Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=221010
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New techniques hold promise for swollen arms in breast cancer patients

by Emily Nelson
May 2, 2013


ARMSWOMAN

Katie Tegtmeyer / Foter.com

Early screening and alternative treatment approaches such as acupuncture to treat lymphedema, swelling of the arms and legs, could prevent costly and time consuming treatment plans for breast cancer patients.  

Dr. Sheldon Marc Feldman, chief of surgery at New York Presbyterian Hospital, spoke about a pre-emptive treatment approach for the common side effect in breast cancer patients during the second day of the annual meeting for the American Society of Breast Surgeons at the Sheraton Hotel and Towers in downtown Chicago.  

The National Lymphedema Network defines lymphedema as the accumulation of fluid in the lymph vessels that can develop when lymphatic nodes and vessels are missing, damaged or removed.  Swelling in the arms and legs is common in breast cancer patients because lymph nodes are often damaged or removed during surgery or radiation therapies.

“There is a lot of inconsistencies when we do arm measurements to determine whether a patient has lymphedema,” Feldman said. “There’s a huge variation in treatment.”  

He added that many practitioners are not adequately trained to treat the condition. In addition, treatment can be time consuming and expensive, so screening patients early can allow them to get treated earlier and prevent swelling.  

Feldman suggested that rather than treat the condition after it occurs, an alternative approach would be to early identify patients who are susceptible. Patients who receive radiation, chemotherapy and mastectomies have an increased risk of developing lymphedema, Feldman said.  

“Everyone treated for breast cancer should be screened,” he said.  

He discussed a new bioimpedence device that measures if a patient’s arm fluid levels are out of range and alerts the physicians to begin early treatment before advance swelling occurs.  

Feldman also mentioned that studies using acupuncture as a treatment of lymphedema shows promising results. Acupuncture is a traditional Chinese medicine treatment approach using small needles to penetrate the skin and stimulate points on the body. A small sample of patients were treated for twice a week for four weeks on average showed a 30 percent reduction in swelling with no adverse side effects.  

While acupuncture could be an effective treatment option based on early results, researchers are still stumped on how and why it works. “The mechanism of how acupuncture works is unclear,” Feldman said.