Cohen SR, Payne D, Tunkel RS.
Lymphedema: strategies for management.
Cancer 2001 Aug 15;92(4 Suppl):980-7

Rehabilitation Service, Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering
Cancer Center, New York, New York 10021, USA.

An important sequela of cancer treatment is lymphedema. Management of this
condition must be based on the physiologic functioning of the lymphatic system
and tailored to the individual patient's presentation of the disease. Early
diagnosis and treatment are essential to prevent worsening of the condition and
to help assuage the psychologic impact of the disease. A review of the normal and
impaired lymphatic system is presented in this article. Current assessment and
treatment options are described, including education of patients in precautions,
positioning, exercise, compression garments and bandages, pneumatic pumps, and
lymphatic massage. Also included is a discussion of the psychologic impact of the
disease as well as management of psychologic symptoms. Various strategies for
management of the physical aspects of lymphedema are available. Studies have
shown that use of physical treatments such as exercise, compression, and
lymphatic massage are effective in reducing the amount of swelling in affected
limbs. The specific type, amount, and combination of these treatments continues
to be debated. The development of lymphedema is commonly associated with
significant psychologic distress that can impact on compliance with physical
treatments. Because there is no consensus as to the optimal treatment approach
for management of lymphedema, additional research must ensue to determine the
efficacy of existing treatments and to develop new management techniques.
Clinicians must be attuned to the signs and symptoms of lymphedema in order to
make prompt referrals for treatment. Copyright 2001 American Cancer Society.