News and events
Highlights from the biennial Manual Lymph Drainage recertification course
presented by the Dr. Vodder School of North America in Victoria, April 28-30, 2017
All manual techniques including bandaging checked, corrected and fine tuned for maximum effectiveness.
Additional edema assessment techniques learned to evaluate initial status and monitor changes even more accurately.
Research Updates: Precautionary measures
Many of you may have heard about the study published recently in the Journal of Clinical Oncology http://jco.ascopubs.org/cgl/dol/10.1200/JCO.2015.61.5948 examining common guidelines for helping to prevent lymphedema in the at-risk arms of women who have been treated for breast cancer. The precautions examined include avoiding injections, blood draws and blood pressure readings on the ipsilateral (same side) arm and wearing a compression sleeve on airplane flights.
The authors found that the guidelines did not clearly reduce the risk of developing lymphedema and stated that patients and healthcare providers could disregard them. An editorial about the study followed, making an even stronger statement that the precautions were unnecessary and causing confusion and concern among breast cancer survivors and healthcare workers.
As pointed out by numerous members of the medical community and several lymphedema organizations, the study had serious shortcomings (including short duration, unreliable methods and incomplete edema assessment techniques) and the editorial clearly overstated the conclusions of the study.
More research is needed into this topic. For now however, we can say that while following these precautions will not prevent lymphedema in every case, it does help reduce the risk by shielding the arm from possible damage that could trigger the condition.
It is most important to protect the arm from any unnecessary puncture or squeezing which could injure the tissue and possibly lead to infection. Even the study authors stated clearly that cellulitis infections are proved to raise the risk of lymphedema in the affected arm.
Thus, If possible, avoid injections, blood draws and blood pressure readings in the at-risk arm and wear a well-fitted compression sleeve or wrap on airplane flights.
Research Updates: Prevalence of secondary lymphedema from various causes
Drs. David Keast, MSc, MD FCFP, Western University, London and Anna Towers, MD FCFP, McGill University, Montreal, presented research estimating the prevalence of secondary lymphedema from various causes. www.lymphedemapathways.ca
Of key interest was their finding that cancer is not the most common cause of secondary lymphedema. It is the second most common cause, and percentages vary for different types of cancer. Overall, cancer is the cause of about 19 percent of secondary lymphedema cases in the United States and Canada.
By far the primary cause of secondary lymphedema is morbid obesity (Body Mass Index of 40 and up). This condition causes over 67 percent of secondary lymphedema cases. It places a tremendous load on the lymphatic system, eventually causing lymphatic insufficiency and chronic edema.
Disability of various types (being chair-bound) causes about 10 percent of secondary lymphedema cases, as lymphatic transport depends in part on the pumping action of the leg muscles.
Non-cancer related surgeries cause about 4 percent of secondary lymphedema cases.
Chronic venous insufficiency often co-exists with lymphatic edema ('mixed edema'), as well as with obesity. Thus the percentage of lymphedema cases caused by venous insufficiency is difficult to estimate; the authors list it as 'undetermined'.
In Conclusion, Drs. Keast and Towers recommend a coordinated program to help people with secondary lymphedema, including meticulous skin hygiene, appropriate exercise, MLD and compression therapy, and counseling and support with weight reduction and maintenance, as well as research into post-op compression therapy for procedures demonstrated to raise the risk of lymphedema.
Thank you for visiting!
Additional edema assessment techniques learned to evaluate initial status and monitor changes even more accurately.
Research Updates: Precautionary measures
Many of you may have heard about the study published recently in the Journal of Clinical Oncology http://jco.ascopubs.org/cgl/dol/10.1200/JCO.2015.61.5948 examining common guidelines for helping to prevent lymphedema in the at-risk arms of women who have been treated for breast cancer. The precautions examined include avoiding injections, blood draws and blood pressure readings on the ipsilateral (same side) arm and wearing a compression sleeve on airplane flights.
The authors found that the guidelines did not clearly reduce the risk of developing lymphedema and stated that patients and healthcare providers could disregard them. An editorial about the study followed, making an even stronger statement that the precautions were unnecessary and causing confusion and concern among breast cancer survivors and healthcare workers.
As pointed out by numerous members of the medical community and several lymphedema organizations, the study had serious shortcomings (including short duration, unreliable methods and incomplete edema assessment techniques) and the editorial clearly overstated the conclusions of the study.
More research is needed into this topic. For now however, we can say that while following these precautions will not prevent lymphedema in every case, it does help reduce the risk by shielding the arm from possible damage that could trigger the condition.
It is most important to protect the arm from any unnecessary puncture or squeezing which could injure the tissue and possibly lead to infection. Even the study authors stated clearly that cellulitis infections are proved to raise the risk of lymphedema in the affected arm.
Thus, If possible, avoid injections, blood draws and blood pressure readings in the at-risk arm and wear a well-fitted compression sleeve or wrap on airplane flights.
Research Updates: Prevalence of secondary lymphedema from various causes
Drs. David Keast, MSc, MD FCFP, Western University, London and Anna Towers, MD FCFP, McGill University, Montreal, presented research estimating the prevalence of secondary lymphedema from various causes. www.lymphedemapathways.ca
Of key interest was their finding that cancer is not the most common cause of secondary lymphedema. It is the second most common cause, and percentages vary for different types of cancer. Overall, cancer is the cause of about 19 percent of secondary lymphedema cases in the United States and Canada.
By far the primary cause of secondary lymphedema is morbid obesity (Body Mass Index of 40 and up). This condition causes over 67 percent of secondary lymphedema cases. It places a tremendous load on the lymphatic system, eventually causing lymphatic insufficiency and chronic edema.
Disability of various types (being chair-bound) causes about 10 percent of secondary lymphedema cases, as lymphatic transport depends in part on the pumping action of the leg muscles.
Non-cancer related surgeries cause about 4 percent of secondary lymphedema cases.
Chronic venous insufficiency often co-exists with lymphatic edema ('mixed edema'), as well as with obesity. Thus the percentage of lymphedema cases caused by venous insufficiency is difficult to estimate; the authors list it as 'undetermined'.
In Conclusion, Drs. Keast and Towers recommend a coordinated program to help people with secondary lymphedema, including meticulous skin hygiene, appropriate exercise, MLD and compression therapy, and counseling and support with weight reduction and maintenance, as well as research into post-op compression therapy for procedures demonstrated to raise the risk of lymphedema.
Thank you for visiting!
