Supporting patients with lymphoedema: the role of healthcare professionals in improving health-related quality of life

Lymphoedema is a chronic swelling of tissue caused by disruption to the normal functioning of the lymphatic system. It may be developmental (primary lymphoedema) or acquired (secondary lymphoedema). The body's extremities, such as an arm or a leg, are the most commonly affected areas (BMJ Best Practice, 2022). Globally, the most prevalent cause of secondary lymphoedema is a filarial nematode infection, affecting nearly 657 million people in 39 countries worldwide (World Health Organization, 2024). However, this is rare in developed countries and secondary lymphoedema is more often a result of malignancy.

Both primary and secondary lymphoedema affect the patient's health-related quality of life (HRQOL) in multiple ways. There are several physical, emotional and mental impacts of lymphoedema, and these often vary depending on the severity of the condition.

The pain experienced by patients with lymphoedema can restrict mobility and activities of daily living, such as washing and dressing. Skin is significantly affected by the condition as it becomes hardened and is vulnerable to cellulitis. The nature of the chronic swelling with no realistic cure becomes increasingly restrictive over time, causing chronic discomfort and fatigue. The secondary physical effects of lymphoedema originate from decreased mobility and a lack of physical activity.