["Tertiary" lymphedema--procedures in lymph drainage therapy]

In patients with malignant tumours (with or without secondary lymphedema) a so-called tertiary lymphedema may develop. This edema is mostly caused by exacerbation of the primary tumor, by local recurrences or by loco-regional metastases. If a tertiary lymphedema is suspected oncologic diagnostic investigations must be immediately performed. During this period lymphatic drainage therapy is stopped. In patients with safely established hopeless prognosis drainage therapy may be continued if necessitated by pain or functional decrease. Otherwise, oncologic therapy should be completed before lymphatic drainage is continued.