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General information and treatment options for breast cancer survivors battling lymphedema as presented by Jane A. White, Director of Rehabilitation Services at CTCA in Phoenix at Well-Healed: A Survivor Celebration.
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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