Coping with damage left behind by cancer.
Byline: DR MIRIAM STOPPARD
Around one in five women who have been treated for breast cancer will go on to develop lymphoedema within two years of their operation. But what is lymphoedema? And what does it mean to a woman who gets it?
Lymphoedema is a common complication of breast cancer surgery.
Surgery and x-rays can inflame the lymphatic system, shrink it and scar it. They can also distort its architecture. Fluid then tends to accumulate in the hand and arm.
While swelling is prominent in the arm it can involve the chest and back.
And it can be painful and disabling, interfering with normal life.
There are emotional effects too: many women feel their body image is damaged, they see themselves as unattractive and lose self-confidence.
There are certain things that make lymphoedema more likely including some treatments. The higher the number of affected glands that are removed, the greater the risk. Mastectomy itself can raise the risk of developing lymphoedema, as can radiotherapy and chemotherapy.
Other factors are obesity, a high BMI, and not exercising. Getting an infection in the swollen arm at any time makes matters worse and is an emergency needing urgent attention.
There are strategies to prevent lymphoedema such as explaining to patients the early symptoms like swelling, feelings of heaviness, or tension in the skin. It's crucial to avoid damaging the skin of the arm which can quickly get infected.
Maintaining a healthy body weight is crucial. Wearing compression garments for exercise, travel or even all day will help. Every woman should know the signs of infection or cellulitis and seek immediate medical advice. She should also be meticulous about skin hygiene.
Lymphoedema treatment is based around decongestive lymph therapy. It has two phases: a reduction phase to lessen lymphoedema which might last two to four weeks, followed by a maintenance phase to prevent its recurrence.
Treatment comprises helping lymph drainage through manual massage by a trained lymphoedema nurse.
Wearing compression bandaging after massage and exercise will help the reduction phase.
Compression is also used in the maintenance phase.
Yes, lymphoedema is literally a lifestyle, but now help is at hand in the shape of a new book called Let's Talk Lymphoedema by Professor Peter Mortimer - a specialist - and Gemma Levine, who is a sufferer. It is an essential read for patients, friends, family and medical professionals.
While swelling is prominent in the arm it can involve the chest and back. It can be disabling