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There is not much science backing up the following practical tips. They are
based largely on common sense, clinical and anecdotal experience.
Over 75% of breast cancer – related lymphedema occurs in the first three years
after axillary dissection (with or without radiation). Arm infection/injury and
weight gain are the only two statistically significant controllable risk factors
for developing or aggravating lymphedema. Therefore, scrupulous skin care is
recommended, at least for the first three years after breast cancer treatment.
This includes avoiding cuts, insect bites, pet scratches, burns (including
sunburn), hang nails, contact irritants to the arm as well as medical procedures
such as blood drawing, intravenous lines, vaccinations, blood pressure
monitoring, and acupuncture. Most vaccinations, however, in order to work, need
to be given in an arm. Liberal use of moisturizing creams, sunscreen,
insecticides, oven mitts, protective gloves when gardening, and long sleeves are
encouraged.
When faced with breast cancer in both breasts, the arm that has not been
subjected to axillary dissection or that of the least diseased breast (least
number of cancerous nodes harvested from the axilla) should be used for medical
procedures. The oldest arm, in terms of treatment can also be used. For
instance, if a woman, after having had breast cancer in the left breast,
develops breast cancer in the right breast three years later, she could probably
get away with using her left arm for procedures. If the axilla on the breast
cancer side has not been touched by radiation or dissection, it is probably very
safe to use that arm for medical procedures. Drawing blood from or starting
intravenous lines in the lower extremities (legs) can be very painful,
inconvenient and prone to infection.
Maintenance of ideal body weight is important in preventing and controlling
lymphedema. Exercise, such as running, cycling, swimming, hiking, walking may
help in controlling weight. Vigorous upper body exercise such as rowing, tennis,
squash, golf, skiing, racket ball has, so far, not been shown to worsen or cause
lymphedema. Diet, unless used for weight loss, has not been shown to prevent or
affect lymphedema.
or the control of lymphedema, compression therapy, especially the compression
sleeve, has the best scientific support so far. Compression pumps, pneumatic
pressure sleeves, and the bandaging techniques of Manual Lymph Drainage (MLD)
and Complex Physical Therapy (CPT) may be useful in reducing the lymphedema to a
controllable size that can then be maintained by a compression sleeve.
Because there is anecdotal evidence that air travel may aggravate lymphedema, a
compression sleeve for air travel may be advisable. Saunas, steam baths, and
tropical climates can also aggravate lymphedema in some people.
As mentioned above, scrupulous skin care to prevent infection and ideal body
weight maintenance are crucial for the control of lymphedema. If infection
develops, which is almost always streptococcal, prompt treatment with an
antibiotic such as penicillin, cephalosporin or a macrolide is necessary. If
recurrent infections occur, it may be advisable to have an emergency home supply
of antibiotics to be taken at the earliest signs of infection. When traveling to
a remote area, a supply of antibiotics should be taken along in case of
infection.
If lymphedema develops or worsens abruptly, it is important to check for cancer
in the axilla or a blood clot in the arm.
For further information please refer to:
1. Canadian Medical Association Journal 2001;164(2):191-9 Clinical practice
guidelines for the care and treatment of breast cancer: 11. Lymphedema
2. Cancer , September 15, 2001 / Volume 92 / Number 6. Lymphedema in a cohort of
breast carcinoma survivors 20 years after diagnosis – Jeanne A. Petrek et al.
Source :
http://www.abreastinthewest.ca/corner2.cfm?Num=42