- Lymphedema is a condition caused by a blockage in the lymphatic system, resulting in swelling in tissues. It can be primary (genetic) or secondary (caused by cancer, surgery, radiation, etc.). - The lymphatic system plays an important role in fluid balance and immune function. Manual lymph drainage, compression therapy, skin care and exercise are key parts of complete decongestive therapy for lymphedema treatment. - Prevention through healthy habits like exercise, skin care and avoiding tight clothing can help reduce lymphedema risk. While there is no cure, treatment aims to manage swelling and prevent infection.

1. Lymphedema after
Cancer
BETTINA M
BROWN
Physical Therapist
Board-Certified Lymphedema Therapist
Board-Certified Wound Specialist

2. Lymphedema
Main Topics
• Define Lymphedema
• Learn basic concepts of
lymphedema
• Review Lymphedema
Prevention
• Discover the function of
lymphatic system
• Recognize Lymphedema
presentations

3. 3

4. PHILIP MCMASTER
(HARVARD
LECTURE 1942)
“The Lymphatic System
is arguably the most
neglected bodily
system, and as a result,
it’s contribution to
human disease in not
well understood.”
4

6. What is
Lymphedema?
6

7. Lymphedema
• Congenital condition
• Issue with the development
7
Primary Secondary
• Infection
• Trauma
• Cancer
• Surgery
• Radiation

8. Lymphedema term: clarified
8

9. Lymphatic System
Roughly parallels venous system, though highly variable
Terminal lymphatic capillaries originate where arterial-
venous capillary exchange occurs (dermis)
500-800 lymph nodes
Lymphatic fluid:
• White Blood Cells
• Plasma
• Electrolytes
• Water
• Protein
9

11. 11

12. Phases of Lymphedema
DocHealer This file is licensed under the Creative Commons Attribution-Share Alike 4.0 International license. 12
Stage 1 Stage 2
Stage 0 Stage 3

13. Common Symptoms of
Lymphedema

14. Physical Symptoms
14
Heaviness Fullness
Clothing fits
differently
Fatigue in
the limb
“Swelling”
Change in
appearance

15. Peau d’orange
15

16. Progression
• Usually progresses slowly and steadily
• Can happen at any time
16

17. If you notice any physical
changes-
seek out a lymphedema specialist
17

18. 18
What can a Physical or
Occupational Therapist
do?

19. 19
Cardiologist Physical/Occupational
Therapist
Dermatologist
Nephrologist

20. Foldi Institute
GERMANY

21. Golden Standard- CDT
Complete Decongestive Therapy
• Manual Lymph Drainage
• Skin Care
• Compression
• Exercise
21

22. Manual Lymph
Drainage
Light Pressure
Addresses Superficial Lymphatics
Increases Lymphatic Flow
Directional Pressure

23. Skin Care
Moisturize Skin
Gentle cleansing
Reduce risk of infection

24. Compression
Bandaging in the intense phase
Compression garments
Proper fit/pressure always important

25. Exercise
Stretching
Yoga & Tai Chi
Strengthening
Aerobic exercise

26. Diaphragmatic Breathing
26

27. LymphedemaTreatmentAct.org
27

28. The way to get started is
to quit talking and begin
doing.
Walt Disney
28

29. Prevention
• Maintain a healthy body weight
• Avoid limb constriction (tight jewelry, etc)
• Care and moisturize your skin
• Gentle stretch/exercise program
• Wear gloves when gardening
• Ask to have blood pressure taken on other arm
• If leg affected, wear hard-soled shoes when outside
29

30. Surgery
• Vascularized Lymph Node Transplant
• Lymphaticovenous Anastomosis
• Debulking
30

31. Summary
• Lymphedema Association of North America
• Speak to your surgeon/ medical provider
• It is not a fault-driven condition
31

32. References
9/3/20XX Presentation Title 32
• Baxter, G. D., Liu, L., Petrich, S., Gisselman, A. S., Chapple, C., Anders, J. J., & Tumilty, S. (2017). Low level laser therapy
(Photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review. BMC cancer, 17(1), 833.
https://doi.org/10.1186/s12885-017-3852-xittar, S., Simman, R., & Lurie, F. (2020). Lymphedema: A Practical Approach and
Clinical Update. Wounds : a compendium of clinical research and practice, 32(3), 86–92.
• Bonkemeyer Millan, S., Gan, R., & Townsend, P. E. (2019). Venous Ulcers: Diagnosis and Treatment. American
family physician, 100(5), 298–305.
• Douglass, J., Graves, P., & Gordon, S. (2016). Self-Care for Management of Secondary Lymphedema: A
Systematic Review. PLoS neglected tropical diseases, 10(6), e0004740.
https://doi.org/10.1371/journal.pntd.0004740
• Fife, C. E., Farrow, W., Hebert, A. A., Armer, N. C., Stewart, B. R., Cormier, J. N., & Armer, J. M. (2017). Skin
and Wound Care in Lymphedema Patients: A Taxonomy, Primer, and Literature Review. Advances in skin &
wound care, 30(7), 305–318. https://doi.org/10.1097/01.ASW.0000520501.23702.82
• Földi, M., Földi, E., In Strossenreuther, R. H. K., & In Kubik, S. (2012). Foldi's textbook of lymphology: For
physicians and lymphedema therapists. München : Elsevier Urban & Fischer
• Houck, P., Dandapantula, H., Hardegree, E., & Massey, J. (2020). Why We Fail at Heart Failure: Lymphatic Insufficiency Is
Disregarded. Cureus, 12(6), e8930. https://doi.org/10.7759/cureus.8930

33. References
• Rockson S. G. (2017). Lymphatic Medicine: Paradoxically and Unnecessarily Ignored. Lymphatic research and biology, 15(4),
315–316. https://doi.org/10.1089/lrb.2017.29033.sr
• Schulze, H., Nacke, M., Gutenbrunner, C., & Hadamitzky, C. (2018). Worldwide assessment of healthcare personnel dealing with
lymphoedema. Health economics review, 8(1), 10. https://doi.org/10.1186/s13561-018-0194-6
9/3/20XX Presentation Title 33

34. Thank you!
Bettina M Brown