Compression, decongestive therapy and exercise for lymphoedema
Arm or leg swelling after lymph node surgery or radiotherapy is managed with compression garments, specialised massage, skin care and exercise. Weight lifting, once forbidden, was shown in a randomised trial to reduce flare-ups rather than cause them.
Overview
Lymphoedema follows axillary or groin node dissection and radiotherapy in a substantial minority of patients. Complete decongestive therapy combines manual lymphatic drainage, multilayer bandaging then fitted compression garments, skin care and exercise, and reduces limb volume in randomised and cohort studies; compression is the element with the most consistent effect, and pneumatic pumps add modestly. The PAL trial of 141 breast cancer survivors with lymphoedema (Schmitz et al., NEJM 2009) found that slowly progressive weight lifting halved the proportion with exacerbations and improved strength, overturning decades of advice to avoid lifting. Newer options include lymphaticovenous anastomosis and vascularised lymph node transfer for selected patients, and prevention by axillary reverse mapping and sentinel node biopsy instead of dissection. Reflexology, laser and herbal diuretics have no reliable evidence.
How it works
External compression and rhythmic muscle activity increase lymphatic return and prevent re-accumulation; resistance exercise strengthens the muscle pump and improves the limb's tolerance of load.
- Randomised evidence that exercise is protective
- Compression is effective and widely available
- Surgical options for refractory cases
- Lifelong garment use
- Specialist therapists in short supply
- Advanced fibrotic lymphoedema responds poorly
Latest papers
topQuery for this technology: (TITLE:"Compression, decongestive therapy and exercise for lymphoedema" OR ABSTRACT:"Compression, decongestive therapy and exercise for lymphoedema") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Compression, decongestive therapy and exercise for lymphoedema, not a curated reading list.
Pages like this
not linked directly; found by shared links- TechnologyCognitive behavioural therapy for insomnia (CBT-I)
Shares Late effects and survivorship toxicity, Survivorship care and late-effects surveillance, Survivorship and late effects are neglected and the tags complementary, supportive-care, evidence:strong.
- TechnologyYoga during and after cancer treatment
Shares Exercise & lifestyle oncology, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer and the tags complementary, supportive-care, evidence:strong.
- TechnologyCognitive behavioural therapy for fatigue and distress
Shares Exercise & lifestyle oncology, Survivorship and late effects are neglected and the tags complementary, supportive-care, evidence:strong.
- TechnologyMindfulness-based stress reduction and cognitive therapy
Shares Survivorship and late effects are neglected and the tags complementary, supportive-care, evidence:strong.
- TechnologyAcupuncture for aromatase-inhibitor joint pain
Shares HR-positive / HER2-negative breast cancer and the tags complementary, supportive-care, evidence:strong.
- TechnologyOral cryotherapy (ice chips) to prevent mucositis
Shares the tags complementary, supportive-care, evidence:strong.
- TechnologyPhotobiomodulation (low-level laser) for oral mucositis
Shares the tags complementary, supportive-care, evidence:strong.
- TechnologyWigs, cranial prostheses and head coverings
Shares the tags complementary, supportive-care, evidence:strong.