Introduction
If you ask most people that are familiar with lymphedema the question, “Are you aware of secondary lymphedema,” most would reply that “yes, it is where the arm swells after the lymph system has been damaged by breast cancerbiopsy and treatment.” This is called arm lymphedema.
Even if they are aware that such a condition as secondary leg lymphedema exists, their response might well be that it is a small group of afflicted men who have prostate cancer.
Thus shows how little awareness there is about this particular form of lymphedema. Even in the lymphedema world it is a poor step-child.
However, if the membership of Lymphedema People and the posts in the online lymphedema support groups are an indication, this condition is increasing dramatically.
The reasons for this increase are multiple. They include:
1. increased survival rates of cancer 2. improved treatment of trauma injuries that previously would have been terminal 3. increase in antibiotics for infections and treatment for other conditions that previously might have resulted in death.
It is also important to note that secondary leg lymphedema does not necessarily start immediately after the injury or trauma. It may not start for years.
What is secondary leg lymphedema?
Secondary lymphedema is a condition where the lymphatic system has been damaged. The main job of this system is to move excess through and out of our bodies. When it becomes damaged or impaired, it is no longer able to accomplish this function and these fluids (lymph fluids) collect in the interstitial tissues of our legs. This causes leg swelling.
Another important function of the lymph system is to help our bodies fight infections. With lymphedema, this ability is also weakened and the patient becomes more susceptible to infections.
What causes secondary leg lymphedema?
Secondary leg lymphedema (also referred to as acquired lymphedema) is caused by or can develop as a results of:
1.) Surgeries involving the abdomen or legs where the lymph system has been damaged. This includes any intrusive surgery.
Examples are
vein stripping surgery for peripheral vascular disease hip replacement knee replaement insertion of bolts, screws and other devices in orthopaedic repair lipectomy
2.) Removal of lymph nodes for cancer biopsy. These cancers include, but are not limited to
prostate cancer testicular cancer ovarian cancer uteran cancer vulva cancer bladder lymphoma - both hodgkins and non hodgkinsmelanoma colon Kaposi Sarcoma
3.) Radiation treatment of these cancers that scars the lymph system and lymph nodes
4. Some types of chemo therapy. For example, tamoxifen has been linked to secondary lymphedema and blood clots.
5.) Severe infections/sepsis. Generally referred to as lymphangitis, this is a serious life-threatening infection of the lymph system/nodes.
6.) Trauma injuries such as those experienced in an automobile accident that severly injures the leg and the lymph system.
7.) Burns - this even includes severe sunburn. We have a member that acquired secondary leg lymphedema from this.
8.) Bone breaks and fractures.
9.) Morbid obesity - the lymphatics are eventually crushed by the excessive weight. When that occurs, the damage is permanent and chronic secondary leg lymphedema begins.
10.)Insect bites
What are some of the symptoms of secondary leg lymphedema?
These symptoms may include:
1.) Unexplained swelling of either part of or the entire leg. In early stage lymphedema, this swelling will actually do down during the night and/or periods of rest, causing the patient to think it is just a passing thing and ignore it.
2.) A feeling of heaviness or tightness in the leg
3.) Increaseing restriction on the range of motion for the leg.
4.) Unsual or unexplained aching or discomfort in the leg.
5.) Any change involving hardening and/or thickening of the skin or areas of skin on the leg.
