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Lymphedema represents an abnormal accumulation of tissue proteins, edema fluid and chronic inflammation within the extremity due to low output failure of the lymphatic circulation. Secondary, or acquired lymphedema is the most common lymphedema worldwide, most of these cases are due to cancer or cancer therapy such as surgery and radiotherapy. This condition can cause physical discomfort and pain, impaired function, and emotional distress. Diagnosis of lymphedema requires a detailed medical history and physical examination. Changes may include pitting of tissues, increased thickness of skin folds, and enlargement of the affected limb. Physical examination techniques include sequential circumferential measurements of the limb, water displacement volumetry, optoelectric volumetry, and tonometry. Lymphoscintigraphy uses a radiopharmaceutical to help determine functional and morphological changes of the lymphatic system, which provides a qualitative and quantitative assessment of lymphedema. Treatment of lymphedema can include combined modality approaches. Although many treatment methods exist, a cure is not currently available and treatment often remains frustrating for both the patient and physician. Complex decongestive physical therapy (CDPT) is a effective program that consists of meticulous skin care, manual lymph drainage, remedial exercises, multi-layered bandaging, and wearing of elastic garment. Lymphedema is a chronic and debilitating disease. It generally is under-reported and undertreated. Further education and better clinical trials are needed to address the importance of early recognition and treatment of lymphedema after cancer treatment.
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