Post-Treatment Condition Often Overlooked In Breast Cancer Patients

As many as 70% of women with breast cancer develop painful swelling of the lymph nodes after treatment, but the condition is frequently ignored, misdiagnosed or otherwise left untreated, the Washington Post reports. The condition, known as lymphedema, affects three million to five million people in the U.S., including those who have undergone treatment for breast, prostate, ovarian and other cancers. Most research on lymphedema has focused on its connection with breast cancer surgery and radiation.

Lymphedema develops when fluid accumulates at or near the surgery site -- typically building up in the groin, the hands, the arms, the legs or the chest -- because of a blockage in the lymphatic system. Over time, this causes swelling, which "can get worse, becoming painful, chronic and debilitating: restricting movement, impeding daily activities and requiring constant care," the Post reports. One patient profiled in the story uses massage and "wears special garments 24 hours a day to deal with her condition," according to the Post. Although cancer surgery is not the sole cause of lymphedema, "there is strong evidence of cause and effect" when patients undergo cancer surgeries involving examination of the lymph nodes to determine whether the cancer has spread, the Post reports.

Few doctors and hospitals acknowledge the risk for lymphedema when discussing surgery or cancer treatment, and patient advocates note that it is not mentioned in consent forms signed prior to surgery or treatment. The criteria for diagnosing the condition are inconsistent; thus, various estimates about lymphedema rates in women treated for breast cancer range from 6% to 70%, depending on which criteria are used, how long after surgery the studies are conducted and which body parts were examined.

Judy Nudelman, a family physician at Brown University who has lymphedema and also treats patients with the condition, said many patients become frustrated because doctors and hospitals tell them "we have zero incidence of lymphedema cases in our institution." According to the Post, some surgeons or hospitals view lymphedema as a complication and avoid mentioning it for fear of developing a negative reputation (Mishori, Washington Post, 11/9).


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