The Physiotherapy and Lymphedema Department at the National Center for Cancer Care and Research (NCCCR) recently held an event for patients and members of the public to raise awareness about lymphedema and the importance of early treatment.
Lymphedema is a condition characterized by localized fluid retention and tissue swelling and is caused by a compromised lymphatic system. It can affect the face, neck, abdomen, and other parts of the body. The condition can be primary or secondary, with primary lymphedema caused by the abnormal development of the lymph system and secondary being the result of damage to the lymph system. The condition is a common side effect of some cancer treatments, including surgery and radiation therapy.
“Lymphedema is swelling that can occur in any part of the body but is commonly seen in the arms and legs. While it can be hereditary, it is often caused by the removal of lymph nodes, trauma, abdominal surgeries, or cancer, and specifically exposure to radiation therapy or removal of the
lymph nodes and vessels as part of cancer treatments,” said Mr. Mohammed Shafi, Head of the Physiotherapy and Lymphedema Department at NCCCR and a Certified Lymphedema Therapist. He added that his department is the only provider of lymphedema treatment in the State of Qatar.
Mr. Shafi explains that protein molecules can accumulate beneath the skin and draw fluid into the affected area. He says removal of, or damage to, the lymph nodes and vessels cause retention of lymph fluid. If the remaining lymph vessels cannot remove enough of the fluid in the affected area, fluid builds up and causes swelling, or lymphedema.
Last year, 341 patients received treatment at NCCCR for lymphedema. The Physiotherapy and Lymphedema Department, which opened in 2013, cares for patients transferred from across Hamad Medical Corporation’s (HMC) network of hospitals, as well as from primary health care centers and other healthcare providers in Qatar. Mr. Shafi says events like the one recently held at NCCCR are important because they help raise awareness among medical professionals and members of the public, including those with the condition who may be suffering in silence.
“We have put a lot of effort into raising awareness among doctors and other healthcare professionals as well as among cancer patients and the public. Our efforts have been effective as demonstrated by the increase in the number of patients we are seeing. In 2017 we treated 341 cases (305 women and 36 men), an increase of 76 percent from the previous year. Increased awareness of our service also meant that we treated a number of patients who might have otherwise traveled abroad for care,” says Mr. Shafi.
He added that women are more likely than men to develop lymphedema due to the types of cancers that are most commonly associated with the condition, including breast and gynecological.
Mr. Emad Basher, a physiotherapist at NCCCR, warns of the dangers of neglecting treatment of the condition. He says infections from the swelling caused by lymphedema are life threatening and while it is an incurable condition, it can be managed.
“Lymphedema cannot be reversed but early and careful management can reduce its symptoms and help prevent the condition from getting worse. Not treating lymphedema puts a patient at an increased risk of infection caused by bacteria, which can further damage the lymphatic system and even lead to sepsis. Other risks associated with not treating the condition include a limited range of motion, reduced strength, and nerve damage,” said Mr. Basher.
He adds that the condition can develop very slowly, with some of the early changes happening without noticeable symptoms. Symptoms of lymphedema include a full or heavy sensation in the limb(s), tightness of the skin or tissue, decreased flexibility in the hand, wrist, foot, ankle, and swelling. Mr. Basher says it is important to watch for subtle signs, which can include clothing or jewelry feeling tight, to ensure treatment is started as early as possible.
“Treatment plans are customized for each patient and generally include lymph drainage, which is a form of massage that stimulates the lymph vessels, compression bandages and garments, exercise, and skin care. Patient education and nutrition counseling are also an important part of the treatment plan,” added Mr. Basher.
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