Lymphoedema

Combined Decongestive Therapy (CDT) 

The lymphatic system is an important part of our immune system. and plays a role in fighting infections and destroying old or abnormal cells, such as cancer cells.

The lymphatic system is a continuous system of thin tubes and lymph nodes that runs throughout the entire body. These vessels are called lymph vessels or lymphatic vessels. The lymphatic system also includes organs such as the Spleen, Thymus, Tonsils and Adenoids. 

In lymphoedema there is a build up of lymphatic fluid that causes a swelling in an area of the body. Unfortunately, Lymphoedema cannot be reversed but it can be well controlled.

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Lymphoedema occurs there is a dysfunction in the lymphatic system resulting in the inability of the lymphatic system to drain excessive lymphatic fluid. This causes an accumulation of fluid within the tissues causing swelling. 

Lymphoedema related to cancer may develop when the cancer blocks a lymph node or lymph vessels or the treatment received for cancer removes or damages part of the lymphatic system.

​Lymphoedema is most commonly seen in the following Cancers:

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• Breast cancer
• Prostate cancer
• Vulval (vulva) cancer
• Cervical (cervix) cancer
• Uterine (Womb) cancer
• Bladder cancer
• Penile (penis) cancer
• Lymphoma
• Melanoma skin cancer
• Head and neck cancer

The risk of Lymphoedema increases with:

• Surgery to the lymph nodes
• Radiotherapy directly to the lymph nodes or to an area of the body where there are lymph nodes
• Complications after surgery to the lymph nodes, such as infection
• Advanced cancer
• Being very overweight
• Being born with a body structure that puts you at higher risk (congenital predisposition)
• Varicose veins or other blood vessel problems in the area of the body where you are having cancer treatment
• Getting a skin infection after surgery or radiotherapy
• Not being able to move around as poor mobility makes it more difficult for the lymph fluid to move through the lymphatic system

Research has shown:

• About 2 out of 10 people (20%) with breast cancer develop lymphoedema
• About 5 out of every 10 women (50%) who have treatment for cancer of the vulva get lymphoedema
• About 3 out of every 10 men (30%) with cancer of the penis get lymphoedema
• The number of people who get lymphoedema after treatment for melanoma in the lymph nodes in the groin shows lymphoedema occurs in about 2 and 5 out of every 10 people (20 to 50%)

The aim of treatment for Lymphoedema is to reduce swelling where possible, prevent problems such as infection, encourage a return to normal daily tasks and maximise independence. Once the treatment has reduced swelling, it is very important to engage in self-management strategies to maintain the limb or body part affected. 

The 4 components of CDT are:

• Skin care: by keeping skin in the swollen area clean, dry and moisturised and preventing injury and infection
• Reducing swelling with MLD
• Compression including bandaging, compression pumps, or compression garments
• Exercise to keep lymph flowing through the lymphatic system and help maintain a healthy weight

​Reference Cancer Research UK