Be stronger than the challenge,
And let the challenge make you stronger!
Our young therapist Dr. Priyanka Bodhe has written a wonderful article inspired by a woman she knows. Read what she has to say about dealing with one of the outcomes of breast cancer treatment, lymphedema.
- Dr. Harshada Rajadhyaksha
Recently, I came across a lady, otherwise healthy, who discovered a pea sized lump in her axilla. Having lost a very dear family member to breast cancer not more than a year ago, she became very conscious and immediately met a doctor to seek medical help. A few tests and they detected her with early stage of breast cancer which has also affected few lymph nodes in the axilla. Within a week she underwent Lumpectomy (surgical removal of the lump). For further management she has been advised few chemotherapy sessions and one radiation.
They say “The best protection is early detection”. But this has also arose few questions in my mind.
- Is breast cancer genetic and only women with family history carry the risk of developing the disease? If it was not for this 37 year old young lady, to have lost a near one to the disease, would she have become aware and alert about the monster that was about to grow in her body so early?
- And will chemotherapy and radiation end her fight or will they leave behind them some scars?
I m not an expert in the topic but witnessing the growing incidence of breast cancer in the community, I would like to highlight certain after effects of cancer treatment and what we as Physiotherapists can do to improve the Quality of life of those affected.
Firstly, let me start by wiping out the belief that family history is the biggest risk factor. Because in reality only 5-10% of cases are due to faulty genes. Thus, regular mammograms and clinical breast examination annually for all women above 40 years of age and every 3 years for women between 25- 40 years of age can help detect the disease in its earliest stage.
Secondly, chemotherapy and radiation therapy might not end her fight as they carry certain side effects such as:
- General de-conditioning and weakness of muscles
- Cancer related fatigue
- Joint pain and stiffness
- Soft tissue fibrosis
- Radiation related shoulder capsular thickening
- Lymph edema
- Postural changes
In other patients surgery might be opted for. Surgical management may include a lumpectomy as mentioned earlier or mastectomy-radical or modified.
Post surgery complications:
- Scars and skin adhesions
- Swelling/Lymph edema
- Upper limb, trunk and abdominal weakness
- Chest , neck and shoulder muscle tightness
- Axillary web syndrome/ cording with reduced flexibility, pain and weakness of upper limb
How can physiotherapy benefit in preventing and managing these side effects? When should one start physiotherapy?
- Physical therapy integrated with these cancer treatments create a more comprehensive approach to survivorship.
- It reduces mortality by 40% in breast cancer patients
- Among all the known complications, recognition and prevention of lymph edema, is critical in breast cancer rehabilitation.
- Lymphedema manifests itself as swelling in the affected arm because of a blockage of lymph passages and the body’s inability to drain fluid from surrounding tissues.
Treatment for lymphedema includes:
- Education about skin care
- Compression: compression bandages or compression sleeves and garments are designed to create pressure in arm and hand to keep lymph moving in the right direction.
- Manual lymphatic drainage or massage: uses light touch to move excess lymph and fluid out of the tissues and back into the lymphatic vessels.
- Exercise: includes basic mobility and strength exercises, individually designed for every patients by a physiotherapist.
- Hydrotherapy: water offers buoyancy and upthrust. “Water supports us, assists movement and causes resistance leading to strengthening”. Exercising in water will help in improving cardiovascular endurance, reducing lymph edema, improving range of motion and decreasing stress.
Physiotherapy might not be “The answer” to all the complications but it plays a major role and goes a long way in preventing and managing the breast cancer treatment after effects thus improving the quality of life of those who seek help.
Kill cancer, before it kills you…!!!
Turn a setback, into a comeback…!!!
-Dr. Priyanka Bodhe