Hello Dr. Francis Collins (NIH),
I am a lymphatics researcher, conducting several clinical studies of cancer-associated lymphedema and reparative microsurgeries. My physician co-PIs are keenly aware of lymphatic dysfunction arising during and after cancer treatment, but sadly, many cancer physicians do not even mention lymphedema to their patients.
A research paper published in 2010 showed that almost all extracellular fluid must transit back to the blood circulation via lymphatics, not venous capillaries, as was previously taught (Starling principle is now revised [Levick JR & Michel CC. Microvascular fluid exchange and the revised Starling principle, Cardiovascular Research 89, 198-210]). As such, all edema is basically lymphedema.
At least 10 million Americans struggle with lymphatic disease, and another 40% of Americans encounter chronic venous insufficiency and peripheral venous disease, which my colleagues have shown to be driven by dysfunctional lymphatics (Rasmussen JC, et al., Degradation of lymphatic anatomy and function in early venous insufficiency, J Vasc Surg Venous Lymphat Disord 2020, PMID 32977070).
With lymphatic anomalies driving such large proportions of health problems in the US, strong NIH support for lymphatics research is crucial.
I appeal to you for your support for increased lymphatics research funding.
Melissa B. Aldrich, MBA, PhD
Center for Molecular Imaging
The Brown Foundation Institute for Molecular Medicine