October is Breast Cancer Awareness Month

breast cancer awareness

Fiona McMahon PT, DPT

It’s here again. You can see pink on everything, ribbons, coffee cups, even football players. October is National Breast Cancer Awareness Month. Breast cancer is the most common form of cancer in women in the developed world. Over the years a concerted effort has been made to raise awareness for early screening and treatment of breast cancer to help save lives. We go over the basics about breast cancer screening in last year’s Breast cancer awareness blog which you can check out here.

For this year’s blog we are going to take a more physical therapy centric approach and talk about what happens from a functional standpoint, once you are finished with treatment and how you can help yourself to reduce pain, improve strength, and mobility with physical therapy.

There are different treatments for breast cancer, and based on the specific type (there are many different types) and how advanced it is, as well as personal considerations. It is important to manage recovery from your treatment as you would any other procedure. Although survival rates are improving, which is excellent news, it was found in an Australian study that 62% experienced an upper extremity impairment and approximately 27% had 4-6 impairments 6 years later. An impairment in the upper extremity can be described as loss of range of motion, which can impair one’s ability to groom oneself, clean, etc. Other impairments can include pain, loss of strength, and lymphedema. Lymphedema is a condition in which the body’s ability to filter return fluid and waste products out of a limb is impaired and severe swelling as well as permanent tissue changes can occur.

Physical therapy can be a wonderful and helpful tool in treating symptoms following breast cancer treatment and the benefit can extend beyond just symptoms following surgery. In the study cited below, hormonal and radiotherapies were the top contributors to pain. The good news is, physical therapists, especially the one’s at Beyond Basics are specially trained to recognize and treat chronic pain syndromes. Physical therapists may use techniques such as nervous system down training, gentle exercises and expert massage techniques to help lessen pain.

It may seem obvious, but if you are experiencing any difficulty with the strength or mobility of your shoulder or upper extremity, you should see a physical therapist right away. Scar tissue and fibrosis from your original treatment can severely reduce your ability to move your shoulder and the quicker it is identified and treated, the faster and easier treatment will be.

Patient’s experiencing swelling in their arm following breast cancer treatment should see a Certified Lymphedema Therapist (CLT). CLT’s are physical therapists who enroll in rigorous training to be able to treat and manage lymphedema. Lymphedema should be managed aggressively to prevent permanent tissue changes. We at Beyond Basics are lucky to have Victoria Lamanna PT, DPT, CLT working with us. She is specially trained to treat complex lymphedema cases and will be able to perform manual lymphatic drainage, fit compression garments, and provide you with lifestyle changes to help manage lymphedema.

Once you are done with treatment for breast cancer, it is important to take stock and note how you body feels. If you feel like you aren’t moving the way you used to, there is something that can be done and physical therapy is a great option from routine orthopedic care to higher level pain management and lymphedema treatment. If PT sounds right to you, give Beyond Basics Physical Therapy a call today or search the Lymphedema Education and Resource Network for a LANA certified lymphedema therapist near you.

Also check out our other blogs on lymphedema physical therapy:

Sources:

Hidding J, Beurskens C, van der Wees P. Treatment Related Impairments in Arm and Shoulder Patients with Breast Cancer: A Systematic Review. PLOS ONE. May 2014;9(5): e96748

March 6th is Lymphedema Awareness Day!

lymphedema

Victoria LaManna PT, DPT, CLT

March 6th is Lymphedema Awareness Day! The lymph system carries the body’s waste products, dead pathogens, and water. Eventually these substances are cleared by the body. Problems can occur if the lymph system gets blocked and cannot clear these substances. Problems with the lymphatic system can cause swelling in affected limbs, and sometimes pain, as well as fibrotic changes in the skin.

You can be born with issues in your lymph system which can cause primary lymphedema or you can have damage to your lymph system because of surgery or radiation treatments, especially for breast cancer.

If you are living with lymphedema, try these tips from the Mayo Clinic to keep your limbs as healthy as possible:

  • Avoid injections, vaccinations, blood pressure monitoring, or IV’s on the affected limb
  • Don’t wear tight fitting clothing or jewelry
  • Avoid exposure to extreme temperatures, like hot baths, or saunas
  • Monitor your affected limb for signs of infection, and go to the doctor if you suspect infection

 

You can also check out our list of Self Care Tips 

Physical therapy can help manage lymphedema, which requires a very specialized lymphedema certified therapist.  At Beyond Basics Physical Therapy, we are lucky to offer lymphedema treatment with our own Certified Lymphedema Therapist, Victoria LaManna, PT, DPT, CLT . If you are interested in starting your lymphedema treatment journey, call and make an appointment with Victoria today!

For more reading on lymphedema, check out our previous blogs:

Lymph Drainage  Therapy for Breast Health at Beyond Basics Physical Therapy

Beyond Basics’, Victoria LaManna Receives Lymphatic Drainage Therapy Certification

 

Sources
Ness S. Living with lymphedema: Take precautions, get support. 2011. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/cancer/expert-blog/lymphedema-management/bgp-20056387. Accessed February 10, 2017

Lymph Drainage Therapy for Breast Health at Beyond Basics Physical Therapy

Victoria LaManna, PT, DPT, CLT

lymphAs Breast Cancer Awareness Month comes to an end, we at Beyond Basics are working hard to help spread the word on the importance of regular self-examination and early detection. For further review, please see our blog post from earlier this month.

In addition to regular self-examination, regular breast massage is shown to help increase the circulation in your breasts. Therapeutic breast massage can also lessen discomfort associated with breast cancer treatments, help relieve post-surgical symptoms, and reduce discomfort during pregnancy, breastfeeding and weaning. Breast massage also contributes to improved skin tone while promoting relaxation and balancing your energy.
With regular massage, you will help diminish benign breast cysts while helping to flush lymph nodes and stimulating your glandular system. The breasts are soft tissue and do not have muscles to help them move, therefore they require assistance for improved circulation and lymph flow.
If you have been diagnosed with breast cancer and have undergone lymph node removal, mastectomy and/or radiation, you may experience lymphedema. About 15-20% of women who have axillary lymph nodes removed during breast cancer surgery will develop lymphedema. Working closely with your medical team to manage lymphedema is key! A Certified Lymphatic Therapist (CLT) can effectively apply gentle hands-on techniques to help enhance circulation and drainage.
Lymphedema is an accumulation of protein-rich lymphatic fluid in the tissues that contributes to swelling secondary to blockage in lymphatic flow when nodes or vessels are damaged. Individuals who have lymphedema may complain of discomfort in the affected limb, feeling of fullness in the limb, fatigue, or decreased flexibility. They may also complain of breast pain, tight-feeling skin, difficulty fitting into clothes, or tightness when wearing rings, bracelets, or watches. Venous insufficiency and obesity can contribute to lymphedema.

Complete Decongestive Therapy (CDT) consists of Manual Lymphatic Drainage (MLD) that aids in the circulation of body fluids, drains toxins from the body, stimulates the immune system and the parasympathetic system, reduces pain and/or muscle spasms, increases ROM, and decreases swelling. CDT can be used to treat conditions such as post-surgery and scars, fibromyalgia, chronic fatigue syndrome, infertility, painful periods, constipation, and irritable bowel syndrome. In conjunction, it is important to have an exercise program of stretching and strengthening to get the maximum benefits of CDT. After treatment, the patient may experience increased urinary frequency or increased amount of urine, increased sleep time or better quality of sleep, tension release and/or emotional release, or improved senses.

If you are seeking treatment, you need to see a licensed healthcare provider that is trained in Lymphedema Drainage Therapy. To find a specialist in your area, go to www.apta.org and click on “Find a PT”, specializing in LDT. Alternatively, you can search through the National Lymphedema Network or the Lymphatic Association of North America (LANA).

victoria2016Victoria LaManna, DPT, CLT, is our lymphedema expert. If you have had a mastectomy and are unsure about lymphedema care, she is an excellent resource. She will be able to instruct you in self- care and lymphedema prevention measures. Physical therapy can also help to release scar tissue in the breast and upper arm area, regain strength in the arm, and ultimately improve your function. Visit us, and read up on Victoria’s bio here, as well as on our website at: www.beyondbasicspt.com/lymphedema.

Lymphedema Risk Reduction

Risk Reduction Practices For People With Lymphedema According to the National Lymphedema Network

By Roseanne Cruz

It is not known why some people with the same risk factors develop lymphedema and some do not. People at risk of lymphedema are individuals who have not yet displayed the signs and symptoms of lymphedema but have a known insufficiency of their lymphatic system. This includes people who have undergone removal of lymph nodes or radiation therapy, which increases the risk for developing lymphedema. At-risk individuals have altered lymphatic function that may impede the body’s ability to take up excess fluids in the tissues.

For those with a confirmed diagnosis of lymphedema or at risk for developing it, consider the following:

  1. Routine medical check-ups
  2. Report changes- such as increase in size, change in sensation, color, temperature, or skin condition
  3. Body Weight- maintain normal body weight and seek help to lose weight if needed
  4. Exercise- incorrect or unsafe exercise may exacerbate lymphedema
  5. Compression garments- wear for air travel, exercise, and exertion
  6. Infections (cellulitis)- be aware of any signs of redness, warmth, pain, fever, or flu-like symptoms
  7. Skin care- maintain proper hygiene and use a moisturizer regularly
  8. Trauma- avoid trauma; protect against falls, fractures, and burns; use non-involved limb for venipunctures; proper nail care
  9. Constriction- ensure properly fitting compression bandages and clothing; avoid tight stockings or bras
  10. Avoid exposure to extreme heat or cold
  11. If you are having surgery, inform your surgery of your lymphedema condition
  12. Stasis- move, change position, and exercise periodically throughout the day
  13. Varicose veins- treating varicose veins may help to reduce lymphatic load and improve lymphedema
  14. Air travel- it is imperative to wear compression garments for the duration of the flight. It is also important to move around and exercise the affected limb and hydrate well to lower the risk of venous thromboembolism