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lymphoedema treatment

Nicky Kramer, Jo Ramjith, Delva Shamley
PURPOSE: Breast cancer is the most frequently diagnosed cancer and leading cause of cancer death among women, representing a considerable public health burden in South Africa and other low-middle income countries. Short- and long-term complications of these treatments include shoulder morbidities such as pain, decreased range of motion, tightness, weakness, pain, numbness and lymphoedema and may be present for up to 6 years post-treatment. An understanding of baseline demographic and clinical risk factors can guide rehabilitation and management strategies for high-risk patients...
November 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Hiroo Suami, Louise Koelmeyer, Helen Mackie, John Boyages
Upper extremity lymphoedema after axillary node dissection is an iatrogenic disease particularly associated with treatment for breast or skin cancer. Anatomical studies and lymphangiography in healthy subjects identified that axillary node dissection removes a segment of the lymphatic drainage pathway running from the upper limb to the sub-clavicular vein, creating a surgical break. It is reasonable to infer that different patterns of lymphatic drainage may occur in the upper limb following surgery and contribute to the various presentations of lymphoedema from none to severe...
December 2018: Surgical Oncology
Wei Wang, Rachel Ward, Dan Jia, Simon Ashworth, Edgar Estoesta, Trevor Moodie, Verity Ahern, Kirsty Stuart, Nicholas Ngui, James French, Elisabeth Elder, David Farlow
BACKGROUND: Lymphoedema of the arm following axillary surgery or radiotherapy remains a significant side effect affecting some women after breast cancer treatment. Axillary reverse mapping (ARM) is a technique used to identify the lymph node draining the arm (ARM node). Our study aim was to examine the location of the ARM nodes in relation to target volumes and treatment fields for breast cancer radiotherapy. MATERIALS AND METHODS: Eighteen breast cancer patients underwent lymphoscintigraphy of contralateral arm (left 10, right 8) and SPECT CT scan on a research study...
November 13, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Lavanya Anandan, Aza Mohammed
Introduction: Buried penis is a condition that causes the penis to become hidden beneath the skin. It has a significant impact on quality of life and can present in a variety of ways, with lower urinary tract symptoms and erectile dysfunction being common. Whilst there are several causes, obesity is the most common in adults. Due to the burden that obesity is increasingly presenting to healthcare, buried penis may become more common in the future.The purpose of this article is to provide an overview of the causes, presentation and surgical management of this condition in adults...
2018: Central European Journal of Urology
Mette Tambour, Marianne Holt, Anette Speyer, Robin Christensen, Bibi Gram
BACKGROUND: We investigated the comparability of Complete Decongestive Therapy (CDT) including manual lymphatic drainage (MLD) vs. without MLD in the management of arm lymphoedema in patients with breast cancer. METHODS: Patients randomised into either treatment including MLD (T+MLD) or treatment without MLD (T-MLD) received treatment 2×weekly for 4 weeks. The primary outcome was the volume reduction (%) of arm lymphoedema at 7-month follow-up. The secondary outcomes were volume reduction after the end of treatment, circumference of the arm, patient experience of heaviness and tension, and health status...
October 24, 2018: British Journal of Cancer
A A Khan, I Hernan, J A Adamthwaite, K W D Ramsey
BACKGROUND: Breast cancer-related lymphoedema (BCRL) presents a significant healthcare burden and adversely affects quality of life of breast cancer survivors. A prospective feasibility study was performed on lymphaticovenous anastomosis (LVA) for the treatment of BCRL. METHODS: Patients with BCRL underwent near-infrared spectroscopy with indocyanine green lymphatic mapping to identify suitable lymphatic channels for LVA. End-to-end anastomoses to subdermal venules were performed and patients recommenced compression garment therapy (CGT) after surgery...
October 8, 2018: British Journal of Surgery
Pauline McGee, David Alex Munnoch
OBJECTIVE: To evaluate outcomes in patients with gynaecological cancer related lymphoedema treated with liposuction. METHODS: A prospective analysis of 21 patients who underwent liposuction followed by compression therapy for chronic unilateral lower limb lymphoedema with up to 8 years follow up was performed. RESULTS: Duration of lymphoedema prior to liposuction ranged from 4 to 28 years (mean 15.2 years). The mean age at time of liposuction was 52 years (range 37-67)...
October 4, 2018: Gynecologic Oncology
Garry Cooper-Stanton
Chronic oedema (CO) and lymphoedema (LO) are long-term conditions that can become more complicated or are more likely to develop with age. The ageing process can involve alterations in the structures that support the normal function of the lymphatic system or put it at greater risk of damage. The main three components (skin care, exercise and compression therapy) within the management of CO/LO can become more difficult to apply with age. This is because of reduced healing rates, decreased cardiovascular capacity and deterioration in vascular and arterial structures...
October 1, 2018: British Journal of Community Nursing
Natalie Lee, Sue Lawrance
The aim of compression therapy is to apply pressure on the skin and underlying structures to counteract the force of gravity, supporting venous and lymphatic function, to prevent or minimise oedema in the affected tissues. Compression therapy to manage lymphoedema is supported by a plethora of research, as it helps to increase the velocity of flow and lymphatic contraction of the lymphatic collecting vessels. This encourages drainage to the route of the limb, which increases fluid drainage from the tissues into the lymphatics...
October 1, 2018: British Journal of Community Nursing
Viviana Galimberti, Bernard F Cole, Giuseppe Viale, Paolo Veronesi, Elisa Vicini, Mattia Intra, Giovanni Mazzarol, Samuele Massarut, Janez Zgajnar, Mario Taffurelli, David Littlejohn, Michael Knauer, Carlo Tondini, Angelo Di Leo, Marco Colleoni, Meredith M Regan, Alan S Coates, Richard D Gelber, Aron Goldhirsch
BACKGROUND: We previously reported the 5-year results of the phase 3 IBCSG 23-01 trial comparing disease-free survival in patients with breast cancer with one or more micrometastatic (≤2 mm) sentinel nodes randomly assigned to either axillary dissection or no axillary dissection. The results showed no difference in disease-free survival between the groups and showed non-inferiority of no axillary dissection relative to axillary dissection. The current analysis presents the results of the study after a median follow-up of 9·7 years (IQR 7·8-12·7)...
September 5, 2018: Lancet Oncology
Jodie L Nixon, Amanda E Pigott, Bena Cartmill, Jane Turner, Jennifer Fleming, Sandro V Porceddu
PURPOSE: This study aimed to examine the course and nature of distress and quality of life (QoL) during and after head and neck lymphoedema (HNL) treatment in people who developed HNL following treatment for head and neck cancer (HNC). METHODS: This study (n = 10) used a mixed method explanatory design to explore distress associated with HNL. Component 1 used a prospective repeated measures design to examine distress during a 22-week HNL program. Component 2 used a qualitative interview approach to understand the patient experience of distress after completion of HNL treatment...
August 2018: Oral Oncology
Judith Whatley, Rachael Street, Sally Kay
BACKGROUND AND PURPOSE: An estimated 1 in 5 women surviving breast cancer will go on to develop breast cancer related lymphoedema (BCRL). There is a gap in the literature capturing experiences of people living with BCRL who use complementary therapies. MATERIALS AND METHODS: Data were collected from 26 participants via a semi-structured interview. Questioning centred around their personal experiences of living with lymphoedema, and their use of reflexology lymphatic drainage...
August 2018: Complementary Therapies in Clinical Practice
Claire Jeans, Elizabeth C Ward, Bena Cartmill, Anne E Vertigan, Amanda E Pigott, Jodie L Nixon, Chris Wratten
Head and neck lymphoedema (HNL) is common following head and neck cancer (HNC) treatment, and may contribute to numerous physical, functional and psychological symptoms. However, its impact on swallowing, voice and speech is less well understood. The aim of this study was to use interpretive description to explore patient perceptions relating to the impact of HNL on swallowing, voice and speech. Twelve participants, >3 months post HNC treatment and experiencing some form of HNL, participated in individual, semi-structured interviews...
July 25, 2018: European Journal of Cancer Care
T N Shim, P R Doiron, N Francis, S Minhas, A Muneer, D Hawkins, M Dinneen, C B Bunker
BACKGROUND: Penile lymphoedema (with and without cellulitis) is a rare, often chronic, clinically heterogeneous entity with an uncertain pathogenesis and an important differential diagnosis. It creates significant physical and psychosexual morbidity, and presents considerable therapeutic challenges. The existing literature is limited. AIM: To describe and share our updated cumulative experience of a cohort of patients with penile lymphoedema. METHODS: This was a retrospective review of the case records of patients with chronic penile lymphoedema seen in two dedicated male genital dermatology clinics between January 2011 and July 2016...
July 15, 2018: Clinical and Experimental Dermatology
Derek B Hennessey, Ned Kinnear, Justin Chee
A 44-year-old man with a spinal cord injury was referred to a specialist urology service with a 7-year history of significant genital swelling. His condition had eluded diagnosis and was refractory to all previous treatments. The considerable swelling both impacted his quality of life and prevented the patient from adequately managing his neurogenic bladder. He was diagnosed with chronic idiopathic genital lymphoedema and underwent total scrotectomy, wide penile skin excision and split skin graft to the penile shaft...
July 5, 2018: BMJ Case Reports
Louise Rooney, Garry Cooper-Stanton, Jayne Cave-Senior
Compression therapy is the main method used within the treatment and management of lymphoedema and chronic oedema. The increasing prevalence of the condition, which has multiple causes, such as genetic factors, age and external factors, require the effective management of the condition, and to enhance the management methods used to contain the condition. The use of exercise alongside the mainstay method of treatment (compression therapy) has been an underutilised area. The application of a structured exercise programme in conjunction with multi-layer lymphoedema bandaging combined with an adjustable velcro wrap based systems led to a decrease in limb volume in one case study...
July 2, 2018: British Journal of Community Nursing
Eran Shavit, Uwe Wollina, Afsaneh Alavi
Lipoedema is a rare painful disorder of the adipose tissue. It essentially affects females and is often misdiagnosed as lymphoedema or obesity. It is globally misdiagnosed or underdiagnosed, and the literature is lacking appropriate guidance to assist clinicians towards this diagnosis. However, the need to recognise this disorder as a unique entity has important implications to establish proper treatment and, therefore, its tremendous effect on patients. Early diagnosis and treatment can turn these patients' lives upside down...
December 2018: International Wound Journal
Rikke Falsig Vestergaard, Alexander Andersen Juhl, Tine Engberg Damsgaard
Lymphoedema is a frequent condition after surgical treatment for breast cancer. Lymphoedema causes great discomfort for the patients and is primarily treated conservatively with compression garments and physical therapy. Recently, surgical interventions have gained popularity in the form of lympho-lymphatic anastomoses, lympho-venous anastomoses and autologous lymph node transplantation, either as stand-alone treatment or in combination with secondary breast reconstruction. In Denmark, lympho-venous anastomoses is currently the primary surgical treatment for lymphoedema...
June 18, 2018: Ugeskrift for Laeger
Marie Todd, Charlotte Stubbs, Stacy Pugh
Lymphoedema can result in debilitating physical and psychosocial morbidity and when combined with other chronic comorbidity, often requires holistic, specialist management that encompasses all the complex and compounding problems. Self-care is an integral component of any treatment strategy, however, the patient must be fully prepared and ongoing support should be provided. Self-care consists of managing the symptoms of lymphoedema but should include other fundamental aspects of healthy living, for example, maintaining a healthy weight and activity levels...
April 1, 2018: British Journal of Community Nursing
Valentina Triacca, Marco Pisano, Claudia Lessert, Benoit Petit, Karima Bouzourene, Aimable Nahimana, Marie-Catherine Vozenin, Nikolaos Stergiopulos, Melody A Swartz, Lucia Mazzolai
OBJECTIVE/BACKGROUND: Despite recent advances in pharmacological research and microsurgery, lymphoedema remains an incurable disease that deeply affects quality of life. There is an urgent need for innovative approaches to restore continuous lymph flow in affected tissues. To this end, the efficacy of a subcutaneously implanted draining device in reducing lymphoedema volume in a rat hindlimb lymphoedema model was tested. METHODS: A rat model of chronic lymphoedema was developed by surgical removal of popliteal and inguinal lymph nodes, followed by irradiation...
May 24, 2018: European Journal of Vascular and Endovascular Surgery
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