Tuesday, December 2, 2008 - 11:35PM EST

Treatment Options for Lymphedema

Objectives of Treatment for Lymphedema

The objectives of treatment of lymphedema include:

  • Prevent progression of lymphedema (e.g. breakdown of skin infection)
  • Encourage the flow of lymph through unaffected vessels
  • Help patients cope with the psychological aspects of lymphedema
  • Improve the patient's overall quality of life

An essential aspect of lymphedema treatment is to educate the patient about the condition and teach preventive measures to minimize or prevent serious complications. Patient education is an important factor in the management of lymphedema in order to better control the condition and prevent complications. Management of lymphedema is a life long endeavor and the more the patient is familiar with the condition, treatment, and parameters of risk, the better and more effectively they can control the progression of the disease.

Currently, there is no general consensus among doctors regarding a uniform, standard treatment of lymphedema, although conservative treatment is typically initiated before more invasive approaches are considered. The lack of controlled clinical trials in this area is one reason for the lack of consensus. Treatment options are individualized to the patient's specific situation and take into account a variety of factors including the medical history, the extent and severity of the lymphedema, and the patient's overall health and lifestyle.

Treatment for lymphedema is a multidisciplinary task and involves several healthcare professionals including:

  • Lymphologist - doctor who is a specialist in lymphedema
  • Nurse
  • Lymphedema therapist - may be an occupational therapist, physical therapist, or massage therapist all of whom should be specially trained in treatment of lymphedema. As yet, there is no national certification of lymphedema therapists but the National Lymphedema Network recommends that therapists undergo a minimum of 135 hours of formal training and they also provide a partial listing of therapists who have conformed to these recommendations. For further information, please follow this link: http://www.lymphnet.org/pdfDocs/trainingnln.pdf
  • Psychologist - may be needed to help the patient cope with issues resulting from the significant cosmetic change that can occur in a limb, such as the size and skin changes. Self image and social issues can become quite overwhelming for the patient and they need to be addressed in order to minimize the impact of lymphedema on daily functioning.
  • Other related professionals related to many issues that the patient may have to deal with, such as skin problems, chronic wound care, loss of employment or reduced income, and reduced quality of life.

It is crucial for the patient to be a full partner in their treatment and to be well educated actively participate in their rehabilitation, treatment, prevention of complications, and safeguarding of the affected limb. The ISL notes that the most accurate indicator of treatment efficacy is the measurement of limb volume before, during, and after treatment.

In general, the treatment options for lymphedema include:

  • Complete Decongestive Physiotherapy
  • Pneumatic Pumps
  • Drug Therapy
  • Surgical Therapy

It is important for therapy to start as early and as quickly as possible to minimize damage and progression to fibrosclerotic changes in the tissue as these are irreversible. Strict compliance to treatment protocols is essential even though they may be uncomfortable, inconvenient, or time consuming. Treatment continues throughout the lifetime of the patient.