An estimated 2 million women in the United States are at risk of developing lymphedema, and while physicians recommend proven techniques to manage the swelling, a University of Missouri researcher has found patients often won’t follow the recommendations, or they will use alternative treatments and not discuss them with their doctors.
"Lymphedema has a profound impact on health and well-being, but often goes undiagnosed and untreated by physicians and patients," says Jane Armer, professor in the [removed]Sinclair School of Nursing[/removed], University of Missouri-Columbia, Mo,and director of nursing research at the Ellis Fischel Cancer Center, Columbia, Mo. "Understanding the ways that people self-manage the chronic symptoms of lymphedema is essential to facilitate an improvement in the use of treatments and the quality of life of these people."
Armer surveyed breast cancer survivors with lymphedema about their practices for managing symptoms, including swelling and heaviness. She found the most common strategy was to not treat the symptom. For 12 out of 14 symptoms, patients reported taking no action 29% to 65% of the time. This finding is consistent with Armer’s conclusions from a previous study.
"Considering the entire lymphedema population (not just breast cancer survivors), the percentage of patients who treat their symptoms is probably even lower," Armer says. "Data have shown that breast cancer survivors are more proactive in seeking information for self-care, and they are more likely to follow a daily self-care plan for lymphedema than those who developed lymphedema for a different reason."
Armer found patients who choose to treat their symptoms use a variety of techniques, which can be divided into three main groups. The first group includes recommended management techniques, non-pharmaceutical strategies typically recommended by physicians, including manual lymphatic drainage, compression garments and elevation. Patients use these techniques most often, or 47% of the time. The second group was pharmaceutical treatments, including the use of medications.The final group was lay symptom management techniques, strategies not necessarily recommended by health care professionals but common sense, folk, complementary, or alternative methods.
According to Armer, patients increasingly are using lay therapies, but less than 40% report discussing their use of complementary therapies with a doctor. Previous research has found these unconventional therapies are generally not taught at medical schools or are unavailable at most hospitals.
"While lay symptom management is undoubtedly an important form of health care, the discrepancy between the use of self-care treatments and doctor-recommended treatments for lymphedema must be addressed," Armer says. "It’s important for health care professionals to recognize the scope and diversity of practices that breast cancer survivors choose when managing their symptoms. Continued research of this issue can help develop effective management techniques to be incorporated into standards of practice for physicians and patients."
"A critical next step in lymphedema research is the rigorous evaluation of the effectiveness of self-management techniques," Armer says.
[Source: Medical News Today]
