What Is The Best Treatment For Lymphedema?
The recommended best treatment for stage 0 & 1 of lymphedema is decongestive lymphatic therapy (DLT). Surgery is the treatment for stage 2 & 3. There is no cure for lymphedema; the swelling can be controlled by the following methods.
Decongestive Lymphatic Therapy
Intensive Phase – With The Therapist
You may receive daily lymphedema treatment for several weeks to reduce the lymphedema of the affected body part by your therapist.
Maintenance Phase – Self Management
Intensive phase is followed by a maintenance phase where you will be encouraged to maintain the reduce lymphedema status by wearing compression garments, doing self-massage at home & continuing the exercises daily. Your doctor will review you every few months to check the progression of the treatment.
Components in the decongestive lymphatic therapy treatment:
Compression Bandages & Garments
Compression bandages/multi- layer bandaging is done by a trained therapist. Towards the end of intensive phase compression garments such as gloves, stockings or tights, sleeves, fitted garments will be measured for you. It helps by moving the lymph fluid out of the affected limb & reduces further lymph collection in the limbs by acting as counterforce to muscles. This stimulates more lymphatic drainage. Doing exercises while wearing compression bandages or garments helps the lymphatic drainage more.
Compression garments can be worn after a massage session to reduce the lymph fluid collecting back. Your doctor will show you how to apply a compression bandage, Velcro bandage or garment properly.
You should give special skin care & maintain healthy skin to reduce the chance of infections like cellulitis. Any cuts, scratches can create a door for the organisms to enter your body & this can give rise to an infection. Skin infections can damage your lymphatic system & cause lymphedema. Treat cuts, scratches immediately with an antiseptic cream. Moisturize your skin daily with an appropriate cream to keep it healthy. Take necessary precautions to avoid damage to your skin.
Exercises help the forward flow of lymph in the lymphatic system, thereby reducing the lymph collection. Walking, cycling, swimming also stimulates lymph drainage by the movement of muscles. There are special exercise you should do to reduce lymphedema. Your health care provider will teach you how to do those exercises.
Specialized Massage Techniques
This is known as manual lymphatic drainage (MLD). It’s a special massage therapy done by a trained therapist to move the lymph from the swollen areas to the lymph nodes which function normally. This helps the forward flow of lymph & reduces lymph collection & swelling. During the maintenance phase your therapist will teach you on how to do a self-massage which is called simple lymphatic drainage at home.
Weight Control & Maintenance
Maintain a normal weight; lymphedema can get worst with overweight.
Pneumatic Compression Devices
A pneumatic compression device (PCD) consists of an inflatable garment for the arm or leg & an electrical pneumatic pump that fills the garment with compressed air. This helps the lymphatic drainage.
In some people surgery may be used for the treatment of lymphedema. There are four main types of surgery that can be useful.
- Vascularized lymph node transfer – healthy lymph nodes are transferred to the affected areas & rewired to the lymphatic system to reduce the swelling.
- Lymphaticovenous anastomosis – this is done by connecting the lymphatic system to the veins nearby. Outpatient procedure with a small incision.
- Debulking – Removal of sections of excess skin & underlying tissue
- Liposuction – removal/suction of fat from the affected limb
We cannot say exactly the best treatment method for lymphedema is this method, as it depends on the stage of lymphedema, your fitness level, & other co-morbid conditions. Usually decongestive lymphatic therapy (DLT) is recommended for stage 0 & 1 lymphedema. Surgery is recommended for stage 2 & above stages.
- National Cancer Institute – Lymphedema (PDQ) Patient Version: https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-pdq
- Mayo Clinic – Lymphedema: https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682