Posted by: bcconnections | November 2, 2012

Lymphedema, an unwelcome consequence of cancer treatment

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Lymphedema is characterized by the accumulation of fluid in the limbs, resulting in tissue swelling.  Lymphedema is an incurable medical condition that has the potential to cause pain, reduced mobility, and dramatically reduce one’s quality of life.  Estimates of the number of breast cancer survivors that experience lymphedema vary dramatically, ranging from 13%-65%, depending on the method of assessment and criteria used to define the condition.  In a recent publication in the Journal of Clinical Oncology, researchers from Ohio State University reviewed 60 different studies, mostly involving breast cancer patients, in order to characterize the causes, risk, prevention, diagnosis, treatment and impact of lymphedema.

They found evidence that exercise and sentinel lymph node biopsy reduce the risk of lymphedema, while being overweight or obese increase the risk.  They also found limited evidence that physiotherapy, “including manual lymph drainage, massage of scar tissue, and progressive active and action-assisted shoulder exercise,” reduces lymphedema risk.  They found minimal or conflicting evidence for an association between lymphedema risk and the following factors:  age, air travel, needle sticks, mastectomy, and occupation.

The authors report that lymphedema symptoms can be managed if treatment begins when symptoms first appear.  Complex physical therapy, which involves “manual lymph drainage, exercise, non-elastic wrapping, use of compression garments, and skin care,” is an effective treatment modality, and there is also some evidence for a benefit from low-level laser therapy.

The impact of lymphedema on quality of life measures was substantial.  Patients reported that the condition not only caused pain and disability, but also affected their body image, social life, hobbies, activities and occupations.

Perhaps the most important finding of this review was that it highlighted the need for more research on this serious cancer-related side effect.  Little is known about the causes and ways to prevent and treat lymphedema.  “Patients should be informed about signs and symptoms to be aware of and report them, thus enabling treatment to start early, when intervention is most successful, and sequelae of lymphedema are not as deleterious.  Proper and prompt treatment for patients with early signs of lymphedema should be a priority, which suggests that access to qualified providers must be facilitated.”  Finally, practical issues need to be addressed, including the ability of patients to get insurance coverage for the care they need, both physical and psychological, after being diagnosed with lymphedema.

For more information on lymphedema:



  1. Breast Cancer Connections also provides a restorative exercise program, Healthy Steps, designed to stimulate the lymphatic system, improve range of motion, and reduce scar restriction, and more. Join us Friday mornings at 8:30 a.m. at BCC in Palo Alto.

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