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Breast cancer sufferers warned

Chang Yu-mei, right, exercises at National Taiwan University Hospital yesterday, assisted by physical therapist Tsai Han-ju. Chang suffers from lymphedema, an accumulation of lymphatic fluid that causes her arm to swell. Lymphedema is most frequently seen after surgery or radiation therapy. PHOTO: LIAO CHEN-HUEI, TAIPEI TIMES

Five years ago Chang Yu-mei (張玉美) was diagnosed with breast cancer and underwent chemotherapy and radiation therapy before surgery.

After the surgery and treatment was complete, Chang thought she had made it through the worst, but she was wrong.

Three years later, following a mosquito bite, her arm swelled to a frightening size.

This was caused by a condition called lymphedema, an accumulation of lymphatic fluid that causes swelling. It is most frequently seen after surgery or radiation therapy, during which unintended damage to the lymphatic drainage system is caused.

When the lymphatic activity becomes so great that the fluid exceeds the lymphatic system's ability to transport it, an abnormal amount of fluid collects in the tissue of the affected area.

Risk of infections

Untreated, this fluid causes tissue channels to increase in size and number, reducing the availability of oxygen, interfering with wound healing and providing a rich culture medium for bacterial growth that can result in infection.

The Catholic Sanipax Socio-Medical Service and Education Foundation yesterday urged breast-cancer patients to be more aware of lymphedema, including learning how to prevent the disease, recognizing the symptoms and the kinds of medical treatment available.

According to statistics provided by the foundation, 20 percent of breast-cancer patients suffer from lymphedema.

Tu Shih-hsing (杜世興), head of the Center for Breast Cancer at Cathay General Hospital, said that during breast cancer surgery, lymph nodes in the surrounding areas are usually removed in addition to the tumor itself to determine whether the cancer has spread.

Unfortunately, the removal of lymph nodes causes lymphedema of the arm on the same side as the removal, Tu said.

Prevention

However, the more advanced sentinel lymph node dissection technique has become popular recently as it requires the removal of far fewer lymph nodes and results in fewer side effects, Tu added.

Tsai Han-ju (蔡涵如), a physical therapist at National Taiwan University Hospital, said that the best way of preventing lymphedema is to avoid heat, such as direct sunlight, heating pads or hot springs.

Also, breast-cancer patients should avoid getting bug bites and wounds such as those caused by needles, Tsai said.

Patients should also refrain from carrying heavy objects and wearing tight clothes that may obstruct lymphatic circulation, she added.

If patients notice swollen arms or deformity such as elephantiasis, they should seek medical help as soon as possible, Tsai said.

Manual lymphatic drainage and pneumatic compression therapy are available to patients to help relieve swelling and pain, she said.
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