Lymphoedema, or lymphatic obstruction is a chronic (long-term) condition in which excess fluid (lymph) collects in tissues causing edema (swelling). Lymphoedema can be very debilitating but can be managed and improved by a Lymphoedema Therapist.
The ALA (Australasian Lymphology Association) has produced a position statement on Monitoring for Early Detection of Breast Cancer–Related Lymphoedema stating “The early detection and management of sub-clinical lymphoedema may reduce the long term physical, functional and psychological effects caused by a later diagnosis and delayed management of the condition.”
TREATMENT AND THERAPY
As part of the ALA recommendations, our qualified therapists are able to offer:
- Pre-treatment (surgery, radiation, chemotherapy, hormone therapy) measurements – both circumferential and L-Dex bioimpedance measurements
- Post-treatment 3 to 6 monthly interval checks of circumferential and L-Dex bioimpedance measurements, limb inspection and timed pitting tests for up to 2 years post treatment
- Education of both the risk and risk reduction of lymphoedema, including a risk analysis post-treatment
- Simple exercises and basic massage routines to assist with risk reduction.
We are currently working together with the Moreton Region Breast Cancer Support Group, the Metro North Brisbane Medicare Local, local Cancer Surgeons and General Practitioners to educate cancer patients about lymphoedema and our local services.
Of particular importance to us as lymphoedema practitioners is the use of the L-Dex bioimpedance (Lymphoedema Index) U-400 monitoring device. This device is used to detect the onset of lymphoedema up to 10 months earlier than current methods, and before you may notice any visible swelling and other symptoms. The test takes only minutes to perform, is painless and gives and immediate result. The L-Dex U400 has been designed specifically to aid in the PRE-OPERATIVE clinical assessment and post-operative monitoring of lymphoedema in the arms and legs. However, the pre-operative measure is NOT carried out routinely in many hospitals currently and thus we are missing the baseline starting point for many of our patients. The device will not prevent Lymphoedema, but it will enable early intervention with regular monitoring and in the management of lymphoedema, this is critical to ensuring that it does not progress.
The ALA endorses the use of bioimpedance spectroscopy (BIS) as a validated and reliable tool to enable early detection of breast cancer related lymphoedema (BCRL) of the arm.
Key Goals of Treatment
Advice and Education
Manual Lymphatic Drainage (MLD) and Simplified Lymphatic Drainage (SLD)
Compression Garment Prescription
L-Dex Bioimpedance monitoring