Cancer-associated secondary lymphoedema

Ensuring healthy lives and promoting the well-being at all ages is the aim of Sustainable Development Goal #3. Dr Stanley Rockson discusses secondary lymphoedema in individuals who have or survived cancer, and how developments in basic and clinical research can help address the global targets.

Q: What is lymphoedema and why does it particularly affect people with cancer?

A: Lymphoedema is the delay in fluid transport from the tissues to the heart that occurs when the lymphatic vessels are damaged. Thus, fluid accumulates in tissues, resulting in swollen limbs and chronic inflammation. It particularly occurs in individuals with cancer because the treatment of cancer requires surgery, radiotherapy, or sampling of lymph nodes, and all these procedures necessarily create damage to the lymphatic vasculature that is sometimes irreversible. 

Q: When thinking about the specific targets of Goal 3 of the SDGs, can you comment on how aligned these are with the global research picture for lymphoedema?

A: Lymphoedema is an international health problem: it can severely affect quality of life and interfere with the ability to carry out daily and occupational tasks. It is estimated that lymphoedema affects about one in seven individuals treated for cancer, and this figure probably underestimates the actual prevalence, particularly in developing countries. However, throughout the world, the public and their doctors are under-prepared to understand the risk and early signs of lymphoedema. Thus, investing in lymphoedema research is in accordance with Goal 3, as it is an achievable goal to create health awareness regarding lymphatic health and to provide adequate resources to reduce risk. 

Q: What do you envision as the future for treating patients with lymphoedema?

A: My dream would be that the doctors caring for patients with cancer would be fully prepared and well-educated to undertake the evaluation and management of lymphoedema. I also dream that future resources will be available to enable sophisticated imaging, which would enable a timely diagnosis of lymphoedema that is very important for successful treatment, as well as effective drug therapy to prevent deterioration in lymphatic function and, ideally, to restore it.

By: Lucia Brunello/Nature Reviews Disease Primers

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