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Early detection key to managing breast cancer-related lymphedema

Are you at risk for lymphedema? Yes or no
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Take the lymphedema awareness quiz to be entered into a draw for a $50 Thermëa Winnipeg gift card

JENNIFER DALKE
Winnipeg Regional Health Authority
Published Friday, March 3, 2017

It's one of the little known problems that can come with battling breast cancer.

Every year, hundreds of people manage to overcome this disease, thanks to early detection, surgery and treatment. But for many of these women and men, the journey doesn't end there.

Unfortunately, a number of them will go on to develop another chronic condition, one that is associated with the treatment that saved their lives.

The condition is called lymphedema (lim-fa-DEE-ma), and it can affect breast cancer survivors up to 15 years after they have been treated.

Characterized by swelling of the arms, hands or chest, breast cancer related-lymphedema is caused by changes to the lymph nodes.

The body's lymphatic system uses fluids to help fight infection and remove waste. Some treatments for breast cancer, such as surgery and radiation therapy, can remove or alter the lymph nodes, resulting in lymph fluid collecting and pooling in an arm, hand or chest. It is this pooling of fluid that causes the swelling.

Estimates on how many people are affected by breast cancer-related lymphedema vary. The numbers show that more than 800 individuals in this province are treated for breast cancer. And it is generally accepted that about 20 per cent of them will develop breast-cancer related-lymphedema over the course of their lifetime.

But there is good news. While lymphedema is not curable, it can be managed.

Swelling can be reduced with manual lymphatic drainage and compression bandaging, as well as exercise and skin care. Left untreated, lymphedema can progress and cause unnecessary pain and suffering. But if detected early, lymphedema can be managed with less treatment and therapy and can have less of an impact on one's regular life-style.

As a result, it is important for patients at risk for developing this condition to be aware of the signs and symptoms, and report changes to their health-care provider. Warning signs of lymphedema include tightness, heaviness, achiness, and/or visible swelling of the arm, hand, chest or breast.

It is possible to lower one's risk for lymphedema. For example, maintaining as healthy a body weight as possible by following a well-balanced diet and exercising is very important. Research shows that when done correctly and increased slowly, exercise will not cause or worsen lymphedema. In fact, resistance exercise specifically has been shown to help reduce lymphedema symptoms and flare-ups in women with breast cancer.

Patients are encouraged to find an exercise that they like to do. It should be started at a low intensity even if they exercised regularly before surgery. The exercises should be slowly increased. Everyone's body is different. There is no single exercise program that works for everyone.

You can also reduce your risk by taking good care of skin and nails. This reduces the risk of infection or injury. Whenever possible, avoid using the arm on the side of the surgery for blood pressure, blood tests, needles and intravenous therapies (IV). Avoid long exposure to heat for example hot tubs and saunas.

The Winnipeg Regional Health Authority's Breast Health Centre has two certified lymphedema therapists on staff to provide treatment and education for patients. Using current guidelines and up-to-date research, they provide therapy, arm measurements, and customized exercises along with care and support. These services are available for all Manitobans with breast cancer-related lymphedema, but a referral from a primary health-care provider is required.

In order to focus public attention on this condition, various governments around the world have set aside March 6 as Lymphedema Awareness Day. This year, the Breast Health Centre will mark lymphedema awareness with on-line quizzes, new exercise programs and posters at various clinics across the city and province. For more information on Lymphedema, visit the website at www.wrha.mb.ca/bhc.

Jennifer Dalke is a certified lymphedema therapist with the Winnipeg Regional Health Authority's Breast Health Centre

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