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Cancer-Induced Edema/Lymphedema

  • Jennifer Fazzari
  • Gurmit Singh
Chapter

Abstract

Cancer patients are often prone to a variety of pathological changes that disrupt normal homeostatic processes in the body. Aside from medical interventions and therapies associated with treating the disease, the cancer itself is a major contributor to systemic disruption of physiological processes. Extracellular body fluid is tightly controlled and monitored by a variety of sensors, hormones, proteins, and organs. Palpable changes in fluid homeostasis can commonly be attributed to inflammation, where the changes in vasculature necessary to facilitate an immune response compromise the vascular endothelial barrier. Such changes, although transient, reveal the consequences of compromised vessel walls, leakage of plasma proteins, and collection of fluid in the interstitial space. Edema represents a pathological form of fluid extravasation into the interstitium and is a common clinical feature in many cases of malignancy. By examining common inflammatory factors secreted by the tumour, it becomes evident that the increased levels of such factors in patient sera could, indeed, influence a pro-edematous state. Therefore, it is the dynamics of the tumour itself in isolation of therapeutic side effects that can influence local and systemic vasculature by promoting a chronic inflammatory state characterized by leaky vasculature and dysregulated fluid homeostasis.

Keywords

Edema Lymphedema Hydrostatic pressure Oncotic pressure Hydraulic conductivity Coagulation VEGF TGF-β Chronic inflammation Hyaluronan Hyponatremia 

Notes

Definitions

Capillary hydrostatic pressure

drives fluid out of a vessel as a result of osmosis

Osmotic pressure

pressure exerted by the tendency of water to move from an area of low solute concentration to high solute concentration

Colloid osmotic pressure (oncotic pressure)

pressure resulting from the property causing water to move down a concentration gradient by diffusion through a semipermeable membrane from an area of low concentration to an area with a high concentration of high molecular weight molecules, namely proteins, that are unable to pass through the membrane [95]

Hydraulic conductivity

permeability of a vessel wall to water [95], the speed at which fluid will move through a tissue when a pressure gradient is applied [1]

Protein reflexion coefficient

permeability of a vessel wall to protein [95]

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Pathology and Molecular MedicineMcMaster UniversityHamiltonCanada
  2. 2.Department of Pathology and Molecular MedicineMcMaster UniversityHamiltonCanada

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