Lymphedema Post Breast Cancer Treatment
Chances are every single one of us knows someone who has been diagnosed with cancer. Treatments can be difficult; both mentally and physically challenging. The journey continues after medical treatment finishes as survivors begin to reclaim their life.
A breast cancer survivor often means you have experienced surgery, radiation and/or chemotherapy. Any of these individually or a combination of treatment often leads to a reduction in how well you can move the arm.
Common Issues After Treatment
Other common physical issues after surgery and treatment for breast cancer include:
- Tingling, numbness, and pain on the treated side
- Reduced or diminished sensation
- Weakness and some loss of movement
- Reduced or diminished strength
- Axillary Web Syndrome: cording in the arm, armpit, or forearm
- Fatigue/reduced energy
- Lymphedema
What is Lymphedema?
Lymphedema is a debilitating condition of localized fluid retention caused by a compromised lymphatic system. It is most frequently seen after breast cancer treatments such as lymph node dissection, surgery and/or radiation therapy, which can damage the lymphatic system of the arm.
Signs of Lymphedema
- Swelling in the arm, hand, breast, or chest wall
- Heaviness, achiness, or tightness in the arm
- Arm fatigue
- Arm pain
Lymphedema and Physical Therapy
Lymphedema treatment has largely been limited to conservative management interventions to include manual lymphatic drainage therapy, compression garments, bandaging, and pneumatic pump devices.
Chronic swelling, discomfort, and skin infections are among the symptoms that may be improved with proper therapy and in some cases, microsurgical repair may be recommended as part of your overall lymphedema treatment.
Complete Decongestive Therapy(CDT) by certified Lymphedema Physical therapists play a significant role in lymphedema treatment.
Lymphedema treatment often includes but is not limited to:
- Compression sleeves/garments
- Exercises
- Manual lymph drainage
- Self care (skin health, eating well)
Lymphatic therapy has been shown to be successful reducing the degree of lymphedema and improving symptoms.
There is no known cure for lymphedema currently however research continues to explore options.
There is also no known reason for why some develop lymphedema after surgery or radiation, and some do not. Weight gain, trauma/injury or a burn (including sunburn) may trigger lymphedema.
Recent Research on Lymphedema Occurrence
A new study shows that free flap breast reconstruction immediately after mastectomy may reduce lymphedema more than 50%.
Physical Therapy Treatment
Lymphatic therapy is recommended to help manage the symptoms of lymphedema and in many cases the degree of swelling is reduced. it brings together three major therapies — massage, compression, and exercise. It also involves self-care related to skin health, eating well, and other recommendations you can practice at home.
Physical therapy treatment includes a comprehensive initial evaluation. Treatment is catered to your medical history and physical function. Treatment can include manual therapy to decrease pain, improve tissue mobility (scar tissue) and improve range of motion.
Exercises are prescribed to allow for gentle return to activities and a normal routine. Exercises are broken into aerobic, strengthening and then long term health and fitness exercises to decrease the risk of cancer returning, weight gain, and reduce the risk of lymphedema.
Physical Therapy Goals
- Decrease pain
- Mobilize scar tissue and restore tissue mobility
- Improve range of motion and strength
- Improve fatigue levels
- Improve quality of life and physical function
Is Physical Therapy Recommended Before Cancer Treatment?
Pre-hab (or rehabilitation before surgery, chemotherapy or radiation therapy) may also be prescribed by your oncologist. This aims to improve your physical function before treatment in hopes of regaining function and quality of life sooner after treatment finishes.
Resources/More Information
- Lymphedema Breast Surgery, New Orleans, LA – Center for Restorative Breast Surgery (breastcenter.com)
- Dr. Scott Sullivan, Dr. Frank DellaCroce and Dr. Christopher Trahan are all located in the Center for Restorative Breast Surgery in New Orleans.
- The revolutionary Vascularized Lymph Node Transfer (VLNTx) procedure for lymphedema can be performed at the St. Charles Surgical Center when combined with any reconstructive breast surgery or as follow-up treatment to a previous surgery. VLNTx is a microsurgical transplantation procedure where several lymph nodes and their associated perivascular fat, arteries and veins (collectively called a “flap”) are removed from a low-risk location of the body and transplanted to the affected limb.
- www.cancer.org
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508247/
