MQ Health - Macquarie University

Lymphoedema Clinic

Understanding lymphoedema

Lymphoedema is persistent swelling caused by damaged or abnormal lymphatic vessels. It occurs where damaged lymph nodes (glands) and/or vessels drain that part of the body.

There are two types of lymphoedema:

  1. Primary – this is due to abnormal lymphatics. It can occur at any age from infancy to old age.
  2. Secondary – this is most commonly caused by cancer treatment to the lymph nodes, but can also be caused by trauma.

Patients who have lymph nodes removed during cancer treatment have a 20% chance of developing lymphoedema. This risk can be increased by intensive therapy, but if a sentinel node biopsy is performed, the risk is reduced to about 5-8%. If radiation is added on top of surgery the risk can increase to over 50%. Lymphoedema can be a daily reminder of previous cancer treatment and have a significant impact on social life, family, work and finances. It often leads to social isolation and, in some cases, to loss of employment, as a heavy arm or leg means affected patients may not be able to work.

Currently, little is known about the causes of lymphoedema and there is no complete cure. However, what our research has revealed is that the lymph fluid that circulates throughout the body backs up after treatment to the lymph glands. It then spills into the tissues and causes inflammation, stimulating fat stem cells to grow. Once this occurs, it’s too late for compression sleeves or bandaging to work.

Research focus

New treatments for lymphoedema

This research investigates the physical and psychological success of new treatments for lymphoedema. These include:

  • Autologous lymph node transfer (LNT), in which a group of lymph nodes from a healthy area of the patient’s body are moved to the affected area.
  • Lymphovenous anastomosis (LVA), a microsurgical technique for earlier stage lymphoedema in which lymphatic vessels are joined to veins to assist in the drainage of fluid from the impaired limb.
  • Liposuction for the treatment of advanced lymphoedema through the removal of the substantial fat deposition evident at this stage of the condition.
  • Combined lymphatic surgery and breast reconstruction to improve both physical and cosmetic appearance while easing the burden of lymphoedema under the one anaesthetic.
  • Use of Indocyanine Green (ICG) fluorescence in the diagnosis and surgical management of lymphoedema, and its application to manual lymphatic massage to personalize lymphatic drainage pathways in both therapist and self MLD.
  • Early intervention and home monitoring for patients  at risk of developing lymphoedema after breast cancer.

Causes of lymphoedema

We are undertaking research into the causes of lymphoedema, in particular the physiological processes that determine why one patient develops lymphoedema when another does not, even when they have essentially the same cancer diagnosis and/or treatment. This research focuses on how cells from lymphatic vessels respond to the stress of lymph node removal for cancer treatment, and the processes of fat production and deposition within the swollen tissues.

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