Blood and lymph flow in our body. Blood is a fluid that circulates throughout the body through blood vessels, and lymph is a fluid that circulates throughout the body through lymphatic vessels. Lymph contains less protein and more fat than blood, and contains many lymphocytes and white blood cells. Lymph circulates throughout the body, providing nutrients to each cell and taking in waste products.
Lymphedema｜Source: Getty Images Bank
Lymphedema is a disease in which lymph is abnormally accumulated in the skin and subcutaneous fat, causing swelling and chronic inflammation. It usually occurs on the arms or legs, but can also occur in other areas, such as the face, back, stomach, chest, and genitals. The typical symptom of lymphedema is that when you press the skin with your finger, the skin does not rise immediately, but remains there for a while, and then the depression disappears after a few seconds. This usually occurs in the early stages of lymphedema. Because only body fluids are accumulated, the skin is soft and the swelling improves just by raising the edema area higher than the heart.
If it progresses further, fibrosis of the tissue occurs and the skin does not enter even when pressure is applied, and the symptoms do not improve even if the edema site is lifted. Afterwards, the skin gradually becomes thicker and harder through a chronic inflammatory process, and the subcutaneous fat tissue accumulates and the appearance is deformed. In addition, it feels heavy and stiff and painful, making it uncomfortable to wear or move shoes. The area where lymphedema occurs is vulnerable to infection, and soft tissue infection and lymphangitis may occur. In severe cases, soft tissue necrosis may occur.
Lymphedema, what causes it?
First, it may occur due to congenital causes. This is called primary lymphedema. About 1 in 6,000 people have a congenital problem with lymphatic development. Because the function of the lymphatic system is reduced, even a minor wound or infection on an arm or leg can cause lymphedema.
Secondary lymphedema is a condition in which lymphatic vessels or lymph nodes are damaged, causing problems in the passage of lymph fluid. For example, the cancer can be caused by an obstruction to the flow of the lymphatic system, or it can be caused by an infection or trauma. In particular, lymphedema is common after cancer surgery to remove lymph nodes. Professor Song Jun-ho of the Plastic Surgery Department at National Health Insurance Ilsan Hospital said, “For women in Korea, lymphedema accounts for the majority of breast cancer patients. There are statistics that are patients with early-onset lymphedema that appeared within 3 years after surgery,” he said. He added, “The incidence of breast cancer is high in those in their 40s and 50s, so female breast cancer patients in these age groups should be especially careful.”
According to data released by the National Health Insurance Corporation, 28,109 people were treated for lymphedema in 2020. Of these, 7,063 were male and 21,046 were female. This is an increase of 9,277 from the number of patients in 2016, with an average annual growth rate of 10.5%. In 2020, the age group with the largest number of patients was in their 60s, accounting for 21.1% of the total. Those in their 50s were followed by 20.3%, followed by those in their 70s with 17.2%. In the case of men, the proportion of patients in their 70s was the highest, and the proportion of women in their 50s was the highest.
Lymphedema, to prevent
If the hand or arm is swollen, the upper extremity lift method, which raises the arm, is performed first. However, if you show signs of bacterial infection such as fever, pain, redness, or swelling on your hands or arms, you should take antibiotics at the hospital to prevent the disease from getting worse.
In everyday life, it is better to keep your arms higher than your heart. It is recommended to hold the position with your arms raised at 45 degrees off the floor for at least 30 to 60 minutes. At least 3 times a day, whenever you rest on the sofa, put your arm on the cushion to see a noticeable change.
Also, be careful not to injure the edema site. The fat layer of the skin thickens due to edema, and fungal or bacterial infection can easily occur. Therefore, it is necessary to check the skin for damage every day, and avoid injecting, drawing blood, or measuring blood pressure in the edema site.
Obesity is a risk factor for lymphedema. It is essential to maintain an appropriate weight, as shown in the study result that the volume of arm swelling was significantly reduced in the case of weight loss among obese people who underwent mastectomy for breast cancer. In addition, if you do moderate-intensity aerobic exercise such as walking, swimming, or cycling regularly, you will continue to contract and relax your muscles and move your joints. It can improve lymph flow, relieve swelling and prevent muscle loss. Wearing compression stockings or bandages during or after exercise can increase the effectiveness of exercise.
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