Reduction of Lymphedema Using Complete Decongestive Therapy: Roles of Prior Radiation Therapy and Extent of Axillary Dissection

Thomas, R. Croft; Hawkins, Kennedy; Kirkpatrick, Stephanie; Mondry, Tammy E.; Gabram-Mendola, Sheryl; Johnstone, Peter A.S.

doi:10.2310/7200.2007.004

Cited by 11 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, a 35% reduction in lymphoedema volume was achieved after 12 treatments. This compares positively with the findings of Thomas et al (2007) who found a median lymphoedema reduction of 36% after 12 treatments. Mondry, Riffenburgh and Johnstone (2004) reported a median reduction of 138 mL after a median treatment period of 2 weeks (10 treatments).…”

Section: Discussionsupporting

confidence: 76%

See 1 more Smart Citation

Yes, breast cancer related lymphoedema can be managed

Maree

2011

Health SA Gesondheid

View full text Add to dashboard Cite

The purpose of the study was to demonstrate that breast cancer related lymphoedema can be managed by means of Complete Decompression Therapy and consequently improve quality of life. An instrumental case study design was used. The target population was all women with breast cancer related lymphoedema living in Tshwane, the context of the study. The patient with the most severe breast cancer related lymphoedema treated by the researcher is presented. Mixed methods were used to gather data. The expected 60% limb volume reduction could not be achieved after 4 weeks of induction therapy. After 8.5 weeks of treatment, the limb volume reduced from the initial 3841 mL to 1639 mL, a 57.2% reduction. Patient compliance to compression therapy was a challenge and led to relapse extending the induction phase of treatment. Despite the prolonged treatment, the limb volume reduction improved the patient’s quality of life. The study demonstrated and confirmed that despite a degree of noncompliance, breast cancer related lymphoedema can be managed with Complete Decongestive Therapy which, in turn, improves the quality of life of women living with breast cancer.OpsommingDie doelstelling van die studie was om te demonstreer dat borskanker-verwante limfedeem deur middel van Volledige Dekompressie Terapie beheer kan word wat gevolglik die pasiënt se lewenskwaliteit verbeter. ‘n Instrumentele gevallestudie-ontwerp is gevolg. Die populasie waaruit die geval gekies is, het uit alle vroue met borskanker-verwante limfedeem in Tshwane, die konteks van die studie, bestaan. Die pasiënt met die ergste limfedeem wat die navorser behandel het, word voorgedra. Gekombineerde metode is ingespan om data in te samel. Die verwagte 60% vermindering in die armedeem binne 4 weke van induksie behandeling is nie bereik nie. Na 8.5 weke van behandeling het die edeem van die oorspronklike 3841 mL tot 1639 mL verminder wat ‘n 57.2% reduksie verteenwoordig. Die pasiënt het nie die voorskrifte ten opsigte van dekompressie terapie noukeurig nagekom nie, wat terugvalling en ‘n verlengde induksie-fase tot gevolg gehad het. Die vermindering van die armedeem het die pasiënt se lewenskwaliteit nogtans positief beïnvloed. Die studie het aangetoon dat, ten spyte van pasiënt afvalligheid, dit moontlik was om borskanker-verwante limfedeem deur middel van Volledige Dekompressie Terapie te verminder en lewenskwaliteit te verbeter.

show abstract

Section: Discussionsupporting

confidence: 76%

“…Bertha's volume reduction after 12 treatments was 1095 mL. The median duration of treatment before reaching a measurement plateau is reported to be 2 weeks (Mondry et al 2004) and 12 treatments (Thomas et al 2007). Bertha's measurements did not reach a plateau but went up and down.…”

Section: Discussionmentioning

confidence: 95%

Yes, breast cancer related lymphoedema can be managed

Maree

2011

Health SA Gesondheid

View full text Add to dashboard Cite

show abstract

“…The extent of LE is quantified at regular intervals throughout Phase 1, such that total differences in volume can be calculated from measurements taken at the beginning and end of Phase 1. The assessment of LE is performed by interval measurements of girth along the affected limb and computation of a volume 6. A difference in girth ≥2 cm between a patient's limbs is sufficient to diagnose LE.…”

Section: Methodsmentioning

confidence: 99%

Manipulative therapy of secondary lymphedema in the presence of locoregional tumors

Pinell

Kirkpatrick

Hawkins

et al. 2008

Cancer

Self Cite

View full text Add to dashboard Cite

BACKGROUND. Complete decongestive therapy (CDT), including manual lymphatic drainage (MLD) is a manipulative intervention of documented benefit to patients with lymphedema (LE). Although the role of CDT for LE is well described, to the authors' knowledge there are no data regarding its efficacy for patients with LE due to tumor masses in the draining anatomic bed. Traditionally, LE therapists are wary of providing therapy to such patients with ‘malignant’ LE for fear of exacerbating the underlying cancer, and that the obstruction will render therapy less effective. In the current study, the authors' experience providing CDT for such patients is discussed. METHODS. Cancer survivors with LE were referred to therapists at 2 Atlanta‐area clinics. CDT consists of treatment (Phase 1) and maintenance phases (Phase 2). During Phase 1, the patient undergoes manipulative therapy and bandaging daily until the LE reduction plateaus; at that point, Phase 2 (self‐care) begins. At the beginning and end of Phase 1, LE is quantified and differences in girth volume calculated. The results for patients completing Phase 1 therapy for LE in the presence of locoregional masses were compared with results for patients with LE in the absence of such disease. Both volume reduction of the affected limb and number of treatments to plateau were analyzed. RESULTS. Between January 2004, and March 2007, LE of 82 limbs in 72 patients was treated with CDT and Phase 1 was completed. The median number of treatments to plateau was 12 (range, 4–23 treatments); the median limb volume reduction was 22% (range, −23 to 164%). Nineteen limbs (16 patients) with associated chest wall/axillary or pelvic/inguinal tumors had nonsignificant difference in LE reduction (P = .75) in the presence of significantly more sessions to attain plateau (P = .0016) compared with 63 limbs in 56 patients without such masses. CONCLUSIONS. Patients with LE may obtain relief with CDT regardless of whether they have locoregional disease contributing to their symptoms. However, it will likely take longer to achieve that effect. Manipulative therapy of LE should not be withheld because of persistent or recurrent disease in the draining anatomic bed. Cancer 2008. © 2007 American Cancer Society.

show abstract

“…Both patients with upper and lower extremity lymphedema who were adherent during the maintenance phase were found to retain 90% of the initial reduction, whereas nonadherent patients regained on average 33% of the initial reduction 74. Other smaller studies with subject numbers ranging from 14 to 138 patients reported volume reductions of 22% to 73%, with the number of treatment sessions varying from 6 to 36 visits 75–81…”

Section: Management Of Lymphedemamentioning

confidence: 97%

Lymphedema: A primer on the identification and management of a chronic condition in oncologic treatment

Lawenda¹,

Mondry²,

Johnstone³

2009

CA: A Cancer Journal for Clinicians

309

272

View full text Add to dashboard Cite

The primary goals of oncologic therapy are the compassionate care of cancer patients, eradication of disease, and palliation of symptoms. Advances in various targeted therapies such as highly conformal and image-guided radiotherapy techniques, sentinel lymph node dissection, and molecularly targeted agents hold the promise of allowing those goals to be reached with fewer treatment-related complications. Unfortunately, certain side effects remain problematic due to the inability to completely avoid injuring normal tissues. Lymphedema, a chronic condition that occurs as a result of the body's inability to drain lymph fluid from the tissues, is a common treatmentrelated side effect experienced by cancer patients. In this review, many of the important aspects of lymphedema with which clinicians who treat cancer patients should be familiar are outlined, including the anatomy, pathophysiology, diagnosis, and management of this condition. The authors also identify some of the resources available both to cancer patients with lymphedema and to the clinicians who treat them. It is hoped that this review will convey the importance of the early identification and management of this incurable disorder because this is essential to minimizing its complications.

show abstract

Reduction of Lymphedema Using Complete Decongestive Therapy: Roles of Prior Radiation Therapy and Extent of Axillary Dissection

Cited by 11 publications

References 0 publications

Yes, breast cancer related lymphoedema can be managed

Yes, breast cancer related lymphoedema can be managed

Manipulative therapy of secondary lymphedema in the presence of locoregional tumors

Lymphedema: A primer on the identification and management of a chronic condition in oncologic treatment

Contact Info

Product

Resources

About