Chronic oedema/lymphoedema: under‐recognised and under‐treated

Abstract

Even though it is estimated that at least 300 000 people in Canada may be affected by chronic oedema/lymphoedema, recognition of the seriousness of this chronic disease in health care is scarce. Lymphoedema affects up to 70% of breast and prostate cancer patients, substantially increasing their postoperative medical costs. Adding to this problem are the escalating rates of morbid obesity across North America and the fact that 80% of these individuals are thought to suffer with an element of lymphoedema. The costs related to these patient populations and their consumption of health care resources are alarming. Untreated chronic oedema/lymphoedema is progressive and leads to infection, disfigurement, disability and in some cases even death. Thus, prognosis for the patient is far worse and treatment is more costly when the disease is not identified and treated in the earlier stages. Although the number of individuals coping with chronic oedema/lymphoedema continues to increase, the disparity between diagnosis, treatment and funding across Canada endures. The reasons for this include a lack of public awareness of the condition, insufficient education and knowledge among health care providers regarding aetiology and management and limited financial coverage to support appropriate methods and materials.

Felt Needs for Rehabilitation After Breast Cancer Treatment in Mexico

“…Contrary to previous indings showing that the needs and complications reported by patients tend to be greater than those reported by clinicians [38], the women in this study seemed to give less importance to the functional limitations than to what their actual clinical assessment revealed nearly all women included in this study had signiicant functional motion restrictions as assessed by a physiotherapist data not presented . Yet, most of those experiencing limitations after surgery did not even try to seek rehabilitation care in agreement with others studies reporting that just few women are aware of the importance of postreatment rehabilitation, especially in poor setings [17,39,40].…”

“…"t present, the health system mainly focuses on survival, namely, on primary and adjuvant treatment [56,57] whereby postreatment care is left to NGOs such as the RETO group that provide information, exercise programs, lymphatic drainage and other activities to support women during the rehabilitation period. Yet, this study and others [16,17,39,40] illustrate the need of rehabilitation and psychological therapy in addition to surgical treatment and radiotherapy for "C women.…”

Knowledge of Primary Care Physicians About Breast-Cancer-Related Lymphedema: Turkish Perspective

“…Also, early diagnosis and treatment of BCRL is believed to lead to better outcomes [19]. The integration of BCRL assessment during routine follow-up visits of primary care physicians, general surgeons, and oncologists could lead to significant declines in the emotional, physical, and financial costs of BCRL to breast cancer survivors as well as to society [20]. Also, general surgeons should provide sufficient information for patients and their caregivers to prevent this complication, especially for those who are at high risk of developing lymphedema in preoperative period [21].…”

Lower limb chronic edema management program: Perspectives of disengaged patients on challenges, enablers and barriers to program attendance and adherence

“…Chronic edema is under-recognized and under-managed globally [8]. This has been postulated as due to a lack of published diagnostic and epidemiological data [7, 9, 10]. Hence, there is little published data on prevalence rates of the CO of a non-cancer etiology.…”