What is the Role of the Lymphatic System in Cancer Rehabilitation?

The two primary functions of the Lymphatic System are that it activates the inflammatory response and controls infections. In addition, the Lymphatic System drains protein-containing fluid from the tissue and conducts it in a unidirectional flow to the circulatory system.

What is Lymphedema?

Lymphedema is defined as an abnormal accumulation of lymphatic fluid in the tissue that causes swelling most often in the arm or leg but can develop anywhere in the body including the face, neck and chest. Lymphedema can develop when lymphatic vessels are missing or impaired (Primary) or when lymphatic vessels are damaged or removed (Secondary).

Who is at Risk?

Those who have had cancer in conjunction with node dissection and radiation therapy are most at risk for lymphedema. Lymphedema can occur immediately postoperatively, within a few months, or years after cancer therapy. With proper education and care, lymphedema can be avoided or, if it develops, kept under control.

Signs and Symptoms

Swelling in the arm, leg trunk or pelvis any time after surgical removal of lymph nodes and/or radiation treatment

What is Combined Decongestive Therapy (CDT)?

CDT is a gentle treatment technique, provided by a specially-trained health professional, which has been proven safe and effective for reducing swollen areas to normal or near normal size. When lymphedema is diagnosed promptly and CDT is begun early, patients can enjoy productive lives with few complications and little or no lifestyle restrictions.

CDT normally consist of 4 phases:

1. Skin care including cleansing, lubrication, debriding and administration of lotion.
   
2. Manual lymph drainage is a form of gentle massage that stimulates and directs lymphatic flow towards adjacent functioning lymph systems.
   
3. Compression therapy is the application of compression to the limb, which aids in reducing swelling and assists in the removal of lymph fluid.
   
4. Exercise therapy is a key component in stimulating venous and lymphatic flow. Exercises are aimed at augmenting muscular contraction, enhancing joint mobility, strengthening the limb, and reducing the muscle wasting that frequently occurs with lymphedema.