Patient Fact Sheet – Lymphoedema

By Dr Kheng Soo, Consultant Physician at Ringwood Private Hospital

What is Lymphoedema?

Lymphoedema is swelling from the build-up of protein-rich fluid, called lymph, that does not go away. Lymphoedema happens when the lymphatic system is not working properly, such as damage from cancer or cancer treatment (especially surgery to remove lymph nodes). Lymphoedema is most common in the first few months after surgery or injury to the lymphatic system but can also appear at any time, including years later.

Lymphoedema may also happen without a cancer diagnosis, often due to obesity, injury, infection or immobility. Lymphoedema most commonly affects the arm or leg(s), although it can appear anywhere in the body. 

Not all swelling is lymphoedema. It is common to get swelling near the surgical site immediately after surgery that can take several weeks to go away completely. Other conditions, like blood clots or problems with the veins, can cause swelling. Further tests may be required to find out the cause.

What are the risk factors for developing lymphoedema?

Around 20% of breast, genitourinary, gynaecological or melanoma survivors experience lymphoedema. Key risk factors include surgery to remove lymph nodes and radiotherapy. Other risk factors involve injury, infection, high body weight and immobility.

What are the symptoms of lymphoedema?

Talk to your doctor for advice if you notice any of the following signs:

• Swelling
• Tightness of clothing, shoes or jewellery (such as rings), particularly on one side
• Change in sensation (feeling heavy, tight or full) where the swelling is
• Discomfort, aching or heaviness where the swelling is
• Recurrent skin infections called cellulitis

If lymphoedema is severe, sometimes lymph fluid leaks from the skin (lymphorrhoea). If this happens, you should seek medical advice as soon as possible.

What can be done to help prevent it?

Early diagnosis and management of lymphoedema is the key! Education and ongoing monitoring can help with early detection. Recent evidence shows that the early detection of fluid build-up by routine monitoring with bio-impedance spectroscopy combined with early interventions reduces the risk of progression of breast cancer-related lymphoedema by as much as 81%. Keeping the skin healthy, using the affected limb as normal as possible, avoiding extra load on the lymphatic system and maintaining ideal body weight can also help prevent and manage lymphoedema.

What should I do if I am worried about lymphoedema?

If you are worried about any swelling, speak to your doctor or nurse about getting assessed for lymphoedema or a lymphoedema clinic referral. Health professionals with specialised knowledge in lymphoedema may include: lymphoedema nurses, breast care nurses, doctors, physiotherapists and occupational therapists. Look up the National Lymphoedema Practitioners Register (NLPR) ) by the Australian Lymphology Association (ALA) to find a qualified lymphoedema therapist.

How is lymphoedema treated?

Lymphoedema treatment aims to reduce swelling and the immediate impact of the condition and prevent long-term complications such as infections. An individualised treatment plan may include a combination of:

• Learning things you can do to manage the condition
• Taking care of your skin 
• Regular exercises to improve lymphatic return 
• Draining lymph fluid by massage (manual lymphatic drainage)
• Applying compression
• Low-level laser therapy
• Maintaining ideal body weight
   

---

Lymphoedema Clinic at Ringwood Private Hospital

The Lymphoedema Clinic at Ringwood Private Hospital is a multidisciplinary lymphoedema service with consultant physician and lymphoedema therapists working together to provide comprehensive lymphoedema care. We have access to a wide range of lymphoedema treatment, including manual lymphatic drainage, compression bandaging, compression garments, sequential intermittent pneumatic compression, lymphoedema taping and low-level laser therapy.

For more information, please contact:
Lymphoedema Clinic | Ringwood Private Hospital
36 Mt Dandenong Rd, Ringwood East VIC 3135
Phone 03 8804 4050   Fax 03 8804 4199