Quality of life of women with lower-limb lymphedema following gynecological cancer

Background: Eighteen to 25% of patients after gynecological cancer treatment suffer from lower limb lymphedema (LLL) that decreases the quality of life of gynecological cancer survivors. Lumbar sympathetic ganglion block (LSGB) is widely used in practice for the evaluation and management of sympathetically mediated pain in the lower limbs. Several articles have suggested that sympathetic ganglion block could be an effective treatment for lymphedema. Objectives: To investigate the effect of LSGB on patients with secondary lymphedema related to the treatment of gynecologic cancer, who do not respond to a conservative treatment. Study Design: Prospective clinical study. Setting: A single academic medical center, outpatient setting. Methods: Eighteen patients with stage II lower limb lymphedema who did not response to the conservative treatment were recruited. The patients underwent fluoroscopy-guided LSGB 3 times at 2-week intervals. The circumference of the thigh and calf was measured in the upright position at the first visit and 2 weeks after each session of LSGB. The pain score of the lower limb was checked at the same time by a numeric rating scale (NRS) from 0 to 10. The patients were asked about their satisfaction with the procedure at the last follow-up visit. The Wilcoxon signed rank test was used for data analysis. Significance was accepted at a P-value less than 0.05/3. Results: The circumferences of affected thighs and calves decreased from 56.38 ± 4.77 and 35.33 ± 3.51cm to 54.42 ± 5.27 and 34.41 ± 3.35cm, respectively, in a significant manner after 3 consecutive LSGBs (P < 0.05/3). The maximal decrease after the third LSGB was 4 cm in the thigh and 2cm in the calf. The pain score also showed a significant decrease after 3 consecutive LSGBs from 2.17 to 1.28. The tightness and heaviness of the affected limb decreased after the first LSGB in 15 patients (83.3%) and after the second LSGB in 2 patients (11.1%). Five of 18 patients (27.8%) answered that the result of the LSGB met their expectations, 10 (55.6%) answered they would undergo the same treatment for the same outcome, 2 (11.1%) answered they did not improve as much as they had hoped, and they would not undergo the same treatment for the same outcome, and only one patient (5.6%) answered the LSGB showed no effect. Limitations: This study lacks a placebo control group and has only 18 patients. We did not evaluate the quality of life of the patients. Conclusion: We suggest that LSGB can be one of the treatment options for patients suffering from LLL after gynecologic cancer treatment. Our result could provide a basis for a randomized controlled trial in future investigations. The pain physicians can play an important role as one of the multidisciplinary team for a comprehensive treatment of LLL. Key words: Lumbar sympathetic ganglion block;gynecologic cancer;lymphedema

Download Full-text

Effects of a complex rehabilitation program on edema status, physical function, and quality of life in lower-limb lymphedema after gynecological cancer surgery

Gynecologic Oncology ◽

10.1016/j.ygyno.2017.09.003 ◽

2017 ◽

Vol 147 (2) ◽

pp. 450-455 ◽

Cited By ~ 12

Author(s):

Jung Hwa Do ◽

Kyoung Hyo Choi ◽

Jun Su Ahn ◽

Jae Yong Jeon

Keyword(s):

Quality Of Life ◽

Physical Function ◽

Lower Limb ◽

Gynecological Cancer ◽

Rehabilitation Program ◽

Cancer Surgery

Download Full-text

Role of a Structured Physical Activity Pathway in Improving Functional Disability, Pain and Quality of Life in a Case of Breast and Gynecological Cancer Survivorship

Journal of Clinical Medicine ◽

10.3390/jcm8040531 ◽

2019 ◽

Vol 8 (4) ◽

pp. 531 ◽

Cited By ~ 3

Author(s):

Daniela Mirandola ◽

Maria Grazia Muraca ◽

Eleonora Sgambati ◽

Mirko Manetti ◽

Mirca Marini

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Cancer Survivors ◽

Lower Limb ◽

Functional Disability ◽

Short Form ◽

Gynecological Cancer ◽

Individual Characteristics ◽

Lower Limb Pain

Physical activity (PA) interventions can improve physical functioning, treatment-related symptoms and quality of life (QoL) in cancer survivors. Most investigations have been conducted in breast cancer survivors, while studies on PA interventions in gynecological cancer survivors are scant. Here, we report for the first time the possible benefits of a structured PA pathway (i.e., eight weeks of adapted PA followed by twelve weeks of adapted fitness) on physical side effects, pain and QoL in an uncommon case of survivorship of both primary breast and gynecological cancers. For this purpose, a 69-year-old woman was assessed by functional test battery (shoulder–arm mobility, range of motion, back flexibility) at baseline and after the structured PA pathway. QoL and surgical shoulder, back and lower limb pain intensity were evaluated by Short Form-12 (SF-12) and numerical rating scale questionnaires, respectively. Lower limb circumference was also assessed. Improvement in upper limb function, reduction of lower limb edema and pain perception, as well as an increase in overall QoL were achieved after the completion of structured PA intervention. Our findings suggest that a PA intervention tailored to individual characteristics may represent an effective countermeasure to reduce post-treatment functional disability and pain, and thus to improve QoL in breast and gynecologic cancer survivors.

Download Full-text

QUALITY OF LIFE PROBLEMS OF GYNECOLOGICAL CANCER PATIENTS

Problems in oncology ◽

10.37469/0507-3758-2017-63-3-368-374 ◽

2017 ◽

Vol 63 (3) ◽

pp. 368-374

Author(s):

Olga Churuksaeva ◽

Larisa Kolomiets

Keyword(s):

Quality Of Life ◽

Gynecological Cancer ◽

Social Aspects ◽

Cancer Data ◽

Life Problems ◽

Anticancer Treatment ◽

Short And Long Term ◽

The Relationship

Due to improvements in short- and long-term clinical outcomes a study of quality of life is one of the most promising trends in oncology today. This review analyzes the published literature on problems dealing with quality of life of patients with gynecological cancer. Data on quality of life with respect to the extent of anticancer treatment as well as psychological and social aspects are presented. The relationship between quality of life and survival has been estimated.

Download Full-text

A Review of Psychoeducational Interventions to Improve Sexual Functioning, Quality of Life, and Psychological Outcomes in Gynecological Cancer Patients

Cancer Nursing ◽

10.1097/ncc.0000000000000234 ◽

2016 ◽

Vol 39 (1) ◽

pp. 20-31 ◽

Cited By ~ 10

Author(s):

Ka Ming Chow ◽

Joanne C. Y. Chan ◽

Kai K. C. Choi ◽

Carmen W. H. Chan

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Sexual Functioning ◽

Gynecological Cancer ◽

Psychological Outcomes ◽

Psychoeducational Interventions

Download Full-text

Economic assessment of a community-based care package for people with lower limb disorder caused by lymphatic filariasis, podoconiosis and leprosy in Ethiopia

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa111 ◽

2020 ◽

Vol 114 (12) ◽

pp. 1021-1034

Author(s):

Natalia Hounsome ◽

Mersha Kinfe ◽

Maya Semrau ◽

Oumer Ali ◽

Abraham Tesfaye ◽

...

Keyword(s):

Quality Of Life ◽

Lymphatic Filariasis ◽

Lower Limb ◽

Life Quality ◽

Psychosocial Care ◽

Northwest Ethiopia ◽

World Health ◽

Care Package ◽

The Cost

Abstract We conducted an implementation research study to integrate a holistic package of physical health, mental health and psychosocial care for podoconiosis, lymphatic filariasis and leprosy into routine healthcare in Gusha cluster, Guagusa Shikudad district, northwest Ethiopia. The healthcare package included training patients in lower limb hygiene and skin care and provision of shoes, hygiene supplies and medication. The implementation activities included training events, workshops, awareness raising, self-help groups, supportive supervision, staff secondments and advisory board meetings. The cost of implementing the care package in Gusha cluster, with a population of 30 558 people, was 802 655 Ethiopian birr (ETB) (£48 159) and the cost of delivering care to 235 participants was 204 388 ETB (£12 263), or 870 ETB (£52) per person. There was a 35% decrease in the mean disability scores (measured using the World Health Organization Disability Assessment Schedule 2.0) and a 45% improvement in the dermatology-specific quality of life (measured using the Dermatology Life Quality Index) at the 3-month follow-up compared with baseline. There were reductions in the number of days with symptoms, days off usual activities/work and days with reduced activity due to illness, all of which were statistically significant. Our pilot suggests that integration of the care package into routine healthcare in Ethiopia may be effective in improving health-related quality of life and disability and reducing time out of economic activity due to illness.

Download Full-text

The Relationship of Fibromyalgia Syndrome with Neuropathic Pain, Quality of Life and Emotional Status in Male Traumatic Lower Limb Amputees

Journal of Musculoskeletal Pain ◽

10.3109/10582452.2012.673548 ◽

2012 ◽

Vol 20 (2) ◽

pp. 87-94 ◽

Cited By ~ 2

Author(s):

Yesim Akyol ◽

Berna Tander ◽

Ahmet Salim Göktepe ◽

Ismail Safaz ◽

Omer Kuru ◽

...

Keyword(s):

Quality Of Life ◽

Neuropathic Pain ◽

Lower Limb ◽

Fibromyalgia Syndrome ◽

Emotional Status ◽

Relationship Of ◽

The Relationship ◽

Lower Limb Amputees

Download Full-text

A Prospective Study in Detection of Lower-Limb Lymphedema and Evaluation of Quality of Life After Vulvar Cancer Surgery

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e31825866d0 ◽

2012 ◽

Vol 22 (6) ◽

pp. 1081-1088 ◽

Cited By ~ 25

Author(s):

Marta Novackova ◽

Michael J. Halaska ◽

Helena Robova ◽

Ivana Mala ◽

Marek Pluta ◽

...

Keyword(s):

Quality Of Life ◽

Lower Limb ◽

Bioelectrical Impedance Analysis ◽

Vulvar Cancer ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Cancer Surgery ◽

Control Group ◽

Inguinofemoral Lymphadenectomy

BackgroundLower-limb lymphedema is one of the most disabling adverse effects of vulvar cancer surgery. Multifrequency Bioelectrical Impedance Analysis (MFBIA) is a modern noninvasive method to detect lymphedema. The first aim of this study was to prospectively determine the prevalence of secondary lower-limb lymphedema after surgical treatment for vulvar cancer using objective methods, circumference measurements and MFBIA technique. The second aim was to compare quality of life (QoL) before and 6 months after vulvar surgery.MethodsTwenty-nine patients underwent vulvar cancer surgery in our study: 17 underwent inguinofemoral lymphadenectomy (RAD), and 12 underwent sentinel lymph node biopsy (CONS). Patients were examined before and 6 months after vulvar surgery by measuring the circumference of the lower limbs and with MFBIA. A control group of 27 healthy women was also measured. To evaluate QoL, the European Organisation for Research and Treatment of Cancer (EORTC) QoL questionnaires (QLQ-C30 and QLQ-CX24) were administered to patients before and 6 months after surgery.ResultsUsing circumference measurement, 9 lymphedemas (31%) were diagnosed: 3 (25%) in the CONS and 6 (37.5%) in the RAD group (P= 0.69). After vulvar surgery, patients in the RAD group reported more fatigue and worsening of physical and role functioning. When comparing both groups, the RAD group had significantly worse parameters in social functioning, fatigue, and dyspnea.ConclusionsLower radicality in inguinofemoral lymphadenectomy shows a trend toward lower morbidity and significantly improves QoL. Multifrequency Bioelectrical Impedance Analysis was tested in these patients as a noninvasive, objective method for lymphedema detection. Detection of lymphedema based on subjective evaluations proved to have an unsatisfactory sensitivity. Less radical surgery showed objectively better results in QoL.

Download Full-text