Swelling and Spelling: What is Lymphedema/Lymphoedema?

Nov 17, 2023

The playwright and novelist, Oscar Wilde, wrote that “We have really everything in common with America nowadays except, of course, language.” Not to be outdone, Sir Winston Churchill described the United States and Great Britain as two nations “divided by the same language.”

Nowhere are these differences more apparent than with spelling. Consider aeon (Br.) vs. eon (Am), aesthetic (Br.) vs. esthetic (Am), enrol (Br.) vs. enroll (Am.), defence (Br.) vs. defense (Am.), offence (Br.) vs. offense (Am.), lymphoedema (Br.) vs. lymphedema (Am.). That extra ‘o’ ‘swells’ the word from 10 letters (lymphedema) to 11 words (lymphoedema), which is appropriate because lymphedema involves swelling of the soft tissues.

Specifically, lymphedema is a disease of the lymphatic vasculature in which massive fluid accumulation occurs usually in the extremities. Other signs and symptoms of lymphedema are skin changes, secondary infections, and localized pain.

Primary lymphedema from genetic mutations is rare. Secondary or acquired lymphedema from surgery, trauma, obesity, congestive heart failure, infections (wuchereria bancrofti), or cancer and cancer treatment is not.

Cancer-related lymphedema results from excision of regional lymph nodes or vessels, from metastatic tumors that obstruct the lymph nodes, and from radiation therapy that depletes and scars the lymph vessels. Lymphedema is usually treated with a combination of compressive garments, skin hygiene, limb compression, manual lymphatic drainage, and physical therapy. In fact, Dr. Tony Reid, CEO of EpicentRx, invented a marketed device called the ReidSleeve that is used to manage lymphedema.

The profibrotic cytokine, transforming growth factor-beta (TGF-β), that many tumors overexpress is associated with lymphedema. So, it is perhaps not too surprising that treatment with AdAPT-001 has resolved lower extremity lymphedema in several patients, which is exciting since no cure for it currently exists.

A lymphedema graphic is shown below.

 

 

 

 

 

 

Like with lymphoedema, the Brits also spell diarrhoea with an extra ‘o’, which has a certain logic to it, even in America, given that diarrhea/diarrhoea might easily lead a person to exclaim, “o sh*t!.”