Lymphedema is an accumulation of fluid that can collect in any body part but most typically arms or legs, when lymph
vessels or lymph nodes are blocked or removed. Lymphedema is also found in the face, neck, stomach and genitals.
The lymphatic system is part of the body’s circulatory system and a vital part of the immune system. The lymphatic
system runs parallel with the circulatory system and removes bacteria, proteins, cellular waste and excess water from
the tissues. Lymph nodes are bean-shaped structures that filter fluid and fight bacteria. When these nodes are
damaged, insufficient or surgically removed, lymph fluid backs up and becomes stagnant. The surrounding tissue then
swells, thickens and becomes painful. Bacteria in this environment can multiply and greatly increase the risk of
infection.
Primary Lymphedema is usually due to either a congenital absence of, or abnormalities in, the lymphatic system. It can
be hereditary (Milroy Disease), lymphedema praecox (onset during puberty), or lymphedema tarda (onset later in life).
Primary Lymphedema is more prevalent in females than males.
Secondary Lymphedema is caused by an inadequate lymphatic drainage system due to constriction or obliteration
from surgery, radiation, trauma, malignancies or infections. Secondary Lymphedema can develop immediately post-
operatively, or weeks, months and sometimes several years later
Lymphedema and the Breast Cancer Patient
Edema of the arm after axillary lymph node dissection is the most common cause of lymphedema. In general,
regardless of individual surgical approach or elapsed time since treatment, approximately one in four women will
develop arm edema after treatment for breast cancer.
Can Lymphedema Be Controlled?
With early identification and proper intervention, the condition can be treated and controlled, allowing the individual
to lead a full and normal life.
Treatment is provided using a combination of Manual Lymph Drainage, Combined Decongestive Therapy, Exercise
Therapy, Skin Care and Patient Education. MLD is a gentle, rhythmic, massage-like movement performed with a great
deal of precision. There is no pain, no side effects or reddening of the skin. CDT is the application of compression
bandaging to reduce the swelling of the edemous area. Both compliment each other and when a well-trained therapist
renders treatment, favorable results are obtained.
Combined Decongestive Therapy (CDT)
Combined Decongestive Therapy is a noninvasive treatment for Lymphedema. This therapy includes a variety of
techniques, including manual lymphatic drainage, compression, exercise, skin care and self-care management.
There are two phases of treatment:
Phase 1: Active Phase
Phase 2: Maintenance Phase
Combined Decongestive Therapy aims to reduce your swelling, improve the condition of your skin, increase your mobility,
reduce the risk of infection, enhance function and optimize your overall health.
vessels or lymph nodes are blocked or removed. Lymphedema is also found in the face, neck, stomach and genitals.
The lymphatic system is part of the body’s circulatory system and a vital part of the immune system. The lymphatic
system runs parallel with the circulatory system and removes bacteria, proteins, cellular waste and excess water from
the tissues. Lymph nodes are bean-shaped structures that filter fluid and fight bacteria. When these nodes are
damaged, insufficient or surgically removed, lymph fluid backs up and becomes stagnant. The surrounding tissue then
swells, thickens and becomes painful. Bacteria in this environment can multiply and greatly increase the risk of
infection.
Primary Lymphedema is usually due to either a congenital absence of, or abnormalities in, the lymphatic system. It can
be hereditary (Milroy Disease), lymphedema praecox (onset during puberty), or lymphedema tarda (onset later in life).
Primary Lymphedema is more prevalent in females than males.
Secondary Lymphedema is caused by an inadequate lymphatic drainage system due to constriction or obliteration
from surgery, radiation, trauma, malignancies or infections. Secondary Lymphedema can develop immediately post-
operatively, or weeks, months and sometimes several years later
Lymphedema and the Breast Cancer Patient
Edema of the arm after axillary lymph node dissection is the most common cause of lymphedema. In general,
regardless of individual surgical approach or elapsed time since treatment, approximately one in four women will
develop arm edema after treatment for breast cancer.
Can Lymphedema Be Controlled?
With early identification and proper intervention, the condition can be treated and controlled, allowing the individual
to lead a full and normal life.
Treatment is provided using a combination of Manual Lymph Drainage, Combined Decongestive Therapy, Exercise
Therapy, Skin Care and Patient Education. MLD is a gentle, rhythmic, massage-like movement performed with a great
deal of precision. There is no pain, no side effects or reddening of the skin. CDT is the application of compression
bandaging to reduce the swelling of the edemous area. Both compliment each other and when a well-trained therapist
renders treatment, favorable results are obtained.
Combined Decongestive Therapy (CDT)
Combined Decongestive Therapy is a noninvasive treatment for Lymphedema. This therapy includes a variety of
techniques, including manual lymphatic drainage, compression, exercise, skin care and self-care management.
- Manual Lymphatic Drainage (MLD): A light skin stretching technique that stimulates the lymphatic system. MLD uses light touch to move excess lymph and fluid out of the tissues and back into the lymphatic vessels.
- Compression/Bandages: Layered bandaging with foam or specially fitted garments that support the affected area to control swelling. Wearing a compression sleeve or elastic bandage may help to move fluid and prevent the buildup of excess fluid.
- Exercises: With compression, special exercises will help to pump lymph out of the swollen area.
- Skin Care: Keeping the skin clean and moisturized will help prevent infections that often can happen with lymphedema.
- Self-Care Management: Learning how to manage your lymphedema on your own is a key component in your treatment. Studies suggest to manage your symptoms, eat a healthy diet, control body weight and learning how to reduce injury to the area are important.
There are two phases of treatment:
Phase 1: Active Phase
- The goal of Phase 1 is to get the extra fluid out of the affected body region, to reduce visible swelling, and to reduce other symptoms
- Phase 1 includes: manual lymphatic draining (MLD), bandaging, exercises, skincare
- The number of weeks depends on the amount of swelling and tissue firmness
- It can last on average from anywhere from 2-4 weeks or even longer
- Bandages with foam are worn and are often only removed to bathe. Family patient education is essential
- Exercises are designed to help encourage the drainage of excess fluid from affected tissue
- Skin care is vital. It’s imperative to protect the skin in the affected area from drying, cracking, infection,and skin breakdown.
Phase 2: Maintenance Phase
- The goal of the maintenance phase is to maintain and maximize the achievements of Phase 1, and to gain long-term control of your lymphedema
- The maintenance phase includes: MLD, compression garments, exercises, and skincare
- You can expect to stick with phase 2 of CDT for many years or even for the rest of your life
- Elastic compression garments that fit like a second skin are worn during the day
- Exercises are done while wearing compression
- Self-manual lymphatic drainage is encouraged
Combined Decongestive Therapy aims to reduce your swelling, improve the condition of your skin, increase your mobility,
reduce the risk of infection, enhance function and optimize your overall health.