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Your Positive Living With Lymphedema
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Ultrasound narrows which breast cancer patients need underarm lymph nodes removed
Which breast cancer patients need to have underarm lymph nodes removed? Mayo Clinic-led research is narrowing it down. A new study finds that not all women with lymph node-positive breast cancer treated with chemotherapy before surgery need to have all of their underarm nodes taken out. Ultrasound is a useful tool for judging before breast cancer surgery whether chemotherapy eliminated cancer from the underarm lymph nodes, the researchers found. The findings are published in the Journal of Clinical Oncology.
In the past, when breast cancer was discovered to have spread to the lymph nodes under the arm, surgeons routinely removed all of them. Taking out all of those lymph nodes may cause arm swelling called lymphedema and limit the arm's range of motion.
Now, many breast cancer patients receive chemotherapy before surgery. Thanks to improvements in chemotherapy drugs and use of targeted therapy, surgeons are seeing more women whose cancer is eradicated from the lymph nodes by the time they reach the operating room, says lead author Judy C. Boughey, M.D. a breast surgeon at Mayo Clinic in Rochester.http://www.news-medical.net/news/20150204/Ultrasound-narrows-which-breast-cancer-patients-need-underarm-lymph-nodes-removed.aspx
Number of Breast Cancer Survivors
As of 2006 there were more than 2 million breast cancer survivors alive in the United States. At this time there are about 2.5 million breast cancer survivors in the United States.
- The 2011 American Cancer Society estimates for U.S. breast cancer is 230,480 new cases of invasive breast cancer in women
- Of those, 57,650 new cases of carcinoma in situ (CIS) will be found
- About 39,520 deaths from breast cancer (women) That does not include the men.
- Breast cancer is the most common cancer among women in the United States, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer.
- There is a 1 in 8 risk of having invasive breast cancer during a woman's lifetime.
- The chance of dying from breast cancer is about 1 in 35. Supposedly breast cancer death rates have been going down. I wonder? National Cancer Institute says the number of cancer survivors are increasing.
- NEWS August 2011 | Mammography screening has little to do with drop in the number of women dying from cancer. Statistics show death rates have been falling across Europe since 1989; in Northern Ireland, deaths have fallen by 29 per cent, in the Netherlands by 25 per cent, in Belgium by 20 per cent and by 24 per cent in Norway. Some of the countries that have seen the reduction do not have full screening programmes, and most of the reductions have been in women aged between 40 and 49, who may not have even started to be screened, researchers discovered. (Source: British Medical Journal, 2011; 343: d4411).
NEWS JULY 2014 : Knowledge weak among breast cancer patients about lymphedema
Newly Found Lymphatic System Connects Brain & Immunity
The brain is like every other tissue connected to the peripheral immune system through meningeal lymphatic vessels. For every neurological disease that has an immune component to it, these vessels may play a major role.
Lymph Node Transplants and Surgical Procedures
- Available in Europe Lymph Vessel Transplants and Lymph Node Transplants. Lymphedema occurs in about 20 percent of the three million patients with breast cancer.
Vanderbilt University School of Nursing conducts Study on "Yoga" to improve "Lymphedema"
- Researcher Sheila Ridner, Ph.D., MSN, R.N. conducts study with head and neck cancer patients to increase the mobility of affected parts in order to address lymphedema symptoms, postural problems, and breathing issues, in addition to improving mood with the practice of yoga.
- "Breathing, particularly diaphragmatic breathing, helps move the fluid and standing upright clearly takes away restrictive bends in the body that might keep fluid from moving. . . "
- Individual sessions last 90-minute with a yoga teacher includes awareness practice, postures that focus on improving mobility in the neck, jaw and shoulders, breathing exercises, relaxation and meditation.
Targeting endothelial Cells in the Lymph System
- If it is true that endothelial cells, which form the lymphatic vessel wall express specialized receptors recognize the IL-7 molecule, researchers may be able to develop a new treatment.
- VEGF-C might also be an interesting molecule in this regard. Among patients with advanced melanoma, presence of higher levels of the protein vascular endothelial growth factor (VEGF) in the blood was associated with poor response to treatment with the immunotherapy ipilimumab. et.al. Cancer Immunology Research, a journal of the American Association for Cancer Research.
- Vascular endothelial growth factor-C stimulates the lymphatic pump by a VEGF receptor-3-dependent mechanism. Professor Kari Alitalo of the University of Helsinki, who made the discovery that the growth factor VEGF-C regulates the growth and development of the lymphatic system in humans and other mammals, presented the findings. From this discovery and in association with his co-workers Dr. Tuomas Tammela and Dr. Anne Saaristo, they identified that if VEGF-C is injected into tissues in mice and subsequently in pigs, growth of new lymphatic vessels and the restoration of the lymphatic architecture is catalyzed. http://www.ncbi.nlm.nih.gov/pubmed/17400713
Chinese Herbs To Increase Blood Flow
- Angiogenic effects of the extracts from Chinese herbs: Angelica and Chuanxiong. Angelica and ChuanXiong are used to cure ischemic heart disease in China. Previous studies found that these two herbs could increase myocardial blood flow, oxygen-supply and keep myocardial oxygen balance, etc. However, the mechanisms of angiogenic effects of these two herbs are not well-known. The purpose of this study was to assess the effects of Angelica and ChuanXiong on vascular endothelial growth factor (VEGF) expression in rat myocardial infarction, on endothelial cell proliferation and quantity of vessels on chick embryo chorioallantoic membrane (CAM).
In this study, rats were divided randomly into either pre-treatment or acute-treatment group and sacrificed at the end of the treatments. VEGF expression using Western blot analysis was significantly increased in the groups pre-treated with ChuanXiong and Angelica when compared to the control group (p < 0.05).
There was significant increase in VEGF expression in the rats treated acutely with Angelica (p < 0.05).
In the contrary, the rats treated with ChuanXiong showed a decrease in VEGF expression when compared to the acute-treatment control group (p < 0.05).
Similar results were observed in immunohistochemistry of VEGF expression in the myocardia. Our study also demonstrated that these two herbs significantly enhanced endothelial cell proliferation (p < 0.05) and revascularity in CAM (p < 0.05). The data showed that Angelica and ChuanXiong could affect VEGF expression in rat myocardial infarction, promote endothelial cell proliferation and stimulate quantity of vessels on CAM model. The results suggest that Angelica and ChuanXiong have angiogenic effects, and may provide some mechanisms for the treatment of myocardial infarction and peripheral ischemia.
Live, Live, Live
No matter what the diagnosis; live, live, live. Just take all precautions along the way, especially if you have lymph system impairment. My sister and I are living examples of the thousands of people who have lived through a cancer diagnosis, survived and created lives of abundance. Through pains, sorrows, treatments, family turmoil and roller-coaster emotions we carry on with hope and joy that each day will be better than the next.
I dedicate this article to my sister, Wendy S. Harpham, M.D., a person of empathy and integrity. Her greatest passion comes alive through her writings and lectures. Changing course midstream from physician to author she found a new approach to help friends, family, and community manage the traumatic maze of cancer.
Pope Paul VI
Dr. Harpham offers practical philosophy and science-based knowledge to help people acquire quality care and soul-search their happiness even when illness strikes. Having coined the term "Healthy Survivor," while dealing with her own battle with lymphoma since 1990, Dr. Harpham encourages people dealing with cancer, heart disease, diabetes, or any prolonged illness to simultaneously do all one can to overcome disease and live life to the fullest. In the words of Pope Paul VI (1897-1978)
"Somebody should tell us, right at the start of our lives, that we are dying. Then we might live life to the limit, every minute of every day. Do it! I say. Whatever you want to do, do it now! There are only so many tomorrows."
A Basic Home Kit Helps You
There is tremendous grief and loss after mastectomy or any breast cancer surgery.
They need tender loving care, counseling, education about the potential for Lymphedema , care of surgery site, how to care for the drain and possibly an injection site port. They need physical therapy so they do not get frozen shoulder, like I did. And family members also need special support because they become the care-givers while the breast cancer survivor slowly comes back into the land of the living and the forthcoming trials of chemotherapy and radiation.
A Basic Home Kit
And you know, it wouldn't be like me if I didn't suggest certain homeopathic remedies to address a number of issues. There are remedies for shock, emotional ups and downs, to speed wound and skin healing, to boost the blood, and prevent infection and much more.
Having a basic home kit really gives confidence and support to the patient as they go through the traditional medical system. Homeopathy, a holistic approach to well-being, works on an energetic level above and beyond the physical realm.
Sign The Breast Cancer Petition
Please sign the Petition at MyLifeTime to Protect Breast Cancer Patients from "Drive-Through" Mastectomies. I have already clicked and written in my comments on this petition. (2009-11) Women undergoing mastectomy need a lot of care and instructions for recovery. They are already in shock from a prognosis, at the very beginning of a long journey to recovery, having just faced a major life-changing surgery to their entire body, mind and soul and changing their physical form.
- The Bipartisan Breast Cancer Patient Protection Act Needs Your Support!
- Representatives Rosa DeLauro (D-Connecticut) and Joe Barton (R-Texas) and Senators Mary Landrieu (D-Louisiana) and Olympia Snowe (R-Maine) recently re-introduced the bipartisan Breast Cancer Patient Protection Act in Congress. Lifetime Advocacy & Public Affairs has supported the act for 13 years, since it was originally introduced to Congress by Rep. DeLauro in 1996, and continues to advocate for its passage. Marcia Cross and Jewel have publicly advocated for the bill's passage on behalf of Lifetime. Thanks to its viewers, Lifetime has so far collected close to 24 million online petition signatures urging Congress to pass this critical legislation, which would end the practice of so-called "drive-through" mastectomies when women are forced out of the hospital only hours after invasive breast cancer surgery.
In times of despair we turn to prayer. Let's read a line from Psalms 23:6.
“May only goodness and kindness pursue me all the days of my life, and I will dwell in the house of the Lord for the length of days.”
We all need blessings and positive thoughts when times get rough. This talk takes on a traumatic and life altering topic – lymphedema - a condition with no known cure. As a cancer survivor this condition follows me all the days of my life and I feel compelled to speak out without intending to add more worry to the fears of recurrence and thoughts of an unsure future. This talk will explain how and when it happens and also its effects. Let me assure you this isn’t easy for me to talk about, but I want people to be mindful of others and their own situation.
Ageless Herbs Lymphatic Drainage Massage
Instructions for Self Drainage Massage Plus numerous herbal recommendations
First, let’s learn what and when lymphedema occurs.
Lymphedema, a chronic swelling in a limb or other part of the body never goes away, but it can be managed. Both men and women can get it when surgery has severed through the delicate lymph network or there has been removal of axillary, pelvic or inguinal lymph nodes for gynecologic cancers, ovarian, testicular, colon-rectal, pancreatic or liver cancer or even melanomas. Radiation can also impair the lymph system. Scar tissue can block the movement of lymph fluid, a vital part of the immune system that fights infection. The symptoms can come at any time, right after surgery or even 30 years later when the body becomes especially sensitive to changes in air pressure, weather, temperature, strenuous exercise and carrying or heavy lifting.
So, if you find yourself tiring easily or feeling annoyed and you notice your skin feeling hot, tight, or soft like a sponge or full, and your limb constantly nagging or throbbing with either heaviness, aching, shooting, or tingling then ask your doctor if you might have lymphedema. People with lymphedema find redness, swelling and pain worsens as the day progresses, and especially in hot weather. When doing your morning stretches if you find your joints less flexible with reduced range of motion then take action to recognize something needs attention. And because we need periods of rest to heal, if you have difficulty finding and maintaining a comfortable sleeping position this can be a global clue that creates added stress to the system. Knowing the signs and symptoms of lymphedema can help you prevent the condition from worsening.
Factors That Increase Risk by Limiting Flow of Lymph:
- Numerous Surgeries
What precautions should you take if you have lymphedema?
While dealing with medications and doctor’s visits, you may have lost your instructions teaching you the dos and don’ts for prevention and control. Be careful when using the limb for simple tasks like lifting groceries, carrying the baby, gardening, vacuuming or washing the dishes, because these activities exacerbate pain with a compromised lymph system. In order to preserve your quality of life, maintain specific lifestyle behaviors to lessen the risks of acquiring or worsening this condition. I assure you: Don’t throw caution to the wind, take special care when trimming your nails, avoid cutting cuticles, wear gloves when in the garden or when doing manual work, don’t get into a hot tub or sauna for too long if at all, avoid heavy lifting and repetitive motions, and carry bags on your uncompromised side.
Do your best to avoid cuts, bumps, bruises and animal scratches. Keep limbs dry, clean and lubricated with a nightly application of moisturizing creams or oils to prevent chaffing. Protect your skin from excessive sunlight and insect bites by using sun screens and insect repellents. Use an electric razor rather than a blade for shaving the affected limb to avoid nicks and skin irritation. You might wear a bracelet to remind the nurse to avoid blood draws, injections and the use of blood pressure cuffs on the affected limb whenever possible. Even though we like to dress up, avoid wearing constricting jewelry, only you can tell how much binding or pressure your body accepts. Remember, this serious condition can mean disfigurement, infection, and difficulty with movement and performing simple chores. You may be at a higher risk of developing lymphedema from changes in pressure on an airline flight, so be prepared with compression garments for the journey, and move about to keep the fluids flowing.
Signs of Lymphedema
If you notice your rings, bracelets or sleeves do not fit this may also be a sign of swelling, but, diuretics are not recommended and analgesic drugs are not always effective. If you get a scratch or cut which would normally heal, but redness, pain, heat, chills, swelling or fever persist you may have an infection. See a doctor immediately. Be on the lookout for all these signs and symptoms and get treatment early!
Moments of Relief
During the day, resting your arm or leg in a supported position gives the best relief. For me the fluid drains into my arm, but is unable to move back up into the body to circulate. If this happens, you must have manual lymph drainage (MLD) a specialized form of massage. After getting professional help you will learn how to self-manage with daily home care which includes massage and slow exercises, along with wearing compression bandaging at night and a special hand and arm garments during the day. Like other chronic illnesses, you must care for yourself every single day.
Living With Lymphedema: A Man's Story
Awareness of Emotional Challenges
Now you understand the severity and lingering effects of what the lymphedema patient must endure. I encourage friends and strangers alike to broaden their awareness and understanding for the plight of those dealing with lymphedema. Some of the emotional challenges that result from this condition include sadness, grief, anger, fear, worry and uncertainty, self-consciousness, feeling overwhelmed and over-protective. And as a result of often searching for ways to handle other people’s reactions, sufferers may socialize less, stay home and only wear long sleeved garments. For the lymphedema patient, a “normal” lifestyle or ordinary tasks may be compromised, so they feel socially and physically handicapped. With the emotional and mental stress of learning to live this way, self esteem may diminish, and signs of depression may surface until regaining a sense of control over their lives. So you see this really can be life altering.
After Effects of Lymph Node Removal
What Percentage of Women Do You Think Get Lymphedema After Breast Cancer?
How does one cope with lymphedema or any chronic condition?
Although the percentage risk appears low it actually varies with your situation and number of surgeries. Therefore, your personal risk could be much higher. Ask any breast cancer survivor.
Whatever emotional, physical, and mental obstacles cross our path, I want to stress that we can still live a full and happy life, within new limitations; what my sister calls, a “new normal.” We can only take one day at a time. The survivor must take baby steps towards health without overextending their energy resources. Taking little breaks for tea, aromatherapy, to sit outside, to journal, to stretch and meditate throughout the day eases up the stress on the mind and body. Let’s pause for prayer and deep breathing right now. His Almighty power is everlasting; so, just when you think you’re dealing with this problem alone ask for His help and say a few verses of Psalms chapter 10…10:01 O
Lord, why do You stand from afar? [Why do] You hide in times of distress? 10:11. He says in his heart, "God has forgotten; He has hidden His face, He never sees." 10:12. Arise, O Lord God, lift up Your hand; do not forget the humble.
Finding Comfort With Others
When the myriad of symptoms overwhelm you, find comfort and answers from a lymphedema support group. Speak with others who have “been there and done that” to ease your fears. Seeing that they have learned to manage the condition, have made their lives productive and go out of their way to help others provides encouragement. They will most likely recommend that you learn relaxation and deep breathing techniques, find time for walking, stretching, movement, dance, yoga and exercise, and realize the benefits of meditation and prayer. We are just learning the immense power of the mind body connection. So keep smiling!
Moving Forward With Prayer and Hope
Every day a new lesson in compassion, hope, and wisdom collides with best-laid plans. Perhaps by choosing to change old habits or take on a new improved lifestyle, you move forward choosing life. We can’t know why things happened, but we can react positively to our circumstances. I must teach myself another important lesson every day. Negative thinking creates negative outcomes. Fighting, resisting, struggling, and forcing may be one way to receive the best treatment and make improvements in the medical system for those who follow. However, there may be a toll to pay. I need to listen to my own tone of voice and find ways of acceptance in order to heal.
As this new doorway opens, you walk through with open eyes, a hand to support you, a clear mind to make choices how to continue your life. With the realization that time is short, make all your dreams come to life now, with all the power that is within you. Let us end with a plea for strength and courage today and hope in a better future as we move forward. . .
Psalms Chapter 13:
1. To the conductor, a song of David.
2. How long, O Lord? Will You forget me forever? How long will You hide Your face from me?
3. How long will I take counsel in my soul, having sorrow in my heart by day; how long will my enemy have the upper hand over me?
4. Look and answer me, O Lord my God; enlighten my eyes lest I sleep the sleep of death.
5. Lest my enemy say, "I have overwhelmed him"; my adversaries will rejoice when I totter.
6. But I trusted in Your loving-kindness, my heart will rejoice in Your salvation; I will sing to the Lord for He has bestowed [it] upon me.
Check Your Blood Pressure
Study Results: High Risk
. . . study confirmed the findings of numerous prior studies that have linked the surgical removal of armpit lymph nodes, obesity, and high blood pressure with chronic arm lymphedema. In this study, women with high blood pressure were found to have almost two-and-a-half times the risk of developing lymphedema following breast cancer treatment when compared to women who did not have hypertension. Moreover, this hypertension-associated risk of lymphedema was essentially equivalent to the level of risk associated with the surgical removal of armpit lymph nodes and with obesity, which is a much higher level of risk than has been reported by most prior studies.
Reference from article by Dr. Wascher, an oncologic surgeon, professor of surgery, a widely published author, and the Director of the Division of Surgical Oncology at Newark Beth Israel Medical Center
Lymphedema MCB - Woman Shows How She Wraps Her Leg
Dieting Helps Reduce Risk of Lymphedema
UK Study Results: Weight loss appears to be an effective way to reduce breast cancer-associated lymphedema of the arm
Benefits of Fish Oil
. . .cold water fish can reduce the risk of heart disease. Now, new research, performed at the University of Texas in San Antonio suggests that fish oil may be able to inhibit the growth of breast cancer tumors as well.
Importance of Exercise
A study conducted with 86 women revealed that slowly-progressive weightlifting exercises helped women gradually increase the strength of the damaged arm, making it less likely that the occasional activities of daily living would overstress the injured lymphatic system.
There is also evidence that slowly progressive weightlifting among women with previously diagnosed breast cancer–related lymphedema leads to a reduction by half of the likelihood of a clinically meaningful exacerbation of lymphedema (a flare-up) that requires treatment by a physical therapist. [Level of evidence: I] A group of 141 breast cancer survivors with lymphedema were randomly assigned to a twice-weekly, year-long weight-lifting intervention (N = 71) or to a wait-list comparison group (N = 70). The intervention started with 13 weeks of supervised training with little to no resistance; the amount of weight lifted was increased very gradually and only if there was no change in lymphedema symptoms or swelling. The participants all wore well-fitting, custom-made compression garments that were replaced 6 months into the intervention period. Women with breast cancer–related lymphedema should be guided to work with a certified fitness professional or physical therapist to learn the proper biomechanical form for upper-body weight-lifting exercises before undertaking this program on their own. (The specifics of the intervention are available to certified fitness professionals and physical therapists through the National Lymphedema Network.) Further research is needed to develop a version of this intervention that can be broadly disseminated.
One small pilot study has examined the safety of an intervention similar to that described above in cancer survivors with lower-extremity lymphedema secondary to melanoma or gynecologic or urological cancers. In this uncontrolled pilot study, 20% of participants developed a cellulitic infection within the first 2 months after starting a slowly progressive weight-lifting regimen. Further research is needed to determine whether weight-lifting is a safe exercise modality for cancer survivors with lower-extremity lymphedema.
Physical Activity and Lymphedema
New and Emerging Treatments for Lymphedema
Sentinel Lymph Node Biopsy
Sentinel Lymph Node Biopsy: What Breast Cancer Patients Need to Know
This procedure may prevent the need for removal of all lymph nodes. This is a comprehensive website.
More Link References
Learn More About Lymphedema
Journal Reference :Patients with arm edema secondary to breast cancer therapy can experience a substantial degree of functional impairment and psychological morbidity and diminished quality of life.
Breast Cancer is the second leading cause of death in women in the US. The American Cancer Society estimates that about 40,000 women dies each year of breast cancer.
Mortality Rates of Breast Cancer
Treatment and Outcomes for High-risk and Metastatic Breast Cancer in California
Studying Environmental Impacts
- The strongest known environmental risk fac- tor for breast cancer is exposure to ionizing radiation.
A strong association has been observed between high dose exposure in atomic bomb survivors and persons undergoing prolonged radiation treatment. But few studies have been conducted of low dose occupational exposures or common medical procedures (Henderson et al., 1996). Women who underwent radiation treatment for Hodgkin’s disease and other cancers are at increased risk of breast cancer later in life. So are women who were treated with radiation for scoliosis, underwent repeated cardiac catheterizations, or underwent other diagnostic procedures. But at present it is not possible to
identify which women should avoid such procedures or undergo alternative treatments. The risk of breast cancer from nuclear power plants and other low-level sources of ionizing radiation has not been extensively studied, but is thought to be negligible. Nevertheless, consider- able concern exists about such an association among many grassroots advocacy groups.
Despite scores of epidemiologic studies and decades of research, the association between tobacco smoke and breast cancer remains controversial (Laden and Hunter, 1998). Difficulties in measuring exposure, particularly passive exposure early in life, and disentangling the effects of the complex mixture of compounds within tobacco smoke are a few of the problems encountered. Cigarette smoke may increase breast cancer risk by raising levels of oxidative DNA damage. Exposure to ionizing radiation also increases levels of oxidative damage, so it is possible that hormones, alcohol, smok- ing, radiation, and many other environmental factors share oxidative damage and perhaps other biochemical pathways as common mechanisms of action in breast carcinogenesis.
A variety of factors have been identified as suspected environmental risk factors for breast cancer. These include: light at night (disruptions in melatonin secre- tion), hormone disruptors (including an extensive list of widespread compounds such as phthalates), environ- mental pollutants (hydrocarbons, organochlorines), and occupational exposures (chemical, radiation). The role of electromagnetic fields has been given less atten-
tion recently, with more emphasis on light at night as a source of melatonin disruption. Epidemiologic studies have shown fairly consistent associations between shift work and other sources of exposure to light at night and increased risk of breast cancer. It has been estimated that 20 percent or more of employed women in Califor- nia may be exposed to light at night through shift work on jobs in health care, manufacturing, janitorial work, and transportation.
About the Author
Debby Bruck, CHOM is a student of Kabbalah and Homeopath. She enjoys qigong, healing movement, guided imagery, and meditation. You can also follow Debby on Twitter.
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