Lymphedema beyond breast cancer

Abstract

BACKGROUND: Secondary lymphedema is a debilitating, chronic, progressive condition that commonly occurs after the treatment of breast cancer. The purpose of the current study was to perform a systematic review and meta-analysis of the oncology-related literature excluding breast cancer to derive estimates of lymphedema incidence and to identify potential risk factors among various malignancies. METHODS: The authors systematically reviewed 3 major medical indices (MEDLINE, Cochrane Library databases, and Scopus) to identify studies that included a prospective assessment of lymphedema after cancer treatment. Studies were categorized according to malignancy, and data included treatment, complications, lymphedema measurement criteria, lymphedema incidence, and followup interval. A quality assessment of individual studies was performed using established criteria for systematic reviews. Bayesian meta-analytic techniques were applied to derive summary estimates when sufficient data were available. RESULTS: A total of 47 studies (7779 cancer survivors) met inclusion criteria: melanoma (n ¼ 15), gynecologic malignancies (n ¼ 22), genitourinary cancers (n ¼ 8), head/neck cancers (n ¼ 1), and sarcomas (n ¼ 1). The overall incidence of lymphedema was 15.5% and varied by malignancy (P < .001): melanoma, 16% (upper extremity, 5%; lower extremity, 28%); gynecologic, 20%; genitourinary, 10%; head/neck, 4%; and sarcoma, 30%. Increased lymphedema risk was also noted for patients undergoing pelvic dissections (22%) and radiation therapy (31%). Objective measurement methods and longer follow-up were both associated with increased lymphedema incidence. CONCLUSIONS: Lymphedema is a common condition affecting cancer survivors with various malignancies. The incidence of lymphedema is related to the type and extent of treatment, anatomic location, heterogeneity of assessment methods, and length of follow-up. Cancer 2010;116:5138-49.

A Lymphedema Self-Management Programme: Report on 30 Cases

“…1,4 The incidence of cancer-related lymphe-dema varies by etiology and definition and is considered to be between 6% and 63%. 5 The International Society of Lymphology defines four stages of lymphedema: latent (no noticeable swelling), stage 1 (visible swelling that resolves with elevation), stage 2 (visible swelling that does not resolve with elevation), and stage 3 or elephantiasis (progression to fibrosclerotic changes of the skin). 6 When only one limb is affected, the level of severity is described by comparing the volume of the affected limb to that of the healthy limb: a volume difference up to 20% is considered mild, between 21% and 40% is considered moderate, and above 41% is considered severe lymphedema.…”

The Management of Pain and Opioid Use for Cancer Patients at Palliative Care Clinic

“…[22][23][24][25][26][27] Literatürde kanser hastalarına %8-11 oranında invazif girişim gereksinimi olabileceği, ancak uygun girişimlerin yapılabileceği merkezlerin olmaması veya hastaların bu merkezlere yönlendiril-mesinde çok geç kalındığı bildirilmektedir. [28,29] Terminal dönem kanser hastalarında farmakolojik ve invazif girişimlerin yanısıra ağrı palyasyonunda etkinliği gösterilmiş rehabilitasyon, [30][31][32] psikososyal, [33,34] ve manevi destek [35] gibi tamamlayıcı tedaviler de kullanılmalıdır. Hastanın ve ailesinin ağrı tedavisine aktif katılımı için eğitimleri de göz ardı edilmemelidir.…”

Development of the Lymphoedema Genito-Urinary Cancer Questionnaire

“…To date, most of the research on lymphoedema has focused on its manifestation in relation to breast cancer and its treatment (Cormier et al 2010;Bernas 2013). This has not only led to improved mechanisms for diagnosing and treating lymphoedema for this group of patients (Stout Gergich et al 2008;Torres Lacomba et al 2010), but also to improved cancer treatment techniques.…”

“…By contrast, there is a paucity of research on lymphoedema in relation to other cancer sites, particularly male genitourinary cancer (Cormier et al 2010). The incidence of lymphoedema in relation to genitourinary cancer and its treatment varies according to the richness of the adjacent lymphatic system to the affected site.…”

“…The incidence of lymphoedema in relation to genitourinary cancer and its treatment varies according to the richness of the adjacent lymphatic system to the affected site. A systematic review and meta-analysis reported incidences of 21% for penile cancer, 16% for bladder cancer and 4% for prostate cancer (Cormier et al 2010). These figures are based on a very small number of studies and which, with the exception of one that used penile circumference measurement, utilised subjective approaches to symptom assessment.…”