So you’ve had surgery for breast cancer – it could be in the form of a lumpectomy (partial mastectomy), mastectomy, lymph node biopsy or axillary node clearance. Following such procedures, often, patients find themselves asking, where to from here? Some of the many questions that may arise would be:
- How do you know if you will be at risk of Lymphoedema?
- Where can you access the services to help you get back on your feet and return to work?
- Where can you buy a compression garment for your arm?
As a PINC Cancer Rehab Physiotherapist I am often asked these questions. Lymphoedema is a very real and scary side-effect of breast cancer surgery and treatments used for cancer. So what IS Lymphoedema?
Lymphoedema is the abnormal accumulation of protein rich fluid in the body and limbs. It can be affected by any of the following:
- removal of lymph nodes
- scar tissue
- radiation therapy
Breast cancer surgery and treatment can be one of the major causes of secondary lymphoedema. This means, lymphoedema with an onset later on in life and after any of the above procedures. There are also other risk factors for developing lymphoedema and these may include:
- removal of a large amount of lymph nodes
- large amounts of drainage required post surgery
- people with a higher BMI tend to have a greater risk of developing lymphoedema
- radiation therapy
- age – the lymphatic system gets older as we do
- and chemotherapy – although only a small risk factor, chemo can increase capillary permeability that can predispose someone to Lymphoedema.
You may ask – what does lymphoedema feel like and how do I know if I have it? People often describe the early symptoms of lymphoedema as:
- a tingling or stretching sensation in the skin
- one arm that feels tight in my usual clothes and sleeves
- a mild pain, heaviness or aching in the trunk, under arm, across the back and even down the arm into the fingers (in one or all of these areas)
- the inability to fit into your wedding rings or dress rings
So what happens next? A lymphoedema therapist will take measurements of each of your arms (for comparison) to see whether there is any increase in the circumference of the limb. Based upon these results and extensive investigation into your medical history, your therapist may do one of the following:
- Hands-on treatment for lymphoedema – manual lymphatic drainage technique (MLDT) or the Vodder technique – these are the usual methods used in Australia at present
- Bandage your arm – this might be done to reduce the size and swelling in your arm.
- Measure and prescribe a compression garment – there are many brands on the market but your lymphoedema therapist will know which is most appropriate
- Teach you or your partner/family how to massage and drain your arm at home
- Prescribe and discuss exercises that will help improve lymphatic flow and reduce Lymphoedema
Having had breast cancer increases your risk of developing lymphoedema by up to 30%. If you are concerned that you may be developing lymphoedema, it is important that you consult your PINC cancer rehabilitation physiotherapist, Lymphoedema therapist or other qualified health professionals in the area of cancer rehabilitation. Recognising the symptoms of Lymphoedema early can often reduce the intervention needed, the cost associated with treatment and heartache due to yet another side-effect of cancer treatment.
Cancer rehabilitation is a complex discipline and appropriate postgraduate training is required. Hence it is essential that a person gets the most appropriate care possible. For more information on Lymphoedema and its management contact your local PINC Cancer Rehabilitation Physiotherapist or the friendly staff at Perth Cancer Care on 9367 4966 today!
Blog post by:
PINC & STEEL Cancer Rehabilitation Physiotherapist