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The Potential of Preventing Lymphedema
The information in this article is based on the results of a study supported by the National Navel Medical Center. The results were promising in demonstrating the potential of preventing the development of lymphedema after treatment for breast cancer.
The Goals of This Study
Breast cancer treatment commonly includes surgery, the removal of lymph nodes near the affected breast, and possibly radiation. These treatments disrupt the functioning of the lymphatic system and causes from 7 to 47% of all breast cancer patients to develop the chronic condition known as lymphedema.
The purpose of this study was to prove that lymphedema could be prevented through early detection of developing lymphedema, the prompt beginning of treatment, and the ongoing following the treatment regime.
What is Lymphedema?
Lymphedema associated with breast cancer treatment is abnormal swelling that occurs because the lymphatic system has been damaged by surgery or radiation. Lymphedema is a chronic condition that cannot be cured. It diminishes the patient’s quality of life, contributes to the impairment of the limb’s range of motion, and is controlled only by a daily treatment regimine of massage, wearing compression garments, careful skin care, weight control, and exercise.
You Need to Know
Through public education, most women are now aware of the need to detect developing breast cancer at an early stage. These important preventive steps include regular mammograms and routine self-examinations. Early detection has been proven to save lives! Since lymphedema does not develop until after the breast cancer has been treated, most women are not familiar with it and are unaware of this problem until the painful swelling develops.
This study was performed successfully and has demonstrated that being aware of the risk of developing lymphedema, and taking prompt action, can prevent this condition from developing.
Any woman, who suffers daily from the pain and lowered quality of life due to lymphedema, will testify that there is an urgent need for a public education program to make women, physicians, and oncologists aware of the simple step that must be taken as soon as a woman is diagnosed with breast cancer.
This study demonstrated that there is hope of preventing lymphedema; however this requires that action be taken in a timely manner. This protocol to prevent lymphedema should be made a routine part of early breast cancer treatment.
The goal is to detect any change in the “at risk tissues” as soon as possible so that treatment can be started. The starting point is to obtain baseline measurements of the arms before any cancer treatment is started. The procedure is painless, takes only approximately 5 minutes, and could prevent a lifetime of suffering with lymphedema.
Step One: Obtaining Baseline Measurements
It is essential that baseline measurements be obtained before any treatment begins. The easiest, and most accurate measurements, are taken using technology known as bioimpedance. This non-invasive test measures the composition of body tissues and fluids including lymph. This technology is known as known as bioelectrical impedance analysis or BIA.
To date, ImpediMed is the only bioimpedance device cleared by the FDA for use by health care providers to accurately and quickly detect the clinical assessment of an upper limb at risk of developing lymphedema. These measurements must be taken as part of a pre-operative visits.
These measurements will be used to detect changes in the tissues before any visible signs or symptoms of lymphedema are detectable.
Step Two: Follow-up Measurements
When Change Occurs: Stage 0 -- Take Prompt Action!
When lymphedema is diagnosed, or suspected, a physician or lymphedema therapist should be consulted immediately and a conservative compression intervention should be started.
The following were the steps taken during the study.
Preoperative assessment and early intervention at the earliest signs of changed significantly reduced the affected limb volume to near baseline measurements and prevents progression to a more advanced state of lymphedema for at least the first year postoperatively.
In 2008, the American Cancer Society published the results of a study titled “Preoperative Assessment Enables the Early Diagnosis and Successful Treatment of Lymphedema.” This study was supported by the National Navel Medical Center (NNMC) and the study team included: Nicole L. Stout Gergich, PT, MPT, CLT-LANA, Lucinda Pfalzer, PT, MA, PhD, Charles McGarvey, PT, DPT, MS, Barbara Springer, PT, PhD, OCS, SCS, Lynn H. Gerber, MD, and Peter Soballe, MD
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