Grace Gawler Comments: Lymphedema after breast cancer treatment is often overlooked but affects the quality of life, wellbeing, and self-esteem of millions of women. Many patients are either not informed or do not follow through with advice because it can take months or years to develop. The aftermath of life saving surgery and treatments, lymphedema can lead to several other severe health issues including cellulitis. (refer to end of page for resources). Having had extensive gynaecological, colon and breast cancer surgery, I am all too familiar with staving off lymphedema. Fortunately, I already had knowledge of post-surgical lymphedema so that I could implement interventions, but even so, the outcome is far from perfect. It is a lifetime task to be vigilant in keeping lymphedema managed.
Best advice: Knowledge is a powerful ally when it comes to preventing or lessening the short or long-term impact of lymphedema. Read about prevention and questions to ask your surgeon. Before surgery, ask about a referral to a physiotherapist who specialises in lymphedema prevention and management as well as booking appointments for after your surgical intervention. Remind or enlighten your treating medical practitioners about the new guidelines as mentions in the following article. The global experts in this study have, for the first time, published a clinical guide on how and when to roll out evidence-based interventions.
Strategies to shield breast cancer patients from lymphedema:
In a global effort to improve the lives of breast cancer survivors, new health research has looked at strategies that can help prevent lymphedema for millions of cancer survivors as a result of damage or removal of their lymph nodes during cancer treatment.
Compression sleeves, surgery to repair patients’ lymphatic systems and axillary reverse mapping (ARM) should be offered to people at risk of developing breast cancer-related arm lymphedema (BCRAL), according to the study published in eClinicalMedicine.
Lymphedema is a distressing condition that involves the accumulation of fluid in patients’ arms, resulting from damage or removal of lymph nodes during breast cancer treatment. The global experts in this study have, for the first time, published a clinical guide on how and when to roll out evidence-based interventions.
While there is currently no approach that can completely prevent lymphedema, researchers from Princess Margaret Hospital in Hong Kong, Flinders University and the University of Toronto collaborated with 64 global experts from 16 countries to develop guidance that can effectively help prevent the condition after reviewing clinical trials.
The study reviewed data from more than 60 thousand patients with breast cancer-related arm lymphedema involved in high-quality randomized-controlled studies to determine the best prevention strategies and risk factors that can cause the condition.
These risk factors include post-surgery radiotherapy, not monitoring patients arm volume one month after surgery, the number of lymph nodes removed, and a high body mass index.
Breast cancer survivor Monique Bareham says chronic lymphedema is irreversible, difficult to treat and significantly affects patients’ quality of life, so effective management to prevent it and halt its progression is critical.
“Like many breast cancer survivors, I received limited and conflicting information about lymphedema following cancer treatment, leaving me anxious and ill-equipped to manage my symptoms. It had a negative effect on me psychologically and physically and left me unable to return to work. ”
“This research raises awareness of this under recognized condition and addresses gaps in clinical understanding. It is a necessary step toward providing care that will lead to better health outcomes for many breast cancer survivors Worldwide.”
Deputy Vice-Chancellor (Research) at Flinders University and the study’s co-senior author, Professor Raymond Chan says about half of patients with breast cancer-related arm lymphedema (BCRAL) develop this condition 12–30 months after surgery, but it can also develop many years later.
“Our study has revealed evidence-based approaches to prevent BCRAL through approaches that take into account risk factors for patients, the availability of treatment options and the expertise of health care providers to ensure all patients are offered effective interventions, regardless of where they’re receiving care.”
“This is the first study in the world to provide recommendations on the frequency and duration of surveillance, methods to detect early lymphedema, thresholds for early intervention and types of treatments to offer depending on the degree of the condition. With this knowledge, these interventions can now be applied with confidence in clinical settings.”
SOURCE: https://medicalxpress.com/news/2024-02-strategies-shield-breast-cancer-patients.html
RESOURCES
Cellulitis: https://www.lymphoedema.org/cellulitis/about-cellulitis/
Post treatment lymphedema exercises – Breast and Gynaecological cancers
https://www.gracegawlerinstitute.com/lymphedema/
https://www.gracegawlerinstitute.com/exercise-for-women-after-breast-cancer/
More information: Henry C.Y. Wong et al, Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendations, eClinicalMedicine (2024). DOI: 10.1016/j.eclinm.2024.102441
Journal information: EClinicalMedicine