Lymphedema Therapy

When lymph nodes were removed as part of cancer treatment, or after a more radical surgery, you may be concerned about developing lymphedema. Any surgery which requires lymph node removal puts the patient at risk for development of lymphedema. In the treatment of breast cancer the risk of developing lymphedema as a side-effect runs from 25% to a little over 40% depending on the type of surgery required and other treatment factors. Lymphedema is a condition in which swelling occurs because the lymphatic system is not functioning normally. Lymphedema is also a potential side effect of radiation therapy that can appear in some people during the months or even years after treatment ends.

Signs and symptoms of the onset of lymphedema:

Redness: The appearance of rashes, redness or heat in the at-risk limb is a common symptom. The most common complication of lymphedema is infection.

Achiness and heaviness in the limb: This feeling may precede any other symptoms, including swelling. When this is the case it is called pre-clinical lymphedema.

Swelling: Swelling (for example on the same side of the body as a trauma like cancer) will be mild at first, and may appear as a tightness of the skin. After any trauma, transient (temporary) swelling is normal. When the swelling stays longer than six weeks, it may be considered problematic. If the swelling responds to finger-pressure by maintaining a “dent” for more than 30 seconds, you should contact your physician . Don’t ignore the swelling, even though it may seem to go away at first. If you are already experiencing lymphedema, you should know that it is both treatable and manageable. Great strides in lymphedema treatment have been made in recent years, and you should be benefiting from the advances made in this field.

Treatment may include:

  • Manual lymph drainage through massage
    The treatment of lymphedema consists of a gentle form of massage called manual lymph drainage. Manual lymphatic drainage (MLD), uses light touch to move excess lymph and fluid out of the tissues and back into the lymphatic vessels. One session of MLD typically takes about 20-45 minutes (2/3 times a week). It often takes years of training in MLD, combined with years of hands-on experience, for a lymphedema therapist to become truly skilled. If your lymphedema therapist recommends MLD, ask about his or her training and experience.In between the massages in some cases compression bandaging is applied to reduce the volume of liquid and excess proteins in the limb. Bandaging works by decongesting (moving fluid out of) the limb. This can be learned by the patient for home use.
  • Compression with bandages or compression garments (measurement and fitting included with treatment)
    Compression sleeves and garments are designed to apply pressure to the extremity to keep lymph moving in the right direction. Sleeves are tighter at the bottom than at the top. This helps create the graded pressure that keeps the lymph moving out of the arm.Sleeves apply what’s known as resting pressure, meaning that the pressure is higher when the arm is at rest. When you move your arm, the elastic fabric moves right along with it, which actually reduces the amount of pressure. A compression sleeve may be enough for mild lymphedema, but more advanced cases need the help of bandaging before a compression sleeve can be used.

Medical expenses

Often edema is a chronic condition. It’s good initially to inquire at your health insurance for the fees. We have contracts with most of the Dutch health insurance companies.

Oedema therapy is in cases of chronic edema submitted directly to the insurer. In general, you can assume that the first 20 treatments are either reimbursed under your additional insurance or are for your own expense. After 20 treatments, followed by a reimbursement from the basic insurance.

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