Awareness & Causes
Although lymphedema has afflicted children and adults for centuries, little understanding about the disease of the lymphatic system has existed until relatively recently. Not until 1934 was primary lymphedema described as a clinical entity, and it is only in the past 10 to 15 years that have therapists and clinicians have begun to focus more vigorously on its treatment.
According to the World Health Organization, lymphedema affects over 250 million people worldwide. Others estimate that 1 in 25 people will suffer from some form of lymphedema in their lifetime. According to the American Cancer Society, approximately 400,000 of the 2 million breast cancer survivors in the United States cope with lymphedema. In the industrialized world, the rate of cancer and venous disease continues to climb each year. Along with it, the incidence of lymphedema has skyrocketed.
Despite these startling numbers, research into the causes and treatments of lymphedema has been almost non existent until recently. Even today, with the advanced medical technology available, neither the condition nor the lymphatic system itself is completely understood. The unfortunate result of this lack of knowledge is that far too many patients are being left untreated and may therefore suffer a lifetime of unnecessary pain and discomfort.
Primary Lymphedema involves the leg(s) due to an absence of lymphatic vessels, too few lymphatic vessels or lymph nodes, hugely dilated lymphatic vessels and venous abnormalities.
Defined by the onset of the condition:
- Milroy’s Disease (present at birth)
- Lymphedema Praecox (begins in adolescence; appears during puberty, mostly in females and usually affects one lower extremity)
- Lymphedema Tarda (begins after 35 years of age; occurs in both male and female adults; onset is sudden with no apparent cause and can affect one or both extremities)
Secondary Lymphedema is most often acquired after cancer surgery requiring axillary/groin node dissection and/or radiation therapy. It affects the arm(s) after breast cancer treatment or the leg(s) after melanoma and gynecological cancer (cervical, ovarian and vulvar) treatment. Occasionally, lymphedema occurs after bladder or prostate cancer treatment.
Additionally, Secondary Lymphedema can develop secondary to Chronic Venous Disease whereby the patient has Venous Lymphatic Insufficiency. Venous Insufficiency can be caused by deep vein thrombosis (post blood clot), post phlebitic syndrome (inflammation of the veins) and venous stasis ulcers (open sore, usually located on the inside of ankle).
Sometimes, we see Secondary Lymphedema develop after a patient has multiple cellulitis or lymphangitis infections and/or trauma to the extremity(ies).