Psychosocial Issues Associated with Breast Cancer-Related Lymphedema: a Literature Review

Eaton, Linda H.; Narkthong, Natsayakarn; Hulett, Jennifer M.

doi:10.1007/s12609-020-00376-x

Cited by 51 publications

(36 citation statements)

References 92 publications

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“…Lymphatic pain, swelling, and lymphedema symptoms are ongoing debilitating adverse effects of cancer treatment that elicit distress and negative impacts on breast cancer survivors’ quality of life (QOL). 1 - 3 Breast cancer survivors have a compromised lymphatic system due to cancer treatment, 4 - 6 resulting in an accumulation of lymph fluid in the ipsilateral body or upper limb. 7 - 9 The accumulation of lymph fluid leads to a chronic and co-occurring variety of pain sensations (i.e., pain/aching/soreness) in the ipsilateral upper limb or body defined as lymphatic pain and other symptoms related to fluid accumulation defined as lymphedema symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level

McTernan

Qiu

et al. 2021

Integr Cancer Ther

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Background: The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly. Objectives: This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels. Methods: A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman’s rank correlation coefficients, linear regressions, and Cohen’s d were performed for data analysis. Qualitative data were assessed for common themes. Results: The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain ( MedΔ = −1.00, CI = [−1.5, −0.1], P = .004), arm/hand swelling ( MedΔ = −1.00, CI = [−1.5, −0.5], P = .004), total swelling ( MedΔ = −1.5, CI = [−2.0, −1.0], P = .003), number of lymphedema symptoms ( MΔ = −3.8, CI = [−5.5, −2.1], P < .001), and lymphedema symptom severity ( MΔ = −5.3, CI = [−9.5, −1.1], P = .016). A significant reduction in lymph fluid levels was found in mean L-Dex scores ( MΔ = −2.68, CI = [−4.67, −0.69], P = .010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex ≥ 7.1) ( MΔ = −5.19, CI = [−1.75, −8.63], P = .008). Patients’ qualitative feedback supported the results of the study. Conclusions: The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.

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Section: Introductionmentioning

confidence: 99%

The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level

McTernan

Qiu

et al. 2021

Integr Cancer Ther

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“…It is a chronic and progressive condition, in which insufficient drainage of lymphatic fluid causes swelling and alterations in the upper extremity on the side of the breast in treatment and in functions related to skin, energy and impulses, sexuality, sleep, temperament and personality, as well as in additional sensory functions such as proprioceptive and tactile functions. All these alterations limit the performance of activities and restrict participation in daily situations, decreasing the health-related quality of life (HRQoL) of people suffering from this disorder [ 1 , 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In this sense, patient-reported outcome measures provide valuable information with greater prediction about the effect of BCRL on their HRQoL, rather than objective measurements, and may guide therapeutic decisions, but their heterogeneity hinders international research efforts to improve treatment methods and HRQoL for patients with lymphedema [ 17 ]. Current evidence makes visible the need for further research in cancer rehabilitation, and recommends alternative techniques design and implementation more focused on psychosocial and quality-of-life factors regarding the management of symptoms in patients with lymphedema [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer—A Randomized Clinical Trial

Muñoz-Alcaraz

Torres

Jiménez-Vílchez

et al. 2022

JCM

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Background: Alterations derived from lymphedema in the upper-limb secondary to breast cancer-related lymphedema (BCRL) decrease the health-related quality of life (HRQoL), but there is limited evidence of the impact of the different interventions on it. The aim of this research was to compare the effect of conventional treatment with another treatment based on Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) on HRQoL in women diagnosed with BCRL. Methods: A prospective clinical study was designed with two parallel arms. The study population consisted of women diagnosed with BCRL in stage I and II, belonging to different institutions in Córdoba and Aragon, Spain. Sociodemographic and HRQoL-related variables, pain, tightness, heaviness and functionality were obtained before and after treatments. Results: 51 women participated in the study, 25 received the conventional treatment and 26 the TAPA, with a mean age of 59.24 ± 9.55 years. HRQoL was significantly related to upper-limb function and pain on the participants’ affected side. In addition, covariance analysis (ANCOVA) showed that the TAPA treatment interfered less in the performance of activities of daily life and produced significant improvements in the social dimension of HRQoL. Conclusions: the non-use of compressive elements in the rehabilitative treatment of the BCRL that is proposed with TAPA improves aspects such as self-image and participation in social and recreational activities.

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“…Obesity not only increases the risk of diagnosis and poor prognosis of breast cancer [5][6][7] but also the risk of developing long-term and debilitating adverse effects of cancer treatment [8,9]. Lymphatic pain and swelling due to lymph fluid accumulation are the most common and debilitating long-term adverse effects of cancer treatment that negatively impact breast cancer patients' quality of life [10,11]. Over 90% of women treated for breast cancer have achieved five-year survival due to advances in cancer diagnosis and treatment [12,13].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Obesity on Lymphatic Pain and Swelling in Breast Cancer Patients

Axelrod

Guth

et al. 2021

Biomedicines

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Lymphatic pain and swelling due to lymph fluid accumulation are the most common and debilitating long-term adverse effects of cancer treatment. This study aimed to quantify the effects of obesity on lymphatic pain, arm, and truncal swelling. Methods: A sample of 554 breast cancer patients were enrolled in the study. Body mass index (BMI), body fat percentage, and body fat mass were measured using a bioimpedance device. Obesity was defined as a BMI ≥ 30 kg/m2. The Breast Cancer and Lymphedema Symptom Experience Index was used to measure lymphatic pain, arm, and truncal swelling. Multivariable logistic regression models were used to estimate the odds ratio (OR) with 95% confidence interval (CI) to quantify the effects of obesity. Results: Controlling for clinical and demographic characteristics as well as body fat percentage, obesity had the greatest effects on lymphatic pain (OR 3.49, 95% CI 1.87–6.50; p < 0.001) and arm swelling (OR 3.98, 95% CI 1.82–4.43; p < 0.001). Conclusions: Obesity is a significant risk factor for lymphatic pain and arm swelling in breast cancer patients. Obesity, lymphatic pain, and swelling are inflammatory conditions. Future study should explore the inflammatory pathways and understand the molecular mechanisms to find a cure.

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Psychosocial Issues Associated with Breast Cancer-Related Lymphedema: a Literature Review

Cited by 51 publications

References 92 publications

The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level

The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level

Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer—A Randomized Clinical Trial

The Effects of Obesity on Lymphatic Pain and Swelling in Breast Cancer Patients

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