Health knowledge made personal
Join this community!
› Share page:
Go
Search posts:

Breast Cancer, Physical Therapy & Lymphedema

Posted Jan 23 2010 2:05pm
  

Weekly Health Update:

 


Breast Cancer, Physical Therapy & Lymphedema



 


"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS

 

    Photo of Dr. Wascher  

Updated:  01/17/2010 



The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.

  
Welcome to Weekly Health Update 


 
“A critical weekly review of important new research findings for health-conscious readers”  

BREAST CANCER, PHYSICAL THERAPY &LYMPHEDEMA 

Arm lymphedema, or chronic swelling of the arm, occurs in 10 to 30 percent of women following treatment for breast cancer.  When the lymphatic drainage network in the arm and hand has been disrupted by the surgical removal of axillary (armpit) lymph nodes, or by radiation therapy to the axilla (or, sometimes, following both types of treatment), the delicate network of lymphatic vessels that return excess tissue fluid back to the heart can become obstructed. This lymphatic obstruction can then result in chronic swelling of the hand and arm.  Patients with significant lymphedema of the arm following breast cancer treatment may experience considerable swelling (edema), heaviness, stiffness and discomfort of the affected hand and arm.

Unfortunately, there are no known effective methods available to prevent lymphedema, and once significant lymphedema does develop, compression sleeves and soft tissue massage are the primary treatment modalities currently available.   Unfortunately, currently available lymphedema treatments are often not highly effective for many patients, and there is no known cure for lymphedema once it develops.


Now, a newly published research study, in the British Medical Journal, suggests that physical therapy, when initiated early after breast cancer surgery, can significantly decrease the risk of arm and hand lymphedema.   In this prospective randomized clinical research study, 120 women who underwent removal of their axillary lymph nodes for breast cancer were randomized to one of two groups. Women assigned to the experimental group underwent physical therapy 3 times per week, for a total of 3 weeks. Physical therapy techniques used in this group included manual lymph drainage and soft tissue massage techniques, as well as progressive shoulder exercises.   Both groups of women also underwent the same lymphedema management educational course, but the control group of women did not receive any physical therapy interventions.


Among the 116 women who completed at least one year of follow-up, 18 women (16 percent) went on to develop lymphedema.   Fourteen of the women who developed lymphedema were in the control group, while the remaining 4 women were in the experimental group. Thus, in this clinical study, early physical therapy following axillary lymph node dissection (ALND) was associated with a very significant 72 percent reduction in the risk of developing lymphedema, at least within the first year following breast cancer surgery.


Whether or not the use of early postoperative physical therapy can reduce the incidence of arm lymphedema over periods longer than one year is unknown at this time, and additional follow-up of the patients who participated in this clinical research study will be required to answer this very important question.   However, this is one of the very few studies available that suggests a role for physical therapy in the actual prevention of arm and hand lymphedema following ALND for breast cancer.   If additional, mature follow-up of these patients confirms a long-term benefit from early postoperative physical therapy in preventing arm lymphedema, then a strong case could be made for the routine use of early physical therapy in women who undergo ALND, and perhaps, as well, women who undergo sentinel lymph node biopsy with subsequent radiation therapy to the breast and armpit (axilla) area.


For additional information and resources related to cancer-associated lymphedema, please click on the links below:


http://www.cancersupportivecare.com/Abstracts/asbdpbtps.html


http://meeting.ascopubs.org/cgi/content/abstract/23/16_suppl/8185

http://www.annalssurgicaloncology.org/cgi/content/abstract/15/7/1996

http://www.cancerlynx.com/sln.html

http://doctorwascher.com/Archives/11-23-08.htm

http://doctorwascher.com/Archives/8-16-09.htm 


Disclaimer:  As always, my advice to readers is to seek the advice of your physicianbeforemaking any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author 


For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link:   http://www.youtube.com/watch?v=7-Tdv7XW0qg  


 

  

(Anticipated Publication Date:  March 2010)

 

 

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)

 





Bookmark and Share

  



Send your feedback to Dr. Wascher at:
   rwascher@doctorwascher.net 

Dr. Wascher's Biography 


Links to Other Health & Wellness Sites 


http://doctorwascher.com


Copyright 2007 - 2010   

Robert A. Wascher, MD, FACS
   

All rights reserved
 

 
Dr. Wascher's Archives: 


1-17-2010:   
Breast Cancer, Physical Therapy & Lymphedema

1-10-2010:   Prevention of Surgical Site Infections (SSIs) after Surgery

1-3-2010:     Ginkgo Biloba, Memory & Cognitive Health

12-20-2009:  CT Scans & Cancer Risk


12-13-2009:  
Soy Isoflavones Decrease Breast Cancer Recurrence Risk

12-6-2009:   Salt (Sodium) Intake, Stroke & Cardiovascular Disease

11-29-2009:  Exercise & Prostate Cancer Risk

11-22-2009:  Genistein (Soy Isoflavone) & Prostate Cancer

11-15-2009:  Breast Cancer Treatment & Chronic Pain


1-8-2009:     
Vitamin D & Breast Cancer Risk

11-1-2009:   Exercise & Prostate Cancer Risk

10-25-2009:  HPV Virus & Risk of Breast Cancer

10-18-2009:  
Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009:Vitamin D & Falls in the Elderly


10-4-2009:   
Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber


8-23-2009:   
Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors


8-9-2009:    
Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:    Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer


7-12-2009:   
Breast Cancer & Metformin (Glucophage)

7-5-2009:     Prostate Cancer & Green Tea


6-28-2009:   
Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:   Red Yeast Rice, Statins & Cholesterol

6-14-2009:   Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:     Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery


5-3-2009:     
Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:   Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease


3-15-2009:   
Depression, Stress, Anger & Heart Disease


3-8-2009:    
Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children


3-1-2009:    
Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children


2-22-2009:  
Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer


2-15-2009:  
Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones


2-8-2009:   
Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum


2-1-2009:   Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence


1-25-2009:  
Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?


1-18-2009:  Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors


1-11-2009:  
Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure


1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008:  Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008:  Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008:  Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer;   Postscript: A Possible Cure for Down’s Syndrome


12-7-2008:   
Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival


11-30-2008:  
A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk


11-23-2008:  
Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk


11-16-2008:  
Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?


11-9-2008:     
Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level


11-2-2008:     
Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk


10-26-2008:  
Smoking & Quality of Life


10-19-2008:  
Agent Orange & Prostate Cancer


10-12-2008:  
Pomegranate Juice & Prostate Cancer

10-5-2008:    
Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer


9-28-2008:    
Publication & Citation Bias in Favor of Industry-Funded Research?


9-21-2008:    
Does Tylenol® (Acetaminophen) Cause Asthma?


9-14-208:      
Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke


8-23-2008:  
Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles


8-12-2008:  
Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration


8-3-2008:    Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients


7-26-2008:  
Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer


7-13-2008:  
Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer


7-6-2008:  
Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins


6-29-2008:  
Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer


6-22-2008:  
Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer


6-15-2008:  
Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort


6-8-2008:  
Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer


6-2-2008:  
Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut


5-25-2008:  
Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely


5-18-2008:  
Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers


5-11-2008:  
Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease


5-4-2008:  
Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room


4-27-2008:  
Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function


4-20-2008:  
BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke


4-13-2008:  
Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention


4-6-2008:  
Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)


3-30-2008:  
Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria


3-23-2008:  
Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children


3-16-2008:  
Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer


3-9-2008:  
Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 


3-2-2008:  
Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death


2-23-2008:  
Universal Healthcare Insurance Study; Glucosamine & Arthritis


2-17-2008:  
Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps


2-10-2008:  
Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?


2-3-2008:  
Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer


1-27-2008:  
Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium


1-20-2008:  
Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly


1-12-2008:  
Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer


1-7-2008:  
Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations


12-31-2007:  
Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?


12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease


12-16-2007:  
Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 


12-11-2007:  
Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease


12-2-2007:  
Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 

 

Dr. Wascher's Home Page

  

 

 

 

 

 

 



Post a comment
Write a comment:

Related Searches