Prompt Lymphedema Detection, Intervention Can Minimize Long-Term Risks

Early lymphedema detection, prevention and management can be done using bioimpedance spectroscopy, an expert explained to CURE®.

Lymphedema — which is caused by a disruption in the drainage of lymphatic fluid, and can occur after breast cancer, melanoma or pelvic-area cancers — not only can affect patients’ quality of life but if left untreated, could also increase patients’ risk for infections and lead to an increase in medical costs, explained Dr. Steven Chen.

However, there are measures that patients and clinicians can take to catch and treat lymphedema early, leading to better long-term outcomes and quality of life.

“Early detection, prevention, and effective management are crucial in reducing the risk of (breast cancer-related lymphedema) becoming a chronic condition,” Chen, a breast surgeon and chief medical officer at ImpediMed said in an interview with CURE®.

Chen explained that monitoring for lymphedema should include honest conversations between patients and providers, manual measurements of arm swelling and volume conducted by clinicians, and even the use of bioimpedance spectroscopy (BIS), which is a noninvasive approach to measuring the amount of water in the body by sending electrical currents through skin electrodes.

“In the context of lymphedema, BIS can frequently detect early fluid accumulation before visible symptoms manifest, allowing health care providers to intervene and initiate treatment more promptly compared to traditional volume-based methods,” Chen said.

This was the case with Kathy Lahr, who, after receiving a breast cancer diagnosis, underwent a double mastectomy in 2019.

In each of Lahr’s post-surgical follow-up appointments, she was monitored for lymphedema. Before any major or noticeable swelling occurred in her arm, the tests caught early signs of lymphedema. So, she was instructed to see a physical therapist who specializes in lymphedema and to wear a lymphedema compression sleeve.

READ MORE: Medicare Must Now Cover Lymphedema Treatment Garments

“I just didn’t have any symptoms, there was no reason to think anything was wrong,” Lahr said in an interview with CURE®. “[Lymphedema] can incapacitate you, and none of us want to be incapacitated when you just survived all the ugly stuff … like the cancer diagnosis and cancer treatment.”

While earlier detection of lymphedema may improve patients’ quality of life and help them find tools to manage the condition, lymphedema “can never be completely eliminated,” according to Chen, so continued communication with the health care team is necessary, especially if patients begin to feel signs of lymphedema, such as swelling or heaviness in their arms.

“I know to be aware now; I know that you may not have any symptoms, but if you do find that there’s a heaviness in your arm or any kind of swelling that you notice close fit funky — anything that’s not normal for you, for the patient, then you need to make a phone call. You need to be rechecked.,” Lahr said.

Chen echoed that sentiment.

“By fostering collaboration among the entire multidisciplinary cancer team, the goal is to identify lymphedema at the earliest possible stage, allowing for prompt treatment initiation and minimizing the risk of long-term consequences for patients,” he said. “Considering the crucial role and cost-effectiveness of early intervention, all patients with cancer should be well-informed about their risks, and every team member should actively participate in alleviating the fear surrounding lymphedema. Integrating lymphedema management as a fundamental component of the survivorship plan, just as we do for the long-term effects of other treatments, is essential for providing comprehensive and effective care.”

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