Randomized Trial of Decongestive Lymphatic Therapy for the Treatment of Lymphedema in Women With Breast Cancer

2013 ◽  
Vol 31 (30) ◽  
pp. 3758-3763 ◽  
Author(s):  
Ian S. Dayes ◽  
Tim J. Whelan ◽  
Jim A. Julian ◽  
Sameer Parpia ◽  
Kathleen I. Pritchard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Short Form ◽  
Lymphatic Drainage ◽  
Control Group ◽  
Compression Garments ◽  
Absolute Volume ◽  
Arm Lymphedema ◽  
Decongestive Lymphatic Therapy ◽  
And Control ◽  
Decongestive Therapy

Purpose Because of its morbidity and chronicity, arm lymphedema remains a concerning complication of breast cancer treatment. Although massage-based decongestive therapy is often recommended, randomized trials have not consistently demonstrated benefit over more conservative measures. Patients and Methods Women previously treated for breast cancer with lymphedema were enrolled from six institutions. Volumes were calculated from circumference measurements. Patients with a minimum of 10% volume difference between their arms were randomly assigned to either compression garments (control) or daily manual lymphatic drainage and bandaging followed by compression garments (experimental). The primary outcome was percent reduction in excess arm volume from baseline to 6 weeks. Results A total of 103 women were randomly assigned, and 95 were evaluable. Mean reduction of excess arm volume was 29.0% in the experimental group and 22.6% in the control group (difference, 6.4%; 95% CI, −6.8% to 20.5%; P = .34). Absolute volume loss was 250 mL and 143 mL in the experimental and control groups, respectively (difference, 107 mL; 95% CI, 13 to 203 mL; P = .03). There was no difference between groups in the proportion of patients losing 50% or greater excess arm volume. Quality of life (Short Form-36 Health Survey) and arm function were not different between groups. Conclusion This trial was unable to demonstrate a significant improvement in lymphedema with decongestive therapy compared with a more conservative approach. The failure to detect a difference may have been a result of the relatively small size of our trial.

scholarly journals The Effect of Uncertainty-Tolerance-based Intervention in Couples on the Mental Adaptation to Disease in Women With Breast Cancer: a Randomized Clinical Trial

2021 ◽  
Author(s):  
Somayyeh noori ◽  
Fatemeh moghaddam tabrizi ◽  
Rahim Sharafkhani
Keyword(s):  
Breast Cancer ◽  
Intervention Program ◽  
Short Form ◽  
Intervention Group ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Mental Adjustment ◽  
Fighting Spirit ◽  
Registration Number ◽  
And Control

Abstract Purpose: The aim of this study was to evaluate the effect of a couple-coping intervention aiming to improve uncertainty tolerance in women diagnosed with breast cancer and their spouses on the patients’ mental adaption to their disease. Methods: The present study was conducted on 90 women with breast cancer referred to educational, medical and research centers in Urmia, IRAN, which 45 patients were randomly assigned to each treatment and control groups. Outcome measures were assessed at baseline and 6 weeks using short form mental adjustment to cancer (Mini-MAC) questionnaire. The intervention was performed in 6 group-based sessions consisting of patients and their spouses. Results: comparing the change from before to after intervention revealed that the effect of the intervention was significant in reducing hopeless-helpless (-5.42 ± 2.42 in intervention group VS -0.13 ± 0.46 in control group, P<0.001) and anxious preoccupation (-6.80 ± 2.87 VS -0.16 ± 0.82, P<0.001). It has also been significant in increasing fatalism (4.89 ± 2.09 VS 0.22 ± 1.24) and fighting spirit (3.58 ± 2.05 VS 0.11 ± 1.61). The effect of intervention on changing avoidance scale was not significant (P = 0.83).Conclusion: Couple-centered intervention program based on increasing uncertainty tolerance can be used to improve the situation in order to increase the patients' adjustment and it has an effective support for breast cancer patients in helping to cope with cancer. Trial registration number: IRCT20150125020778N21.Date of registration: 2020-12-13.

scholarly journals Effects of Cancer, Chemotherapy and Cytokines on Subjective and Objective Cognitive Functioning Among Patients with Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2576
Author(s):  
Vincent Chin-Hung Chen ◽  
Chin-Kuo Lin ◽  
Han-Pin Hsiao ◽  
Bor-Show Tzang ◽  
Yen-Hsuan Hsu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Function ◽  
Cognitive Abilities ◽  
Verbal Fluency ◽  
Control Group ◽  
Control Groups ◽  
Semantic Verbal Fluency ◽  
Cytokine Levels ◽  
Chemotherapy Patients ◽  
And Control

Background: We aimed to investigate the associations of breast cancer (BC) and cancer-related chemotherapies with cytokine levels, and cognitive function. Methods: We evaluated subjective and objective cognitive function in BC patients before chemotherapy and 3~9 months after the completion of chemotherapy. Healthy volunteers without cancer were also compared as control group. Interleukins (IL) 2, 4, 5, 6, 10, 12p70, 13, 17A, 1β, IFNγ, and TNFα were measured. Associations of cancer status, chemotherapy and cytokine levels with subjective and objective cognitive impairments were analyzed using a regression model, adjusting for covariates, including IQ and psychological distress. Results: After adjustment, poorer performance in semantic verbal fluency was found in the post-chemotherapy subgroup compared to controls (p = 0.011, η2 = 0.070); whereas pre-chemotherapy patients scored higher in subjective cognitive perception. Higher IL-13 was associated with lower semantic verbal fluency in the post-chemotherapy subgroup. Higher IL-10 was associated with better perceived cognitive abilities in the pre-chemotherapy and control groups; while IL-5 and IL-13 were associated with lower perceived cognitive abilities in pre-chemotherapy and control groups. Our findings from mediation analysis further suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Conclusions: Our findings suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Different cytokines and their interactions may have different roles of neuroinflammation or neuroprotection that need further research.

Complex decongestive therapy for secondary lymphoedema in women after breast cancer treatment

Physiotherapy ◽  
2015 ◽  
Vol 23 (1) ◽  
Author(s):  
Iwona Malicka ◽  
Dawid Marciniak
Keyword(s):  
Breast Cancer ◽  
Fungal Infections ◽  
Compression Therapy ◽  
Lymphatic Drainage ◽  
Skin Care ◽  
Lymph Edema ◽  
Two Phase ◽  
Complex Decongestive Therapy ◽  
Consolidation Phase ◽  
Decongestive Therapy

AbstractSecondary lymph edema occurs in abort 6-40% of women treated for breast cancer. This is not the only an aesthetic problem. Edema makes serious health complications for example recurrent inflammation and rose, limb elephantiasis, which leads to degenerative changes in the joints, nerve plexus damage and angiosarcoma – cancer with poor prognosis. Early diagnosis and implementation of therapy is very important. Too late intervention difficult the rehabilitation and increases the possibility of complications also. The most important in the reduction of swelling and remove the lymph balance is a complex decongestive therapy (CDT): lymphatic drainage, compression therapy, skin care and exercises. Lymphatic drainage results in increased production of the lymph and movement of the lymph. Compression therapy leads to the reduction in the effective pressure ultrafiltration. Skin care is to prevent bacterial and fungal infections. Exercises makes increase muscle pump action and transport of the lymph. CDT consist of two phase: reduction phase and consolidation phase. It is a most popular method of treatment lymph edema around the world. It is most effective therapy also.

scholarly journals Effect of immunoadjuvants on the disease course in patients with operable breast cancer

2019 ◽  
Vol 14 (4) ◽  
pp. 20-23
Author(s):  
M. M. Vasilyeva ◽  
I. P. Moshurov ◽  
L. Yu. Grivtsova ◽  
N. N. Tupitsyn ◽  
N. A. Kozlov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Tissue ◽  
Radical Mastectomy ◽  
Control Group ◽  
Cancer Management ◽  
New Strategy ◽  
Breast Cancer Management ◽  
Grade Ii ◽  
And Control

Background. A new strategy of breast cancer management is required for effective disease prevention and control. Immunotherapy is one of promising options.Objective: to evaluate the effect of immunoadjuvant polyoxidonium on pathmorphological changes in breast tumors.Materials and methods. The study was performed in 75 patients with breast cancer: 50 patients received polyoxidonium in a neoadjuvant regimen (main group), 25 patients did not receive polyoxidonium (control group). Polyoxidonium at a dose of 12 mg was administered intramuscularly 1 time per day on the days 1, 2, 3, 5 and 7 before surgery; on the day 8, radical mastectomy was performed in patients of both groups, followed by histological examination and determination of the grade of therapeutic pathomorphosis of the tumor.Results. The proportion of cases with grade I therapeutic pathomorphosis was 58 %, grade II therapeutic pathomorphosis – 6 %. Pathomorphosis in metastatic lymph nodes was observed in 22.7 % of cases.Conclusion. The anti-tumor effect of polyoxidonium was confirmed on the basis of the induction of pathomorphosis of the tumor tissue of breast cancer.

scholarly journals Effect of Self-care Training on Upper Limb Function and Pain After Breast Cancer Surgery

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Somyye Noura ◽  
Fatemeh Kiani ◽  
Nezarali Moulaei ◽  
Mojtaba Tasbandi ◽  
Ebrahim Ebrahimi Tabas
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Limb Function ◽  
Upper Limb Function ◽  
Care Training ◽  
The Mean ◽  
And Control

Background: Breast cancer patients who undergo mastectomy encounter numerous problems, the most annoying of which is lymphedema followed by pain and decreased function in the affected limb. Objectives: This study examined the effect of self-care training on upper limb function and pain after breast surgery. Methods: This quasi-experimental study was performed on two groups of 60 patients with breast cancer in the Oncology Ward of Zahedan University of Medical Sciences in 2021. The patients were selected based on the inclusion criteria and through convenience sampling and were then randomly divided into intervention and control groups. The patients in the intervention group attended self-care training and exercise programs implemented in five sessions in addition to the routine care. One and three months after the intervention, upper limb function and pain were measured with DASH and McGill pain questionnaires. The repeated measures analysis of variance (ANOVA) and Bonferroni test were used to compare the pre-, and post-intervention mean scores and mean differences in the two groups. Results: The mean scores of upper limb function one and three months after the training program in the intervention group were lower than the mean scores of the control group. In other words, the quality of upper limb function was not significantly different despite the changes in the first month, but upper limb function significantly improved three months after the intervention (P < 0.001 vs. P = 0.06). The mean pain scores before, one month, and three months after the intervention in the intervention group were 10.4, 35.7, and 6.26, respectively, and the corresponding values in the control group were 10.8, 41.7, and 21.1, respectively, showing significant differences between the two groups, with the intervention group having lower pain scores than the control group (P = 0.001). Conclusions: Since lymphedema and its consequences, including decreased upper limb function and pain, are very serious issues, medical staff can give priority to this training program and implement it to prevent and control these complications.

scholarly journals Arm lymphedema after treatment of breast cancer: Etiology, diagnosis, and management

2015 ◽  
Vol 01 (02) ◽  
pp. 077-083 ◽  
Author(s):  
Ashish Goel ◽  
Juhi Agarwal ◽  
Sandeep Mehta ◽  
Kapil Kumar
Keyword(s):  
Breast Cancer ◽  
Solid Phase ◽  
Subcutaneous Tissue ◽  
Fluid Phase ◽  
Team Work ◽  
Treatment Modalities ◽  
Cancer Etiology ◽  
Complete Decongestive Therapy ◽  
Arm Lymphedema ◽  
Decongestive Therapy

ABSTRACTBreast cancer related lymphedema (BCRL) is a chronic debilitating condition seen after treatment of breast cancer. The overall incidence varies from 20% to 56% in all patients treated for breast cancer. Every patient is at a lifelong risk for BCRL and the risk goes on increasing as the followup period increases. Locoregional treatment including surgery or radiotherapy is the most common risk factor for development of arm lymphedema. There are two phases of arm lymphedema. There is increased fluid accumulation in the fluid phase of lymphedema which later on goes into the solid phase where fat and fibrotic tissue is deposited in the subcutaneous tissue. The treatment of BCRL is a challenge both for the patient and the treating surgeon and it needs multidisciplinary team work to be successful. Non-surgical treatment modalities include complete decongestive therapy (CDT) and pneumatic compression therapy. Surgery for BCRL is usually undertaken as a salvage modality after failure of conservative approaches. The surgical spectrum for BCRL varies from extensive excisional operations which were commonly done in the past to newer methods like suction assisted protein lipectomy, lymphatic reconstruction and vascular lymph node transfer (VLNT) using super-microsurgical techniques. There is no consensus regarding the preference of one procedure over other due to lack of randomised control trials. It is however suggested to do lymphovenous anastomosis and complete decongestive therapy for early cases in fluid phase; while patients in the solid phase may be treated with a combination of liposuction with CDT or VLNT alone.

scholarly journals Moxibustion as a Therapy for Breast Cancer–Related Lymphedema in Female Adults: A Preliminary Randomized Controlled Trial

2019 ◽  
Vol 18 ◽  
pp. 153473541986691 ◽  
Author(s):  
Chunhui Wang ◽  
Ming Yang ◽  
Yingyi Fan ◽  
Xiaohua Pei
Keyword(s):  
Breast Cancer ◽  
Scale Score ◽  
Controlled Trial ◽  
Visual Analog Scale Score ◽  
Control Group ◽  
Analog Scale ◽  
Randomized Controlled ◽  
Arm Circumference ◽  
Breast Cancer Related Lymphedema ◽  
And Control

Objective: To evaluate the effect of moxibustion on relieving breast cancer–related lymphedema. Materials and Methods: A randomized controlled trial was conducted in our institution from March 2016 to March 2017. All patients (N = 48) with cancer-related lymphedema were allocated to 2 groups: a treatment group, in which moxibustion was performed, and a control group, in which pneumatic circulation was performed with compression garments worn every day. Therapeutic efficacy was evaluated by measuring arm circumference (wrist crease, 10 cm proximal to wrist crease, elbow crease, and 10 cm proximal to elbow crease) and determining the Revised Piper Fatigue Scale score and Visual Analog Scale score for swelling before and after treatment. Results: All patients were treated for 4 consecutive weeks. Compared with 0 week after treatment, the affected-side arm circumference after 4 weeks’ treatment decreased in both treatment and control groups; the difference value in the treatment group was superior to that in the control group. Compared with the controls, moxibustion resulted in a lower Visual Analog Scale score. The Revised Piper Fatigue total scores were improved in both the moxibustion and control group, and there was no significant difference between the 2 groups. Moxibustion reduced the behavioral, sensory, emotional, and cognitive Revised Piper Fatigue scores, but only the behavioral and sensory scores improved in the control group. Conclusion: Moxibustion has potential effect on breast cancer–related lymphedema. We present promising preliminary data for larger randomized trials to enable accurate evaluation of moxibustion as a lymphedema treatment.

scholarly journals Impact of Islam-Based Caring Intervention on Spiritual Well-Being in Muslim Women with Breast Cancer Undergoing Chemotherapy

Religions ◽  
2020 ◽  
Vol 11 (7) ◽  
pp. 361
Author(s):  
Maria Komariah ◽  
Urai Hatthakit ◽  
Nongnut Boonyoung
Keyword(s):  
Breast Cancer ◽  
Muslim Women ◽  
Well Being ◽  
Control Group ◽  
Religion And Spirituality ◽  
Peace Of Mind ◽  
Chronic Illness Therapy ◽  
Spiritual Well Being ◽  
And Control ◽  
The Impact

This research emphasizes the nurse’s role in incorporating Islamic teaching through the care practices provided in order to promote spiritual well-being in Muslim women with breast cancer undergoing chemotherapy. In addition, religion and spirituality have been recognized as the primary resources for coping. The aim of the study, therefore, was to explore the impact of an Islam-based caring intervention on the spiritual well-being of Muslim women with cancer. Furthermore, data were collected using a questionnaire and, also, the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) on baseline (Time 1), days 3 (Time 2), 23 (Time 3), and 44 (Time 4). The results showed the significant impact of an Islam-based caring intervention on the participants’ level of spiritual well-being. In addition, the mean scores varied between the intervention and control group over time. Based on the reflection, participants stipulated feeling peace of mind, closer to God, spirit for further life, and healthier.

scholarly journals Pain Characteristics and Associations with Quality of Life in Patients with Multiple Sclerosis in Lithuania

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 596
Author(s):  
Greta Veličkaitė ◽  
Neringa Jucevičiūtė ◽  
Renata Balnytė ◽  
Ovidijus Laucius ◽  
Antanas Vaitkus
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Neuropathic Pain ◽  
Short Form ◽  
Depression Scale ◽  
Structured Interview ◽  
Anxiety And Depression ◽  
Control Group ◽  
And Control

Background and objectives: Even though pain in multiple sclerosis (MS) patients is common and possibly associated with reduced quality of life, its exact prevalence and characteristics remain vaguely understood. We aimed to estimate the true extent of pain and its associations with quality of life in Lithuanian MS patients and to compare this data with that of a control group. Materials and Methods: Data were collected prospectively at the Department of Neurology, Lithuanian University of Health Sciences Kaunas Clinics. A face-to-face structured interview and a questionnaire were used to collect demographic and clinical data of the MS (n = 120) and control (n = 120) groups. The Expanded Disability Status Scale (EDSS) was used to quantify disability in the MS group. Scores ≥4/10 in the Douleur Neuropathique 4 questionnaire were classified as neuropathic pain. Patients were evaluated using the anxiety and depression subsets of the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the physical and mental component subsets of the Short Form-12 questionnaire (PSC-12 and MSC-12). Results: The MS and control groups did not differ in pain prevalence (76.7% vs. 65.9%, p = 0.064) or intensity. Lhermitte sign, lower limb, and face pain were more common in the MS group, whereas subjects in the control group were more often affected by lower back, neck, and joint pain. Neuropathic pain and pain lasting longer than 2 years were more common among pain-affected MS patients than among controls. MS patients with pain had higher EDSS, HADS-D, and HADS-A and lower PSC-12 scores than those without pain; however, no difference was found regarding the duration of MS or age. Males with MS and pain had higher MSC-12 and HADS-D scores in comparison to the same subset of females. Conclusions: Pain affects approximately three out of four patients with MS in Lithuania and is negatively associated with the mental and physical aspects of quality of life.

Evaluation of high-dose versus standard FAC chemotherapy for advanced breast cancer in protected environment units: a prospective randomized study.

1987 ◽  
Vol 5 (3) ◽  
pp. 354-364 ◽  
Author(s):  
G N Hortobagyi ◽  
G P Bodey ◽  
A U Buzdar ◽  
D Frye ◽  
S S Legha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Response Rate ◽  
Metastatic Breast ◽  
Ambulatory Setting ◽  
Survival Duration ◽  
Control Group ◽  
High Dose ◽  
Control Groups ◽  
Median Response ◽  
And Control

Fifty-nine evaluable patients under 65 years of age with measurable metastatic breast cancer and without prior chemotherapy were randomly assigned to treatment with fluorouracil, Adriamycin (Adria Laboratories, Columbus, OH), and cyclophosphamide (FAC) at standard or high doses (100% to 260% higher than standard FAC) following a dose escalation schedule. Patients randomized to the high-dose FAC received the first three cycles of therapy within a protected environment. Subsequent cycles for this group were administered at standard doses of FAC in an ambulatory setting, the same as for the control group. After reaching 450 mg/m2 of Adriamycin, patients in both groups continued treatment with cyclophosphamide, methotrexate, and fluorouracil until there was disease progression. Analysis of pretreatment patient characteristics showed an even distribution for most known pretreatment factors, although the control group had slightly (but nonsignificantly) more favorable prognostic characteristics. Fourteen patients (24%) achieved a complete remission (CR) and 32 (54%) achieved a partial remission (PR), for an overall major response rate of 78%. There were no differences in overall, CR, or PR rates between the high-dose FAC and control groups. The median response durations were 11 and 10 months for the protected environment and control groups, respectively, and the median survival was 20 months for both groups. Hematologic, gastrointestinal (GI), and infection-related complications were significantly more frequent and severe in the group treated with high-dose chemotherapy. Stomatitis, diarrhea, and skin toxicity were dose-limiting. However, there were no treatment-related deaths. High-dose induction combination chemotherapy with the agents used in this study failed to increase the response rate or survival duration, and resulted in a substantial increase in toxicity.

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