasses may not fit as before; clothing may become uncomfortable due to tightness. However, swelling is often not visible. Head & neck, and facial edemas are often detected by patients reporting what they are feeling. Neck and throat edemas are often not detected as early as other edemas because they are hidden and patients become accustomed to the small changes that take place over time. Consequently they are often not discussed with their health care provider.
The most effective, long-term treatment for LE is Manual Lymphatic Drainage (MLD). This is a massage technique specifically designed to reroute the lymphatic fluid around the blocked area and drain it into a nearby functional area. In some patients, if this treatment is started early enough after their cancer treatment, small lymphatic vessels sometimes regrow around the blockage and establish a limited system of natural lymph flow.
If the fluid is allowed to remain in the tissues, several changes take place. The first thing patients notice is that their skin stretches to accommodate this excess fluid. As the fluid takes up residence in the tissues, it becomes more jelly-like and obstinate. The longer it stays, the more difficult it is to remove.
It can eventually affect neck rotation, posture, chewing, swallowing, facial expression, opening and closing of the mouth, speaking. Breathing can also become affected.
Another complication of untreated LE is cellulitis. This is a serious infection in someone without LE, but in someone with LE it becomes very serious. The lymphatic system houses the immune system and cellulitis is an infection which involves the lymphatic system. Each time an infection occurs, additional scar tissue is developed, resulting in further blockage, and subsequently increasing the extent of the lymphedema. The potential for developing very serious illness is immense. Proper management of LE helps prevent the occurrence of cellulitis, thus improving quality of life.
When seeking lymphedema therapy, it is very important to receive care from an adequately certified lymphedema therapist. A regular massage therapist or physiotherapist is not trained in this specialized technique. There are 17 certified lymphedema therapists who provide general care in Manitoba. Of these, 2 have taken specialty studies in head and neck cancer rehab.
For further information or to find an appropriate therapist, please contact:
Edith Mulhall (RN, RMT, CLT-LANA)
Lymphedema Association of Manitoba at www.lymphmanitoba .ca.