Often lymphedema after cancer therapy

The disease after cancer: lymphedema due to cancer therapy

17/12/2014

Following surgical intervention, lymphedema threatens, causing fluid to accumulate in the arms and legs. Without treatment threaten permanent damage. Typical symptoms of such edema include swelling of the arms and thick legs following a cancer operation. „This is a pathological change in which lymphatic fluid in the tissue and in the tissue interstices accumulates because the lymphatic drainage is disturbed, "says Susanne Weg-Remers, Head of the Cancer Information Service at the German Cancer Research Center (DKFZ)..

The secondary lymphoedema usually occurs in connection with cancer diseases and therapies. Surgical interventions on lymph nodes, radiation therapies or metastases can interfere with lymph drainage. Affected are especially the limbs, after breast cancer surgery, about the arms, or following a prostate cancer surgery, the legs.

Breast cancer patients are often affected
Approximately One third of all breast cancer patients are affected by secondary lymphedema. Although the number of people affected has fallen overall, because the surgical interventions are being carried out more gently today. The first symptoms usually appear only weeks or months after the procedure. "This may still happen after 15 or 20 years," explains Oliver Rick, spokesman for the Oncological Rehabilitation Working Group of the German Cancer Society (DKG)..

Secondary edema is problematic because it does not regress itself, but steadily worsens: fluid accumulation in the tissue produces so-called proteoglycan. This is able to store large quantities of liquid. Problems with lymphatic drainage, however, cause problems: "The proteoglycan deposits as a spongy mass," says Manuel E. Cornely, chief physician of the CG Lympha Clinic for Operative Lymphology in Cologne. In addition, more and more proteoglycan is being formed.

Treatment mandatory
Without treatment, permanent tissue changes can occur and the affected body part swells permanently. In addition, there is a hardening of the swelling: "This is then a stage that is difficult or impossible to eliminate with the available therapies," said Rick. As a result, arms and legs may lose mobility and stiffen, the affected may become disabled or need care. In addition there are psychological problems due to the physical impairments. Therefore, patients should be promptly consulted by a doctor who examines them at the first sign.

As treatment methods actually only the complex physical decongestion therapy (KPE) comes into question. "This is a comprehensive multi-component therapy program," says Rick. The therapy works in two tracks, on the one hand with lymph drainage and on the other hand with compression stockings and bandages. This should prevent tissue changes.

Initially, the lymphatic drainage must first be drained off, after which bandages and support stockings should prevent the formation of new edema. Close collaboration between doctors, therapists and the compression garment manufacturers is very important. "A well-functioning network is a prerequisite for the treatment to go well on an outpatient basis," says Rick. Otherwise, the treatment must be performed stationary.

Permanent therapy usually unavoidable
Usually, lymphedema requires lifelong treatment. "That means lifelong compression wear, sometimes supplemented with maintenance lymph drainage," says Rick. "If you do not follow the therapy guidelines, you can quickly get to the point where the damage is irreversible."

Once the lymphatic vessels have changed permanently, surgery usually does not help anymore. Then comes an extraction of the proteoglycan tissue into consideration. "We can counteract the circulation of increased fluid accumulation and thus significantly reduce the necessary lymph drainage and compression treatments," explains Cornely. However, patients must pay for such treatment themselves. And: "The scientific data on the effectiveness of surgical procedures is so far thin," says Weg-Remers.

In addition, there are also naturopathic treatment methods. These too are done in two steps. First of all, an attempt is made to stimulate and derive the lymphatic flow. Here, e.g. Leech used. Their use has proven especially in the postoperative area. The use of highly concentrated enzymes is possible. In addition to the further phytotherapeutic treatment with blood-purifying and lymph-draining plants, lymph drainage is also used here. Other manual treatment options include osteopathy, foot reflexology and compression treatments.

In a second step, the natural regulatory ability of the body is to be restored by a profound therapy by recognizing and treating causal disorders. Naturopathic diagnosis uses constitution-oriented procedures such as iris diagnosis. In addition, it uses dark field microscopy to visualize the (microbial) environmental burden or to detect blockages through energetic measurements (such as EAV, bioresonance, vegitation) that can adversely affect a variety of bodily functions, although there is no direct causal link from a conventional perspective. Then follows the individual therapy, which may be depending on the therapist's method of medication, manual, classic ausleitend, physically, nutritionally and orderly therapeutic or subtle-energy oriented. (Jp)