December 30, 2008

Doctors Study New Methods Of Preventing Lymphedema

Hospitals in many states nationwide are looking into new simple methods of reducing breast cancer survivors' risk of developing lymphedema.

Lymphedema is a painful condition that causes a patient's arm to swell. It is a common side effect of cancer treatments such as surgery and radiation.

"I have ladies tell me the lymphedema is much worse than their cancer because the cancer's cured," says Dr. Electra Paskett, an epidemiologist at Ohio State University. Paskett is among those health care professionals who are trying to find the most effective methods of keeping lymphedema at bay.

One of such methods involves elastic sleeves when doing activities that may cause arms to swell.

"The theory is building up muscles in your arm acts as a natural pneumatic pump to move the fluid," explains Paskett, herself a breast cancer survivor who developed lymphedema.

Since lymphedema is caused by an uncontrolled infection, other limbs, such as the legs, can swell as a result of damaged nodes from other cancers. Former presidential candidate John McCain suffered from facial swelling as a result of melanoma treatment.

But, as it affects an estimated 20 percent to 30 percent of patients who have 10 or more under-the-arm nodes examined, called "axillary lymph node dissections," the condition is assumed to be most common among breast cancer survivors

In November, researchers reported findings in the Journal of Clinical Oncology that suggests few such women may be aware that they have the condition.

University of Minnesota researchers analyzed records from the huge Iowa Women's Health study, to cull more than 1,200 patients who'd had breast cancer between 1986 and 2003. Only 8 percent of patients had been diagnosed and another 37 percent of the women suffered persistent lymphedema symptoms, including a swollen arm.

Researchers in the Iowa study found that only 40 percent of the women with swollen arms but no diagnosis had heard of lymphedema and less than 2 percent had sought care for their arm symptoms.

Early treatment of lymphedema is crucial. After 61-year-old Minna Manalo, a nurse practitioner at Georgetown University Hospital's breast cancer unit, was diagnosed with the condition she underwent what's called complete decongestive therapy, where a machine massaged fluid from her arm and it then was tightly bandaged to counter swelling. Once her arm shrank, Holman was prescribed a lifelong therapy: A tight elastic sleeve and fingerless glove to wear regularly, especially during her job as an international flight attendant, plus arm exercises to help push out returning fluid.

"I'm trying to stay ahead of the game," says Holman. "You can't cure this, but you can manage it."


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