Cancer Treatment Centers of America® Lymphedema Education for the

Breast Cancer Survivor

Presented at: Well-Healed: A Survivor CelebrationPresented by: Jane A. White, PT, MPT, CLT

Date: August 30, 2012

© 2012 Rising Tide

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Breast Cancer Statistics

• Most common cancer affecting women in U.S.• Death rates declining – attributed to increased

awareness and earlier disease detection• One in 8 American women will be diagnosed

during their lifetime• Over 2.5 million breast cancer survivors in U.S.

© 2011 Rising Tide

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Cancer Survivor Definition

• National Coalition for Cancer Survivorship states:

– “a cancer survivor from time of diagnosis and for the balance of life”

© 2011 Rising Tide

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Lymphedema

• What is it?• Who gets it?• Early identification important• Four stages• Who can treat it?• How is it treated?

© 2011 Rising Tide

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Lymphedema

• What is it?– Definition: Lymphedema is an abnormal

accumulation of protein rich fluid in the interstitial tissue.

– This leads to swelling of a body part, usually in the extremities but also occurring in the face, neck, trunk, abdomen, or genitals.

– Two types: primary and secondary• Primary – may be present at birth or develops in childhood or

at puberty for unknown reasons• Secondary – known cause, such as surgery or radiation

therapy for breast cancer.

© 2011 Rising Tide

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Lymphedema

• Who gets it?– Anyone who has had surgery, radiation, infection, or

trauma.– Any event that interrupts the normal lymphatic

pathway– Undeveloped countries, filariasis is the most common

cause of lymphedema

© 2011 Rising Tide

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Four Stages of Lymphedema

• I. Latency

• II. Stage 1 (Reversible)

• III. Stage 2 (Spontaneously Irreversible)

• IV. Stage 3 (Elephantiasis)

© 2011 Rising Tide

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Early Identification

• Early treatment may lead to better outcomes• Lymphedema is a chronic condition; no cure• Must be well-managed to maintain quality of life

and be able to perform activities of daily living• Detecting subclinical lymphedema

(bioimpedance)

© 2011 Rising Tide

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Who can treat lymphedema?

• Medical professionals who have received specialized training

• Nurses, physical therapists, occupational therapists

• Directories available (see reference page)

© 2011 Rising Tide

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How is it treated?

• Complete Decongestive Therapy (CDT)– Gold standard of treatment– Four components

• Skin care• Manual Lymph Drainage• Compression Therapy• Decongestive Exercises

© 2011 Rising Tide

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Skin Care

© 2011 Rising Tide

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Manual Lymph Drainage (MLD)

© 2011 Rising Tide

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Compression

© 2011 Rising Tide

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Sleeves, Gloves, & Gauntlets

© 2011 Rising Tide

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Decongestive Exercise

© 2011 Rising Tide

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What can I do today?

• Be aware of potential “red flags” of lymphedema development

• Learn all you can – empower yourself through education

• Be prepared to educate others (including your physician)

• Consider adopting the risk reducing behaviors suggested by the NLN.

• Maintain normal body weight

© 2011 Rising Tide

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In Closing

• The goal of this presentation was to inform you – not scare you.

• Conquering cancer is always the primary focus• Every treatment has some type of side effect• Knowledge gives you control – if you did not

know before, you now know what to look for and what to do

• It is about healing the whole person, improving quality of life, and restoring hope!

© 2011 Rising Tide

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References

• American Cancer Society. (2011). What causes lymphedema? Retrieved from http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/Lymphedema/WhatEveryWomanwithBreastCancerShouldKnow/index

• Klose Training & Consulting, LLC. (n.d.). Therapist Directory. Retrieved from http://www.klosetraining.com/TherapistDirectory.asp

• Lymphology Association of North America. (2008). Certified LANA Therapists. Retrieved from http://www.clt-lana.org/therapists/default.asp

• National Coalition for Cancer Survivorship. (2012). About us. Retrieved from http://www.canceradvocacy.org/about-us/

• National Lymphedema Network. (2011). Lymphedema clinics and therapists. Retrieved from http://www.lymphnet.org/resourceGuide/manualDrainage.htm

• National Lymphedema Network. (2012). Position statement of the national lymphedema network. Lymphedema risk reduction practices. Retrieved from http://www.lymphnet.org/pdfDocs/nlnriskreduction.pdf

• Norton School of Lymphatic Therapy. (2012). Therapist referrals. Retrieved from http://www.nortonschool.com/therapistreferrals_form.html