Lymphedema is the build-up of lymph fluid in tissues that results in swelling. It has been estimated that more than 3 million Americans experience this condition. However, due to a variety of measurement techniques, most research data is unclear about clear lymphedema rates. More than knowing the widespread statistics, what matters to our patients is that they understand their condition and how to manage it.
It has been speculated that as much as 40 percent of the 3 million people who survive breast cancer develop lymphedema as a result of their treatment. Generally, breast cancer treatment involves the removal of one or more lymph nodes. The more nodes that are removed, the higher the incidence of lymphedema. This is because the lymph nodes are critical in moving lymph matter through the body.
In addition to breast cancer survivors, others who are typically at risk for lymphedema include patients who have undergone radiation treatment for conditions such as testicular cancer, ovarian cancer and other gynecological cancers, liver cancer, prostate cancer, pancreatic or colorectal cancer, and malignant melanoma. The risks of secondary lymphedema are vaguely understood but do seem to relate to the type of cancer requiring lymph node dissection. For example, some studies indicate that up to 80 percent of malignant melanoma treatments can result in lymphedema.
Anytime lymph node dissection occurs, it is beneficial to discuss the value of early and routine screening for lymphedema after therapeutic treatment has been completed. Multiple studies indicate that the early detection of latent lymphedema correlates with successful treatment of recurrent or persistent swelling.
Multiple methods of lymphedema screening exist. These include:
- Water displacement measures the volume of a limb by placing part of all of that limb in a container of water. The excess water that is displaced into a measuring container indicates limb volume.
- Circumferential measurement involves a tape-measure recording the circumference of a limb at various points. This screening tracks circumference over several screenings.
- Infrared scanning is a sophisticated method of measurement achieved with parallel arrays of infrared light beams aimed at specific angles.
- Bioelectrical impedance spectroscopy has been used for decades for whole-body scans. For lymphedema, the technique estimates extracellular fluid by measuring the opposition to a small electrical current through tissue.
Several lymphedema screenings may be available and each may offer specific advantages. More than the technique itself, experts agree that consistency is a critical aspect to the successful observation of lymphedema.
Lymphedema can be a frustrating burden to carry. Don’t do it alone. Contact our office at Keck Medicine of USC to schedule your consultation with Dr. Ketan Patel.