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Lymphedema Presentation Aims at Easing Patients' Fears

Group attending therapist's talk learns its causes and solutions.
By Mike Grogan

 CLERMONT | Marge Angelantro knows that the cancer she is fighting is not the only health problem she could be facing.

"Because I had cancer of the lymph nodes, I know I'm a candidate (for lymphedema)," she said as she sat in a classroom at South Lake Hospital last week.

The Lake County woman is going through chemotherapy and will face radiation therapy in the weeks to come.

"It is very scary," she admitted, and added that she hoped that as she learned more about what might be ahead, it might not be as frightening.

That was a primary motivation not only for Angelantro, but for many of the 50 people who filled the classroom at the hospital's National Training Center to hear Kristine Secrest give a presentation on lymphedema, a disorder that often strikes those who have had lymph node surgery.

"Lymphedema," said Secrest - who is an occupational therapist who specializes in lymphedema - "is basically swelling due to the damage that is done to the lymphatic system."

That damage can be caused by surgery, radiation therapy or other trauma, she said.

The lymphatic system, which includes about 700 to 1,000 lymph nodes within various parts of the human body, removes waste fluid and protein. When something occurs to disrupt its function - such as the removal of lymph nodes - that waste can back up, causing uncomfortable swelling.

It is most often seen following breast cancer surgery, Secrest pointed out. But it can occur anywhere, because lymph nodes are found throughout the body, including the groin, legs, face and torso.

The good news is, it is becoming more and more uncommon because of better techniques for mapping the system, which allows doctors to see the threat and deal with it. And, Secrest added, because of better knowledge about the disorder, surgeons are more careful when performing the operation.

"If they can perfect that, I'd be out of a job," she said. "I'd like that."

Several factors play a role in the threat of lymphedema occurring. Among them is the scope of the surgery.

The more lymph nodes that are removed, the higher the risk," Secrest said.

She said that not everyone has the same number of nodes. One person, she said, might have 20 in the armpit area - where breast cancer patients often have them removed - while another might have twice that many. The chances of lymphedema occurring following such surgery is about 20 percent, she said, but it increases to 50 percent when radiation therapy is added.

While the disorder is not painful, it can be uncomfortable and limit movement. And it can force those suffering from it to restrict such activities as flying - because of pressurized airplane cabins - or riding for long periods of time in a car.

Therapists who treat patients for lymphedema have changed the way they deal with it, as more has been learned about the malady.

"It used to be that rest was seen as the best answer," she said. "That has all been thrown out now. Exercise is now seen as important."

She noted that active women like those who have young children or physical jobs have less risk. At the same time, patients whose bodies have a large fat content are more at risk.

Even so, Secrest added, it is important to do the right kind of exercising.

"If you have lymphedema of the leg, I wouldn't suggest running," she said. "Swimming is a very good exercise."

Gentle massage to help move the waste fluid away from the affected area can also help reduce the swelling.

The class Secrest presented was part of South Lake Hospital's Cancer Wellness Education Series, which is free of charge and open to the public.

Held each month at the National Training Center, future presentations carry titles such as "Caring for Your Loved One and Yourself," "Survivorship Care," and "Nutrition and Exercise."

"We like to provide cancer survivors with any information we can about the disease," said Elizabeth Morse, a spiritual-care chaplain at the hospital who is instrumental in organizing the program. "Knowledge is power."

Besides hearing Secrest's presentation, those attending the class were offered free cancer survivor booklets where they can keep paperwork pertaining to their progress throughout their treatment, along with documents and information they might gather concerning having to deal with their cancer.

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