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.

1. Cancer Treatment Centers of America ®
Lymphedema Education for the
Breast Cancer Survivor
Presented at: Well-Healed: A Survivor Celebration
Presented by: Jane A. White, PT, MPT, CLT
Date: August 30, 2012

2. 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.
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3. Cancer Survivor Definition
• National Coalition for Cancer Survivorship
states:
– “a cancer survivor from time of diagnosis and for the
balance of life”
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4. Lymphedema
• What is it?
• Who gets it?
• Early identification important
• Four stages
• Who can treat it?
• How is it treated?
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5. 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.
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6. 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
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7. Four Stages of Lymphedema
• I. Latency
• II. Stage 1 (Reversible)
• III. Stage 2 (Spontaneously Irreversible)
• IV. Stage 3 (Elephantiasis)
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8. 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)
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9. Who can treat lymphedema?
• Medical professionals who have received
specialized training
• Nurses, physical therapists, occupational
therapists
• Directories available (see reference page)
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10. How is it treated?
• Complete Decongestive Therapy (CDT)
– Gold standard of treatment
– Four components
• Skin care
• Manual Lymph Drainage
• Compression Therapy
• Decongestive Exercises
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11. Skin Care
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12. Manual Lymph Drainage (MLD)
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13. Compression
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14. Sleeves, Gloves, & Gauntlets
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15. Decongestive Exercise
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16. 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
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17. 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!
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18. References
• American Cancer Society. (2011). What causes lymphedema? Retrieved from
http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/Lym
phedema/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
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