Acupuncture May Improve Arm Lymphedema



A new study finds that acupuncture may help to decrease lymphedema (arm swelling) in breast cancer patients.


 

ACUPUNCTURE MAY IMPROVE ARM LYMPHEDEMA

Arm lymphedema, or arm swelling, affects between 10 and 30 percent of all women undergoing treatment for breast cancer.Although relatively mild in most cases, lymphedema can be severe enough to interfere with personal and professional activities, and can be associated with significant symptoms such as limb heaviness, and abnormal sensations or discomfort in the affected arm.

Lymphedema is most commonly managed with elastic compression garments, pneumatic compression devices, soft tissue massage, and exercise (collectively, these therapies are often referred to as “decongestive therapy”). However, many lymphedema patients fail to respond to these standard therapies. When patients with lymphedema fail to respond to decongestive therapy, there are few, if any, other noninvasive therapies available that have been proven to be beneficial.

Now, a newly published clinical research study, which appears in the current issue of the journal Cancer, suggests that acupuncture might be useful as a treatment for arm lymphedema associated with breast cancer treatment.

In this small pilot study from the Memorial Sloan-Kettering Cancer Center, 33 breast cancer survivors with chronic arm lymphedema received twice weekly acupuncture treatments for a total of 4 weeks. Arm circumference was measured both before and after each acupuncture treatment.

At the conclusion of this study, 33 percent of the patients who completed this small pilot study experienced a 30 percent or greater reduction in the difference in circumference between their arms, while 55 percent of the study’s volunteers experienced a 20 percent or greater reduction in arm circumference difference.

This is an interesting pilot study, as chronic lymphedema remains such a challenge to manage and treat. Although the mechanism whereby acupuncture might reduce the severity of arm lymphedema remains to be elucidated, the findings of this pilot study are intriguing enough to merit a larger prospective, randomized research study to evaluate the impact of acupuncture on chronic arm lymphedema. Fortunately, the authors of this pilot study are now conducting just such a prospective, randomized clinical study!

 

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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, 3.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Breast Cancer, Physical Therapy & Lymphedema

January 17, 2010 by Robert Wascher  
Filed under Breast Cancer

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”

 

BREAST CANCER, PHYSICAL THERAPY &

 

LYMPHEDEMA

 

 

Arm lymphedema, or chronic swelling of the arm, occurs in 10 to 30 percent of women following treatment for breast cancer.  When the lymphatic drainage network in the arm and hand has been disrupted by the surgical removal of axillary (armpit) lymph nodes, or by radiation therapy to the axilla (or, sometimes, following both types of treatment), the delicate network of lymphatic vessels that return excess tissue fluid back to the heart can become obstructed. This lymphatic obstruction can then result in chronic swelling of the hand and arm.  Patients with significant lymphedema of the arm following breast cancer treatment may experience considerable swelling (edema), heaviness, stiffness and discomfort of the affected hand and arm.

Unfortunately, there are no known effective methods available to prevent lymphedema, and once significant lymphedema does develop, compression sleeves and soft tissue massage are the primary treatment modalities currently available.  Unfortunately, currently available lymphedema treatments are often not highly effective for many patients, and there is no known cure for lymphedema once it develops.

Now, a newly published research study, in the British Medical Journal, suggests that physical therapy, when initiated early after breast cancer surgery, can significantly decrease the risk of arm and hand lymphedema.  In this prospective randomized clinical research study, 120 women who underwent removal of their axillary lymph nodes for breast cancer were randomized to one of two groups.  Women assigned to the experimental group underwent physical therapy 3 times per week, for a total of 3 weeks.  Physical therapy techniques used in this group included manual lymph drainage and soft tissue massage techniques, as well as progressive shoulder exercises.  Both groups of women also underwent the same lymphedema management educational course, but the control group of women did not receive any physical therapy interventions.

Among the 116 women who completed at least one year of follow-up, 18 women (16 percent) went on to develop lymphedema.  Fourteen of the women who developed lymphedema were in the control group, while the remaining 4 women were in the experimental group.  Thus, in this clinical study, early physical therapy following axillary lymph node dissection (ALND) was associated with a very significant 72 percent reduction in the risk of developing lymphedema, at least within the first year following breast cancer surgery.

Whether or not the use of early postoperative physical therapy can reduce the incidence of arm lymphedema over periods longer than one year is unknown at this time, and additional follow-up of the patients who participated in this clinical research study will be required to answer this very important question.  However, this is one of the very few studies available that suggests a role for physical therapy in the actual prevention of arm and hand lymphedema following ALND for breast cancer.  If additional, mature follow-up of these patients confirms a long-term benefit from early postoperative physical therapy in preventing arm lymphedema, then a strong case could be made for the routine use of early physical therapy in women who undergo ALND, and perhaps, as well, women who undergo sentinel lymph node biopsy with subsequent radiation therapy to the breast and armpit (axilla) area.

 

For additional information and resources related to cancer-associated lymphedema, please click on the links below:

http://www.cancersupportivecare.com/Abstracts/asbdpbtps.html

http://meeting.ascopubs.org/cgi/content/abstract/23/16_suppl/8185

http://www.annalssurgicaloncology.org/cgi/content/abstract/15/7/1996

http://www.cancerlynx.com/sln.html

http://doctorwascher.com/Archives/11-23-08.htm

http://doctorwascher.com/Archives/8-16-09.htm

 



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

 

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