Lymphoedema Care

What is lymphoedema?

The body has two major circulation systems. The blood system is most well known and one of its functions is to deliver nutrients to the cells. The lymph system is less well known and its role is to remove waste material from the cells. This waste, which includes proteins, is carried along lymph vessels and then emptied back into the venous blood system near the heart. When the normal functioning of the lymph system is compromised in any way, proteins start to build up in the fluids of the body tissues. The increasing concentration of protein rich fluid draws more water to the area. This build up of lymph fluid is called lymphoedema.

Lymphoedema can be a side effect of chemotherapy and radiation therapy which are used to treat cancer. Lymphoedema can develop months, or even years, after treatment for cancer. The risk seems to be higher for people who have several lymph nodes removed and for those who have both surgery and radiotherapy to the lymph nodes. Conservative estimates suggest that at least 20% of patients treated for melanoma, breast, gynaecological or prostate cancers will experience secondary lymphoedema.

There is no known cure for lymphoedema, but it can be managed with appropriate care. The aim of management is to reduce and control swelling, improve the range of movement of the affected area and prevent infections.

There are three main styles of lymphoedema management. The Vodder method was developed by Dr Emil Vodder, in Germany in the 1940s. The Foldii method was developed by Michael and Ethel Foldii in Germany. The Casley-Smith method was developed in Australia in the 1960-70s.

Dr John R and Dr Judith R Casley-Smith were pioneering lymphologists from Adelaide, Australia. They researched the lymphatic system, developing effective treatments for lymphoedema, and raising awareness about lymphoedema. Their publications spanned four decades.

The Casley-Smith complex lymphatic therapy includes compression bandages, manual lymphatic drainage, compression garments. It has a strong emphasis on self care including specific exercises, deep breathing and self manual lymphatic drainage.

A manual lymphatic drainage massage session uses very simple strokes in a light and repetitive fashion. The aim is to stimulate the movement of lymph inside the lymphatic vessels and to decongest the swollen tissues by diverting the excess fluid to existing lymph nodes. Most experiences of manual lymphatic drainage are of a lighter and freer feeling in the affected area. This can occur over time or in each session.

My training has been with the Casley-Smith complex lymphatic therapy way of working with lymphoedema.


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