Wednesday, June 27, 2012

Diagnosing and Staging Lymphedema

Cancer-related lymphedema is characterized as secondary lymphedema since it is ‘secondary to’ known damage to the lymphatic system due to surgery and/or radiation associated with the treatment of cancer.

There are very few medical tests that are valuable in the diagnosis of lymphedema. The diagnosis is made primarily based on an extensive and accurate medical history and physical examination.

Lymphoscinitgraphy is one diagnostic test that may be performed. In this test, radioactive labeled protein is injected beneath the surface of the skin, and the uptake and transport of the labeled protein is observed over several hours. This test can characterize the impairment of the lymphatic system’s ability to transport proteins and fluid, but is rarely necessary to plan and provide appropriate treatment.

Stages of Lymphedema

The stage of lymphedema is determined as part of the diagnosis. Lymphedema can be successfully treated in all stages, but the best and most rapid results occur when the lymphedema is identified and treated early.
  • Stage 0: Achiness, heaviness, increased warmth, sensation of fullness
  • Stage 1: Visible swelling that is soft and ‘pits’ if pressed and may disappear with elevation or overnight in bed
  • Stage 2: Swelling that doesn’t go away with elevation. Often the tissue is becoming more firm and less likely to be indented or ‘pit’ with pressure
  • Stage 3: Hard swelling associated with other changes in the skin- callus formations or small mushroom-like growths called papillomas.

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