Lymphedema is a painful swelling in a limb where lymph nodes have been removed is a common complication of cancer treatment.
The lymphatic system is a network of nodes, vessels, ducts, tissues, and organs that distributes infection-fighting blood cells throughout the body and plays a major role in the immune system. This network acts as the body’s natural sewage system, eliminating dangerous microbes and damaged cells, such as cancer cells. During cancer-related surgeries, such as mastectomies or lumpectomies, doctors may remove the lymph nodes near the tumor to see if the cancer has spread. Removing these vessels makes it harder for fluid in the arms, legs, or other body parts to flow to the chest through which the fluid can get back into the bloodstream. If this fluid builds up, it can lead to swelling and stiffness where the nodes used to be, or lymphedema. Infection can also be a side effect. Radiation therapy following surgery further compromises the lymph network, leaving scarring and inflammation.
Although lymphedema symptoms can be prevented and managed in a variety of ways, surgeons are pioneering procedures to restore a healthy lymph system in affected patients. One such procedure, called a vascularized lymph node transfer (VLNT), involves taking lymph nodes from one part of the body, usually from the groin, underarm, or neck and transplanting them to the limb with lymphedema. The blood vessels providing circulation for these lymph nodes are reattached to the blood vessels in the swollen limb. The new nodes can then drain the trapped lymphatic fluid. Several preliminary studies have reported promising outcomes for VLNT in both early and advanced stage lymphedema, but the treatment is still in its exploratory stages.