Early detection enhances lymphoedema treatment

n-pillerEarly detection of problems in the lymphatic system is the best way to prevent the discomfort and disfigurement that can result from lymphoedema, the swelling created by disruption to the body’s drainage system.

Flinders University’s Professor Neil Piller [pictured] wants to spread the message not only to the general population, but also to health professionals.

While lymphoedema can have congenital causes, it is likely to occur in its more dramatic forms following surgery or radiotherapy that has damaged or removed lymph nodes or vessels.

“A lot of surgeons and radiation oncologists are not aware of the extent to which they are damaging the lymphatic system,” Professor Piller.

“We need to get stronger in educating them to make them aware that wherever they go in the body, whenever they are cutting lymph nodes or vessels, they are causing problems with the body’s equilibrium.”

Professor Piller said lymphatics play multiple roles in the body.

“The lymphatic system is really important for the body’s homeostasis, for its fluid balance and metabolic function,” he said.

“It also contributes to the absorption of fat. Wherever you have slow lymph flow, you get fatty deposition.” These fatty deposits cause the gross swelling that occurs in acute cases of lymphoedema.

The lymphatic system has a tendency towards ‘laziness’, Professor Piller said, but this has a positive aspect: a range of simple approaches ranging from exercise to massage can help to ‘load’ the lymphatic vessels and improve their performance.

Professor Piller mixes research and practice through his clinical work with the Flinders Medical Centre’s Lymphoedema Screening Clinic, a service which has also toured rural and remote South Australia and the Northern Territory with staff from the School of Medicine and from Nursing & Midwifery, and funding from Lions Australia.

Detection is all-important, and employs techniques that measure fluid or fibre buildup in the tissues. Once fibre has developed in a limb, approaches such as laser treatment may be needed to control the condition.

“If you have early detection of the problems before they become clinically manifest, we may be able to solve them before they becomes serious,” Professor Piller said.

Flinders has established a worldwide reputation for developing and testing instrumentation and pioneering new techniques, and several Flinders researchers attended the recent International Congress of Lymphology in Sydney.

Attitudes to lymphatics are gradually changing, Professor Piller said, as increased referrals of patients for screening attest, and a promising collaboration is developing between lymphologists and vascular surgeons.

“The vascular and lymphatic systems work alongside and assist each other; the professions that look after them need to do the same,” Professor Piller said.

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