The Most Serious Form Of Lymphedema and What Causes It
© Keith Smiley
Secondary Lymphedema can develop as a result of surgery, radiation, infection or trauma. Surgery for melanoma or breast, gynecological, head and neck, prostate or testicular, bladder or colon cancer all currently require removal of lymph nodes which put patients at risk of developing secondary lymphedema.
Secondary lymphedema can develop immediately after surgery, or weeks, months and even years later. It can develop when chemotherapy is unwisely administered to the already affected area. (the side on which the surgery was performed) or after repeated aspirations of seroma (a pocket of fluid which occurs commonly after surgery) in the axilla, around the breast incision, or groin area. This often causes infection and eventually, lymphedema.
Flying has also been attributed to the onset of lymphedema in patients who fly after surgery (likely due to the decreased cabin pressure). It is recommended that patients who have to fly after surgery wear a compression garment, either a sleeve or stocking, even if you do not have lymphedema.
Another cause of lower extremity lymphedema results from the use of Tamoxifen. This medication can cause blood clots and DVT (deep venous thrombosis).
Radiation therapy, used in treating various cancers and some AIDS-related diseases like Kaposi-Sarcoma, can damage otherwise healthy lymph nodes and vessels. This can cause scar tissue to form which interrupts the normal flow of the lymphatic fluid. Radiation can also cause skin dermatitis or a burn similar to sunburn. It is important to closely monitor the radiated area for any skin changes, such as increased temperature, discoloration or blistering which can lead to the development of lymphedema.
Lymphedema can develop secondary to lymphangitis which is an infection that interrupts normal lymphatic pathway function. A severe traumatic injury in which the lymphatic system is interrupted and/or damaged in any way may also trigger the onset of lymphedema. There is a form of lymphedema called Filariasis which is very rare in developed countries. However, it affects as many as 200 million people worldwide primarily in the endemic areas of southeast Asia, India and Africa. When the filarial larvae from a mosquito bite enters the lymphatic system, these larvae mature into adult worms in the peripheral lymphatic channels, causing severe lymphedema in the arms, legs and genitalia. This is also know as elephantiasis.
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