Newswise — A poster session presented today by The University of Texas M.
D. Anderson Cancer Center at the Oncology
Nurses Society 33rd Annual Congress, found
that early nursing intervention and
implementation of effective strategies can
lead to a decrease in the incidence of
lymphedema, better management of chronic
lymphedema and improved quality of life in
breast cancer patients.
The literature review, led by Mattie J. Sennett McDowell, RN, BSN, a
research nurse in the Department of Breast
Medical Oncology at M. D. Anderson, examined
20 years of data about the prevention,
management and care of upper extremity
lymphedema (ULE), or lymphedema that occurs
in the arms, in breast cancer patients.
The goal of the review was to identify a comprehensive list of current
evidenced-based strategies that nurses and
hospitals can use in caring for their
patients.
"Women are living longer as breast cancer treatments get better, but at
the same time, they face more devastating
side effects like lymphedema," McDowell
said.
"So many women present with the symptoms, yet it is understudied and not
well understood. More can to be done to
proactively recognize and address lymphedema
in breast cancer patients."
ULE is an often a distressing and debilitating side effect of breast
cancer treatment in which protein-rich fluid
in the tissue of the arms accumulates and
obstructs the lymph vessels.
According to the National Lymphedema Network, approximately 15 to 20
percent of all breast cancer patients are
affected by ULE.
Its development can be triggered by breast cancer diagnostic procedures,
radiation, surgery or environmental factors.
It also can can occur immediately after treatment or many years down the
road. ULE, which can make simple tasks such
as picking up children, getting dressed or
exercising painful, has a detrimental impact
on the patient's quality of life.
According to the literature, effective strategies to address lymphedema
included early identification of at-risk
patients through enhanced assessment
techniques, monitoring, standardizing
at-risk assessment tools and increased
awareness of lymphedema through educational
efforts of the health care team.
The studies noted that increased awareness through educational forums,
patient-nurse learning modules, and
increasing the number of research studies
focusing on ULE are vital in addressing this
problem.
McDowell, who is dedicated to the study, prevention and management of ULE
after a breast cancer patient died from
significant disease progression, complicated
by advanced, unmanageable lymphedema, said,
"This research is centered on what is
important to the patient and their quality
of life after treatment. Nurses are on the
frontline and may hold the key in
proactively preventing lymphedema in many
patients by educating them about triggers
and symptoms, continual and specific
lymphedema assessments during each visit and
pursuing research in this area."
At M. D. Anderson, nurses and patient care teams have implemented several
strategies to educate breast cancer patients
about lymphedema and treat it aggressively.
One such strategy is having a nurse and physician present information via
discussion and prepared handouts before
women undergo surgery. Additionally, all
women are assessed for lymphedema during
treatment and at follow-up visits.
M. D. Anderson's multidisciplinary care team also offers comprehensive
support and collaboration from prevention of
the sequelae to advanced physical therapy
for those with lymphedema.
McDowell plans to develop further research studies examining the
evidenced-based practices for ULE identified
in this study, with the end-goal of
developing a standard set of
recommendations.
More information on the causes and symptoms of lymphedema, risk reduction
strategies and recommended treatment are
provided online at M. D. Anderson's
Rehabilitation Services Lymphedema homepage
or by logging onto the National Lymphedema
Network Web site.
About M. D. Anderson
The University of Texas M. D. Anderson
Cancer Center in Houston ranks as one of the
world's most respected centers focused on
cancer patient care, research, education and
prevention. M. D. Anderson is one of only 39
Comprehensive Cancer Centers designated by
the National Cancer Institute. For five of
the past eight years, M. D. Anderson has
ranked No. 1 in cancer care in "America's
Best Hospitals," a survey published annually
in U.S. News and World Report.
About Nursing at M. D. Anderson
Nursing is a pillar in M. D. Anderson;s
worldwide reputation for cancer care,
research, education and prevention. Nearly
2500 professional nurses work in M. D.
Anderson's clinics and hospital as direct
care providers, research nurses, advanced
practice nurses, case managers, educators
and many other roles. M. D. Anderson is
recognized internationally as a Magnet
institution.o:p>
