Oedema is swelling (sometimes referred to as ‘fluid retention’) that happens when there is an excessive build-up of fluid in body tissues. Some possible causes are cardiac or renal failure, venous or lymphatic obstruction or disease, hypoproteinaemia, local infection or inflammation or immobility and limb dependency. It is thought that as many as 85% of palliative patients suffer some degree of oedema. Oedema can impair physical function and increase dependence. The psychological effects of altered body image can decrease social participation resulting in social isolation. Pain and discomfort may also be an issue due to tightness and stretching of skin, weight of affected limbs and additional stress on other body structures such as muscles, joints and nerves.

Lymphoedema is a specific type of oedema (see the following section) that, if not managed appropriately, can cause unwanted skin changes and severely deformed limbs. It can also increase the risk of other conditions like cellulitis (inflammation of skin cells) or lymphorrhoea (where lymph fluid leaks through small breaks in the skin), causing additional symptoms that may adversely affect patients’ health and quality of life (Keeley, 2011).

Lymphoedema is oedema caused by an obstruction in or damage to the lymphatic system; an arrangement of vessels and nodes considered to be part of the circulatory and immune systems. The role of this system is to collect or drain interstitial fluid from body tissues and take it back, via the main veins into the blood circulatory system. It helps removal of cell debris, proteins and waste, as well as containing some of the body’s defensive cells, like lymphocytes. Lymph nodes located around the body filter the fluid, removing any bacteria before the fluid returns to the circulatory system.