Emergency -

University of South Florida

Love Your Lymph Nodes too!

Life is full of possibilities and adventures to come.  Slowing down after beating breast cancer is NOT an option.

Dr. Nicholas Panetta, a plastic and reconstructive surgeon for USF Health and an expert in the lymphatic system, urges anyone facing breast cancer surgery to talk with their surgeon about the potential impact on their lymphatic system and their risk of developing lymphedema.

“While we do not yet definitively know how to prevent lymphedema, evolving technical advancements and research efforts are moving us leaps and bounds towards that ultimate goal.” Dr. Panetta said. “Don’t ignore the early signs. If we catch it early, we can slow the progress of this disease and possibly reverse it.”

What is lymphedema?
The lymphatic system is a filtering system that enables the flushing of bacteria, viruses, and waste products via the circulation of lymph fluid throughout the body. When lymph nodes are damaged or removed as part of cancer treatment, lymphedema can develop and prevent lymph fluid from circulating effectively in your arms or legs, which causes swelling, recurring infections, aching and discomfort. Patients who have lymphedema can experience mild to severe symptoms that can have a significant negative impact on a patient’s active life.

Key questions to ask your oncologist during breast cancer treatment
1. Are lymph nodes going to be altered as part of my breast cancer treatment?
2. Will you have an axillary lymph node dissection (ALND) to remove affected lymph nodes?
3. Will radiation be a part of my treatment?

At risk for lymphedema?
“If you have had an ALND or radiation treatment as part of your breast cancer treatment, the risk of developing cancer related lymphedema ranges from 20 to 50%,” Dr. Panetta said. “If breast cancer has not spread to the lymph node closest to the tumor determined by a sentinel node, you have a much lower chance of developing lymphedema, around 5%.”

“It’s important to treat your cancer as completely as possible to save your life. If your lymph nodes need to be removed as part of your treatment, we want to educate patients about the early signs of lymphedema, so we can intervene early,” Dr. Panetta said.

Know the Early Symptoms
“Symptoms of lymphedema present themselves at different times – ranging from after treatment to years later,” Dr. Panetta said. “Early diagnosis and patient specific intervention is the key to mitigating the progression of, and possibly reversing, the signs and symptoms associated with breast cancer related lymphedema.”

Early symptoms of lymphedema:
– Decreased range of motion
– Swelling or a feeling of heaviness in arms
– Tingling in one arm, relative from one arm to another
– Stiffness in arm

Treatment Options
At the USF Health/Moffitt Cancer Center joint program, cancer-related lymphedema is treated with a broad range of options, both noninvasive and surgical:

Noninvasive options (Complete Decongestive Therapy):
– Compression therapy
– Massage therapy
– Physical therapy
– Lymphatic pump therapy
– Treatment under the guidance of a certified lymphatic certified therapist

Surgical treatment options:
– Immediate lymphovenous anastomosis (LVA)
– Delayed LVA
– Vascularized lymph node transfer
– Suction assisted lipectomy (for advanced disease)

Benefits of a multi-disciplinary lymphedema program
Started in 2017, the USF Health and Moffitt Cancer Center joint program for cancer related lymphedema was launched with a skilled multi-disciplinary team comprised of plastic surgeons, surgical oncologists, physical therapists, nutritionists and radiology experts. When referred to our specialized lymphedema clinic, our caring team develops a customized care plan for patients. Patients are able to see our group of health care providers all in one day, with back-to-back scheduled appointments, except for imaging, which will be scheduled as appropriate following your evaluation.

This effective patient-centered approach to lymphedema used by USF Health and the Moffitt Cancer Center is being shared with other oncologists and care providers to expand the positive impact this program has demonstrated on the lives of patients receiving treatment. “We want to enable more patients with lymphedema symptoms to find help earlier and empower the health community to monitor and treat lymphedema as effectively as possible,” Dr. Panetta said.

If you are recovering from breast cancer treatment and have concerns about developing lymphedema, contact the USF Health and Moffitt Cancer Center joint program for cancer related lymphedema at 1-888-663-3488.

Written By: Kathleen Rogers

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