Can lymphoedema be treated?
Why do some people develop lymphoedema and others don't?
Is all swelling lymphoedema?
Does lymphoedema mean the cancer has returned?
Why can't the fluid be drained off?
Would diuretics help?
Can the swollen areas be cut out?
Can my lymphoedema be cured?

Can lymphoedema be treated?

Yes, there are several ways of treating lymphoedema. Despite some scarring of the lymphatic system, some fluid does still drain away. However, it needs to be encouraged to find extra pathways through which to do this.

All treatments aim to restore the balance between the rate at which lymph is produced and the rate at which it drains away. Understanding the condition and receiving advice are both important.

Why do some people develop lymphoedema and others don't?

At present no one can explain why some people develop swelling and not others. Ongoing research suggests that there may be factors, other than scarring, which affect the development of lymphoedema. Further research into this is area is needed.

Is all swelling lymphoedema?

No, there are many reasons why swelling may develop. It is quite usual for swelling to occur immediately following surgery. This can happen as part of the healing process and should go away with little or no special attention. If you have swelling or are concerned contact your hospital doctor for advice.

Does lymphoedema mean the cancer has returned?

When swelling first appears, many people are worried that their cancer has returned. Although recurrent cancer can cause lymphoedema, this isn't often the case. Don't be alarmed if you notice an area of swelling, contact your hospital doctor for advice.

Why can't the fluid be drained off?

This sort of swelling doesn't often collect as a single pool of fluid. Instead it is spread throughout the tissues, making drainage difficult. Also lymph is formed in the tissues all the time and so would be replaced as quickly as it is drained.

Would diuretics help?

As a rule diuretics (water tablets) have little effect on this type of swelling. They tend to 'dry out' other parts of the body, rather than the lymphoedema, which isn't good for your general health.

Can the swollen areas be cut out?

Superficial waterlogged tissue can be removed by surgery but this tends to cause extensive scarring. Also an operation won't remove the cause of the swelling so lymph will still be produced and the lymphoedema will return.

Operations may be carried out to 'bypass' a blockage in the lymphatic system and to create new drainage routes. These rarely produce any long-term benefit. New surgical techniques are looking at creating new drainage routes for the lymph to drain into a vein by using microsurgical techniques. Whilst in the early stages, these surgical techniques may offer some promise for the future but further research is required.

Sometimes after severe swelling has been reduced by treatment, plastic surgery may be carried out to remove excess skin folds. However, this is not always recommended and should be discussed with your doctor. Liposuction has been carried out for lymphoedema. This can be painful and although it may reduce the size of a limb initially, it does not remove the cause of swelling. The swelling may reappear.

Can my lymphoedema be cured?

Lymphoedema can't be cured because glands and lymph vessels can't be replaced or repaired after treatment for cancer. However, for many people lymphoedema treatment can reduce the swelling considerably and this reduction can be maintained. In the very few cases where lymphoedema is caused by cancer, treatment for the cancer may result in reduction or disappearance of the swelling.

However successful the treatment for your lymphoedema, there will always be a risk of it returning. You should continue to wear supportive hosiery, as suggested by your lymphoedema therapist, and practise any lymphatic drainage techniques you may have been taught.

During and after your lymphoedema treatment you should also follow all the advice you have been given about the different aspects of treatment. You may be able to recognise what activities make your swelling worse and, by limiting these, feel in control of your lymphoedema.