Lymphedema is a swelling that can happen in the hand, arm, chest, or breast after removal of lymph nodes for breast cancer. When I started practicing over 15 years ago, most women with lymphedema came to the clinic with their swelling already advanced, ie a visibly swollen arm or breast.
Today, we know better.
We do not have a cure for lymphedema. We cannot prevent lymphedema. We cannot always predict who will get lymphedema, but we better understand through research which patients may be at a higher risk.
But we can educate. Educate physicians and nurses to send patients to Certified Lymphedema Therapists (CLTs) if their patients fall in a high risk category for lymphedema, and to listen to patients who may not be high risk, but are complaining of early signs and symptoms of lymphedema (“my arm feels heavy”, “my hand feels full”, “my rings are tight”, “my arm aches”.) We now know that treatment at the earliest stages of lymphedema can sometimes reverse the swelling back to normal.
We can educate patients and their caregivers. We can teach them to identify early signs and symptoms of lymphedema. We can teach them simple daily habits that they can do to reduce their risk of getting lymphedema. We can teach them what to do if they have some swelling. We can teach them to listen to their bodies and trust their gut if something feels off.
So – if you had lymph nodes removed as part of your breast cancer treatment, ask your doctor or nurse about lymphedema. If you have questions, or are overweight (obese, BMI>30), had an axillary lymph node dissection (more than approximately 10 lymph nodes), radiation to the area above your collarbone and/or in your armpit/axillary nodes, or had an infection (i.e. cellulitis) after surgery – be proactive. Talk to your doctor. Early diagnosis and treatment can give you the best chance at controlling the swelling as much as possible.
One recent study looked at women who had early signs and symptoms of lymphedema. One group had lymphedema treatment and the other did not. The results? 4% of those in the treatment group went on to have clinical lymphedema versus 36% in the control group that did not receive treatment.
Knowledge is power. It is our responsibility to educate everyone involved in the care of cancer patients to the benefits of early intervention in those who are at risk of breast cancer related lymphedema.
PT of Costa Rican National Soccer Team for 2007 World Cup in Victoria, CAN. Clinical Instructor for University of Minnesota Doctor of Physical Therapy Affiliations
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