Breast Cancer Program: Swelling After Treatment

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Breast Cancer: Swelling After Treatment




Welcome to this month’s Breast Health e-Newsletter.  Our topic:  lymphedema, difficult for women after breast cancer.  Some breast cancer survivors can have lymphedema, an uncomfortable swelling of the arm and wrist.  A new study has found that women who develop lymphedema do worse than women without the condition.  As a result, they may have higher out-of-pocket medical costs after radiation and surgery.


The study, reported in the Journal of Clinical Oncology, says breast cancer survivors who develop lymphedema report a lower quality of life and higher levels of anxiety and depression.  In addition, they have an increased likelihood of chronic pain and fatigue, and experience greater difficulty with social and sexual functioning.  The study also found that lymphedema raised two-year postoperative costs by nearly $15,000, to more than $23,000.  The additional costs were from office visits, treatments for infections, and mental health services, including prescriptions for antidepressants.


One reason for higher out-of-pocket costs:  insurance companies don’t always cover lymphedema treatments.  These treatments may include compression garments and specially trained therapists who provide massages and physical therapy to help the area drain.  Study author Dr. Tina Shih says federal regulations in about 21 states require private insurance to cover lymphedema treatments after mastectomies, however, the laws aren’t specific about what constitutes lymphedema treatment.  She says, right now, it’s mostly up to the insurance companies to decide what is appropriate lymphedema treatment based on their own interpretation.


Lymphedema is caused by a buildup of lymphatic fluid, usually as a result of damage to the lymphatic system from radiation, or surgery.  Using medical claims information on more than 1,800 women, researches found that ten percent sought treatment for       lymphedema.  Previous research has shown that up to 50 percent of breast cancer survivors develop lymphedema, and 32 percent have persistent swelling three years after surgery. 


Dr. Robert Smith, of the American Cancer Society, says it’s a terribly overlooked problem.  He says that, as a result, many of these women have significant out-of-pocket expenses and prolonged chronic health problems.  Dr. Smith adds that lymphedema isn’t curable, and unless it’s properly treated and managed, it can become progressively worse.  While some cases are mild, others can be more severe.  Swelling in the affected arm can lead to loss of motion, cysts, skin thickening, infections, and inflammation just below the skin’s surface. 


Dr. Brian Lawenda, a clinical director of radiation oncology, says that standard treatments include keeping the skin clean and moisturized, being careful when clipping nails, wearing compression sleeves to prevent swelling, doing therapeutic exercises, and having massage to promote fluid drainage.  He notes, even though it’s not curable, it’s manageable, treatable, and will improve.


For more information, always consult your doctor.  Thank you for listening.  Please visit our website for more information on health and wellness topics:

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