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Treating Early Lymphedema

Posted 9/28/2013

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  First, the facts about lymphedema: No one really seems to know the incidence of this problem. Some surgeons insist that none of their patients ever developed it (and that is just not so, at least is not so based on my own sample and experience) and some conservation PTs insist that every woman who has had breast cancer surgery is at high risk and can sound downright scary. The percentages bandied about range from 5%-35% or so; I think the most reasonable stance is that some of us are at more risk than others, but that most women are not going to develop lymphedema. Women at highest risk are those who have had full axillary node dissections (as opposed to sentinel node dissection) and radiation therapy that included that area in the field.

  If you want to read more, look at the website of the National Lymphedema Network (www.lymphnet.org). Today's entry is about a study, just reported in the Journal of Clinical Oncology, that compared the success of two common treatments for early lymphedema: wearing compression sleeves and CDT (complex decongestive therapy). To their surprise, the researchers found that a sleeve was equally, if not more, effective, as well as simpler and much less expensive.

  Here is the start and a link to read more:

Try Compression Sleeves First for Early Lymphedema
Fran Lowry

A trial that randomized women with early lymphedema to receive either complex decongestive therapy (CDT) or
compression garments was unable to show that CDT is better than the more conservative, less expensive approach.
Several cohort studies have suggested that CDT — which consists of manual lymphatic massage or drainage, daily bandaging, exercise, and skin care — is superior to compression sleeves for the treatment of lymphedema.
However, a group of Canadian researchers who thought the evidence for such superiority was not good enough decided to conduct a randomized trial to find a definitive answer.
"I actually thought that our study was going to show that complex decongestive therapy was better, but, in fact, it didn't seem to be any more beneficial than elastic compression sleeves, which are much, much cheaper," said lead author Ian S. Dayes, MD, from McMaster University in Hamilton, Ontario.
The results were published online September 16 in the Journal of Clinical Oncology.

http://www.medscape.com/viewarticle/811611

 

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