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Posted 12/4/2014

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  Lymphedema can be a difficult side effect of a number of cancer surgeries or radiation therapy. If lymph nodes are removed, the natural drainage system is disrupted, and sometimes swelling results. Most of the attention and research has been directed at breast cancer-related lymphedema, but it surely can impact other patients. Examples of surgeries that may disrupt the lymphatic system include those for melanoma, GYN surgery, or sarcoma.

  Lymphedema is especially distressing because, once it has happened, there is no real cure. There are various ways to try to minimize or control it, but it rarely disappears. It is also distressing because it is impossible to accurately predict which patients may develop it post surgery or radiation. The current thinking is that people are put at risk both by the treatment received and by various genetic predispositions to this particular form of trouble. No one seems to have good statistics about the incidence of lymphedema, and the numbers you will see are all over the map. This is not exactly reassuring, but my intent is to minimize any concern you feel if you read high numbers.

  The condition can impact many domains of an individual's health-related quality of life. These may include emotional, functional, social/family, and physical well-being. Emotional well-being measures a person’s
coping and feelings ranging from joy to distress. Functional wellbeing identifies a person’s ability to manage the normal activities of daily living, such as dressing, bathing, walking, and performing household tasks. Social well-being includes feelings and activities related to relationships with friends and family. Physical well-being, the domain thought to be most affected by lymphedema, includes questions related to pain.

  The National Lymphedema Network is the best source of patient-friendly information and resources. Their website is

  If you want to read more about this, there is an excellent summary article that has just been published in CA.: A Cancer Journal.  Here is an excerpt and a link:

Recent Progress in the Treatment and Prevention of Cancer-Related Lymphedema
Simona F. Shaitelman, MD, EdM1
; Kate D. Cromwell, MS, MPH2
; John C. Rasmussen, PhD3
; Nicole L. Stout, DPT, CLT-LANA4
; Jane M. Armer, RN, PhD, FAAN5
; Bonnie B. Lasinski, MA, PT, CLT-LANA6,7; Janice N. Cormier, MD, MPH8

Financial Impact
One of the biggest stressors that patients with cancer report
is fear related to the financial impact of their disease both
during and after treatment. This stressor is even more significant
in cancer survivors who develop lymphedema. Patients who have lymphedema are not only more likely to
have higher treatment costs but are also more likely to spend
more time in a hospital because of cellulitis. A study of
claims data found that patients with breast cancer-related
lymphedema were likely to have higher medical costs
($23,167) compared with breast cancer survivors without
lymphedema ($14,877). Compared with patients without
lymphedema, patients with lymphedema were also more
likely to use mental health services, undergo diagnostic
imaging, and receive outpatient therapy



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