1. What does lymphedema look like ?

2.  Lymphedema is a condition that results from impaired flow of the lymphatic system  Secondary lymphedema results from an identifiable damage to or obstruction of normally-functioning lymph vessels and nodes.  lymphedema is most commonly caused by filariasis (a parasite infection)lymphedema most commonly occurs in women who have had breast cancer surgery, particularly when followed by radiation treatment. What is Lymphoedema ?

3. Symptoms Lymphedema signs and symptoms, which occur in your affected arm or leg, include: Swelling of part or all of your arm or leg, including fingers or toes. A feeling of heaviness or tightness. Restricted range of motion. Aching or discomfort. Recurring infections. Hardening and thickening of the skin (fibrosis)

4. Surgical treatment of cancer Cancer cells spread through the lymphatic system, so treatment can involve surgically removing parts of the lymphatic system that contains cancerous cells. There is a particular risk of lymphoedema occurring as a complication of treatment for:  breast cancer  melanoma skin cancer  gynaecological cancers – such as cervical cancer and vulval cancer  genitourinary cancers – such as prostate cancer or penile cancer

5. Lymph nodes (or glands) are part of your body’s lymphatic system. When diagnosed with cancer, your doctor may need to remove one or more of your lymph nodes. This may be done before you have any surgery to see if the cancer has spread It’s also possible that previous tests may have shown that the cancer has reached the lymph nodes. If this is the case, you may have them taken out at the same time as an operation to remove the cancer. Removal of lymph nodes as a consequence of cancer treatment

6. Diagnosis People who have cancer are at risk of developing lymphedema Tests may be occasionally assessed and monitored Numerous tests are used for lymphedema Thorough medical history and physical examinations are done CT or MRI scans may be useful to help define lymph node architecture Doppler ultrasound scans are sound wave tests used to evaluate blood flow

7. Thorough medical history and physical examinations are done CT or MRI scans may be useful to help define lymph node architecture Doppler ultrasound scans are sound wave tests used to evaluate blood flow

8. Treatment for Cancer Radiotherapy  Radiotherapy uses controlled doses of high- energy radiation to destroy cancerous tissue, but it can also damage healthy tissue.  If it's necessary to use radiotherapy to destroy cancerous cells in your lymphatic system, there is a risk that the system could become permanently damaged and unable to drain fluid properly.

9. Treatment for Cancer  It can be given both externally and internally.  External radiotherapy aims high-energy x-rays at the affected area using a large machine.  Internal radiotherapy involves having radioactive material placed inside the body.  Radiotherapy works by destroying cancer cells in the area that’s being treated. Normal cells can also be damaged by radiotherapy, which may cause side effects. Cancer cells cannot repair themselves after radiotherapy, but normal cells usually can.

10. Treatment for Cancer Complete Decongestive Therapy  Complete decongestive therapy (CDT), also called complex decongestive therapy, is an intensive program that combines many of the different treatment approaches discussed in this section, including bandaging, compression garments, manual lymphatic drainage, exercise, and self care.

11. Treatment for Cancer Complete Decongestive Therapy  Phase I CDT is all about getting the extra lymph out of the arm, hand, or other part of the upper body to reduce visible swelling and other symptoms of lymphedema.  Phase II CDT is about maintaining the results of the initial intensive phase on your own. Although individual treatment plans vary, you can expect to stick with phase II of CDT for many years or even for the rest of your life.

12. Treatment for Cancer Manual Lymphatic Drainage  Treatment for oedema following orthopaedic, cosmetic, knee or hip surgery.  Manual lymphatic drainage (MLD) is a type of gentle massage which is intended to encourage the natural drainage of the lymph, which carries waste products away from the tissues back toward the heart.

13. Treatment for Cancer  The lymph system depends on intrinsic contractions of the smooth muscle cells in the walls of lymph vessels (peristalsis) and the movement of skeletal muscles to propel lymph through the vessels to lymph nodes and then beyond the lymph nodes to the lymph ducts which return lymph to the cardiovascular system. Manual lymph drainage uses a specific amount of pressure (less than 9 ounces per square inch) and rhythmic circular movements to stimulate lymph flow

14. References http://www.nhs.uk/Conditions/Lymphoedema/Pages/Diagnosis.aspx http://www.medicinenet.com/lymphedema/page3.htm#how_is_lymphed ema_diagnosed http://www.medicinenet.com/lymphedema/article.htm http://www.breastcancer.org/treatment/lymphedema/treatments/cdt https://en.wikipedia.org/wiki/Manual_lymphatic_drainage http://www.macmillan.org.uk/information-and- support/treating/radiotherapy/radiotherapy-explained/what-is- radiotherapy.html#44473 http://www.lymphoedemani.com/Treatment/Complex-Decongestive- Therapy-(CDT).aspx