The Lymph System

When sickness or infection invades the body, the immune system (Read about "The Immune System") is the first line of defense. A big part of that defense is the lymph system.

Lymph is a clear fluid containing white blood cells, which help fight infection. The main types of white blood cells are lymphocytes. Lymph is carried through the body by lymph vessels that have valves and muscles to help move the fluid. Along the route are lymph nodes that serve as filters for harmful substances. This network of vessels and nodes together is called the lymph system.

Occasionally, this system that normally helps keep the body healthy can cause problems. Keep reading to learn about some of the problems that can develop.

Lymphoma

Lymphoma is cancer of the lymph system. Lymphoma is broken down into two major types: Hodgkin's disease and non-Hodgkin's lymphoma.

(Read about Lymphoma)

Lymphedema

Lymphedema is swelling caused by the buildup of too much lymph fluid in the tissues. It usually affects the arms or legs, but can occur in other parts of the body as well. There are two types of lymphedema:

• Primary lymphedema can occur when lymph nodes or vessels are missing or impaired.
• Secondary lymphedema can result when lymph nodes or vessels are damaged or removed by surgery, radiation, infection or trauma.

What causes it?

Primary lymphedema, which is not common, can be present at birth, occur at puberty or in adulthood, all from unknown causes or may be associated with vascular anomalies, such as hemangioma or lymphangioma, according to the National Lymphedema Network. It can affect from one to all four limbs, and/or other parts of the body.

Secondary lymphedema, which is much more common, can result from surgery, radiation, infection or trauma. It is usually related to cancer treatment, particularly surgeries in which the lymph nodes are removed. (Read about "Cancer Treatments")

Removing lymph nodes and vessels changes the flow of the lymph fluid, making circulation more difficult. If not enough fluid can be removed from an area, the excess builds up and causes swelling. Radiation treatment can affect the flow of fluid in the same way, thus increasing the risk of secondary lymphedema. (Read about "Radiation Therapy")

Lymphedema can develop after surgery or radiation for any kind of cancer, but most often develops with treatment of breast cancer, prostate cancer, pelvic area cancers, lymphoma or melanoma, according to the American Cancer Society (ACS). (Read about "Breast Cancer" "The Prostate" "Cervical Cancer" "Lymphoma" and melanoma in "Skin Cancer")

If lymphedema occurs after breast cancer treatment, it usually affects the breast area, underarm or arm on the side of surgery. After cancer treatment to the abdomen, lymphedema can cause swelling of the abdomen, genitals or one or both legs, according to ACS. It can develop right after surgery, or weeks, months or even years later.

Lymphedema can be very uncomfortable. The fluid buildup and swelling can cause the area to become hot, and the skin hard and stiff. There are several signs that could indicate the onset of lymphedema.

Signs & symptoms

The signs or symptoms of lymphedema may include:

• a feeling of fullness, sponginess or heaviness in the arm or leg
• a feeling of tightness in the skin of an arm or leg
• decreased movement or flexibility in the hand, wrist or ankle
• difficulty fitting into clothing in one specific area
• tight fitting of a ring, watch or bracelet though you haven't gained weight

If any of these symptoms lasts more than a week or two, or you notice persistent swelling, you may want to talk to your doctor, especially if you have had lymph nodes removed or had radiation treatment.

Prevention & control

Lymphedema is a very serious condition. Besides being uncomfortable and sometimes painful, if left untreated it can cause debilitating weakness in the limbs, interfere with the healing of wounds and lead to infection. There is no cure for lymphedema and once it develops, it can be a long-term condition requiring daily treatment.

Although there is no scientific evidence that people can prevent lymphedema, most experts recommend some basic guidelines, which may lower the risk of developing lymphedema or delay its onset.

The following are some suggestions for care from ACS. The most important thing is to try to avoid any infections, or burns or injuries to the affected area. The body responds to these by making extra lymph fluid, which can lead to lymphedema.

• Keep the area/limb clean and moisturized.
• Avoid cuts, scratches, burns, hangnails and insect bites (Read about "Insect Bites") Treat any of these by washing, using an antibacterial cream and clean bandage. (Read about "Wound Care")
• Use an electric shaver, which is less likely to cut the skin.
• Use insect repellent and sunscreen when outdoors. (Read about "Sunscreen")
• Wear protective gloves when working in the garden or kitchen.
• Exercise regularly, but don't fatigue the affected limb. Your doctor can help you develop an exercise program. (Read about "Getting Started on Fitness")
• Wear loose-fitting clothing and jewelry.
• Avoid heavy lifting and pulling.
• If your arm is affected, avoid using shoulder straps on briefcases or purses. Also, have blood drawn, IV's (Read about "Infusion Therapy") and shots given in the unaffected arm.
• If your leg is affected, wear well-fitting closed shoes; don't go barefoot. Also, avoid socks or stockings with tight elastic bands.
• Report any redness, swelling, increased heat or tightness to your doctor.

Treatment

There are treatments for lymphedema, which can help reduce the swelling and prevent it from worsening. The treatment will depend on the cause. If lymphedema develops because of infection, the first course of treatment may be antibiotics, which can reduce the swelling and redness.

If the lymphedema is not caused by infection, your doctor can help develop a treatment plan for you. The treatment is usually performed by a physical therapist or other specialist who has specific training in this area. (Read about "Rehabilitation") The treatment is often called Complex Decongestive Therapy (CDT) and consists of skin care, massage (Read about massage in "CAM Therapies"), exercise, special bandaging, manual drainage and compression garments. The sooner treatment is started, the better. Seeing your doctor right away can mean a shorter course of treatment to get the lymphedema under control.

Lymphadenitis

The American Academy of Family Physicians (AAFP) says lymphadenitis is an inflammation of the lymph nodes, which dot the network of lymphatic vessels and provide a collecting area for the immune system cells that defend against invaders. Lymphadenitis is not uncommon in children. One area that is often affected is the neck, where lymphadenitis can develop as a result of strep throat or infectious mononucleosis. (Read about "Sore Throat & Strep Throat" "Mononucleosis") Causes can include bacterial, viral or other infection. (Read about "Microorganisms") AAFP says people can develop an infection following a cat scratch or bite. This is commonly known as "cat scratch fever." Treatment depends on the specific cause of infection and its severity.

Lymphangitis

Lymphangitis is an inflammation of a lymphatic vessel. The lymphatic vessels are what collect and move lymph back into the blood circulation. Lymphangitis is often caused by bacterial infection and can be treated with antibiotics. (Read about "Antibiotics")

Related Information:

    The Spleen

    Primary Immunodeficiency