Trying to Help Lymphedema

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

DECEMBER 04, 2017

Although it is a relatively infrequent side effect of cancer surgery, many patients are quite worried about the possibility of developing lymphedema. I hear most about it from women who have had breast cancer surgeries, but it happens to others, too. Any time that numerous lymph nodes have been surgically removed, this is a possibility. For women with breast cancer, those who are most at risk are women who have had a full axillary dissection (as opposed to the more common sentinel node dissection) and radiation therapy. The other large cluster of patients for whom this is a concern are melanoma patients, depending on the location of the lesion and the extent of the surgery.

From Hem/Onc Today comes this article about the value of early detection and possibilities and future hopes about treatment. The current reality is that lymphedema can be managed, but not cured.

Awareness, early intervention needed to reduce impact of breast
cancer-related lymphedema

An estimated 10 million Americans suffer from lymphedema or related diseases. The debilitating and painful chronic condition — caused by collection of fluid in fatty tissue — most often is characterized by swelling of the arms and legs. Swelling also can occur in the head, chest or genitals.

All individuals who undergo cancer treatment are susceptible to lymphedema, but it occurs most frequently among those whose lymph nodes were removed or damaged during therapy.
The risk is particularly high for patients with breast cancer, some of whom require axillary lymph node dissection. An estimated 25% to 30% of women who undergo the procedure develop lymphedema.

Despite this high prevalence, the condition often is unaddressed as a possible longterm
side effect of treatment.

“Lymphedema has fallen a bit off the radar, but the problem has not gone away,”
Gary H. Lyman, MD, MPH, FASCO, FRCP (Edin), codirector of Hutchinson Institute
for Cancer Outcomes Research at Fred Hutchinson Cancer Research Center, told
HemOnc Today. “It still, for these affected women, can have a profound impact on
their lives.”

The development of less aggressive surgical techniques — such as sentinel lymph
node biopsy — have reduced the incidence and severity of lymphedema.
“Breast cancer management has trended toward using fewer surgical interventions,
which has led to considerable improvements,” Lyman said. “It’s good news, but I don’t
want to downplay the fact that the problem is still there. Ideally, women who are
affected find it early and are managed with appropriate interventions.”

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