Management of lymphedema related to breast cancer

Tuesday, 26/04/2016  |   Breast Cancer  |  no comments

ona_news0413_app_365555 Breast cancer–related lymphedema is an ongoing challenge for many survivors. A variety of treatments are available for the management of lymphedema, but the evidence supporting them varies. Complex decongestive therapy is a common treatment for lymphedema; however, the evidence supporting it is weaker than that supporting exercise.   Physicians can play a pivotal role as educators by informing breast cancer patients about the risk of secondary lymphedema, prevention strategies, early signs and symptoms, and treatment options. Evidence shows that early intervention is the key to effective treatment. Physicians can also help their patients by referring them to trained health care providers such as physiotherapists or lymphedema therapists.   Exercise prescription and compliance Lower incidences of lymphedema were found in women who exercised regularly, received lymphedema education before treatment, and performed preventive self-care activities (Park et la., 2008). Bani et al (2007) found that provision of education on lymphedema was associated with use of lymph-drainage massage services. Other factors associated with lower lymphedema incidence and severity included chemotherapy and antiestrogen drugs (Vignes et al., 2007).   Two main treatments were identified in the literature for the management of breast cancer–related lymphedema: complex decongestive therapy (CDT)—also known as combined decongestive therapy and complex decongestive physiotherapy—and exercise. Complex decongestive therapy has 4 components: manual lymphatic drainage (MLD); compression therapy; remedial arm and shoulder exercises; and deep-breathing exercises to promote venous and lymphatic flow (Koul et al., 2007).   Source Canadian Family Physician December 2010 vol. 56 no. 12 1277-1284 http://www.cfp.ca/content/56/12/1277.full   References Bani HA, Fasching PA, Lux MM, Rauh C, Willner M, Eder I, et al. Lymphedema in breast cancer survivors: assessment and information provision in a specialized breast unit. Patient Educ Couns 2007;66(3):311-8. Koul R, Dufan T, Russell C, Guenther W, Nugent Z, Sun X, et al. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer. Int J Radiat Oncol Biol Phys 2007;67(3):841-6. Park JH, Lee WH, Chung HS. Incidence and risk factors of breast cancer lymphoedema. J Clin Nurs 2008;17(11):1450-9. Vignes S, Arrault M, Dupuy A. Factors associated with increased breast cancer-related lymphedema volume. Acta Oncol 2007;46(8):1138-42.

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