Breast cancer is by far the most commonly diagnosed cancer in women worldwide, accounting for 21% of all cancers diagnosed in women. Breast cancer incidence, in India, is on the rise and has now become the most common cancer among women, having overtaken cervix in all the cancer registries, rural or urban.
With increasing incidence and longer survival of patients, quality of life issues has gained importance. Many breast cancer patients suffer from treatment-related adverse effects including restrictions in their arm and shoulder function, eg. decreased joint mobility, muscle strength, pain and lymphedema, leading to limitations in activities of daily living and participation in work, sports and leisure activities. Lymphedema of the upper extremity, in addition to being unsightly, can be painful, can limit the arm movements, increase the risk of infection and is psychologically distressing, serving as a constant reminder of cancer.
Lymphedema, following breast cancer treatment, occurs due to lymphatic interruption following surgical trauma or radiotherapy induced fibrosis that leads to chronic inflammation and consequent fibrosis of the hypodermal and dermal connective tissue. Once established, lymphedema is difficult to treat. Prevention by means of good surgical technique, arm care post-surgery, exercises and massage therapy may help reduce the incidence.
AktivHealth Cancer Rehabilitation team focuses on the impact of lymphedema to patients’ physical and psychological health with long lasting and often permanent sequelae to their quality of life. Of the most troublesome issues in patients with severe lymphedema of upper extremity were problems related to the weight of the arm and its impact on arm utility along with issues with dress fitting. A thorough baseline evaluation, clinical assessment and assessment of upper arm morbidity for Pain, Stiffness, Range of movements, Swelling and Activities of Daily Living (ADL) is done. Several patients have demonstrated improvement of shoulder function and lymphedema following physiotherapy in the last few years.
It’s important to know that Cancer Rehab before, during and after treatment is as important as the treatment or the surgical intervention itself.