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Nurse practitioner Christine Rymal consults with breast cancer survivors to help them prevent lymphedema. As the number of breast cancer survivors increases, the incidence of side effects from treatment also increases. One such side effect is lymphedema, which may manifest as a painful swelling of the upper extremity, often resulting from lymph node surgery or radiation therapy to the breast. As a surgeon who treats breast cancer patients at the Walt Breast Center, Mary Ann Kosir, MD, is concerned about her patients’ potential for developing lymphedema. Breast cancer treatments may damage the drainage channels, or lymph channels, in the arm. The resulting swelling in the arm can be painful, disfiguring and may lead to loss of function. The problem occurs in 16-25 percent of breast cancer survivors, but Dr. Kosir believes lymphedema can be reduced if women are trained to recognize and alleviate the problem. She and her multidisciplinary research team have been awarded a five-year grant for nearly $750,000 from the United States Army to study “Lymphedema Prophylaxis Utilizing Perioperative Education.” The grant is a collaborative partnership between the Wayne State University School of Medicine, College of Nursing, Barbara Ann Karmanos Cancer Institute and the John D. Dingell VA Medical Center. Its aim is to minimize the incidence of chronic lymphedema through postoperative screening protocols, early detection, and structured patient education about preventive exercises, precautionary measures and management of complications. “Chronic lymphedema can occur at any time after breast cancer treatment and it is irreversible,” said Christine Rymal, a nurse practitioner who specializes in lymphedema and works in the Walt Breast Center at the Karmanos Cancer Institute. “It’s a serious problem that can cause pain, numbness, throbbing, chronic inflammation, swelling, decreased grip strength, and reduced arm rotation and extension. This can interfere with a patient’s daily routine and because it’s disfiguring, patients may not be able to fit their arms in clothing. This brings a whole host of other psychosocial factors to consider.” Results from this study will provide new knowledge about standardized prospective determination of the occurrence of lymphedema in breast cancer survivors in the first three years following surgery or radiation therapy. Furthermore, researchers predict that training in lymphedema protection methods will improve the quality of life for breast cancer survivors.
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