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Personal and Individualized Treatment for Lymphedema Management

By:

Alan Kimmel, MD

January 24, 2018
Alan Kimmel, MD
Lymphedema is a common unwanted effect of treatment for many types of cancer. The most common cancers that can lead to lymphedema swelling are breast, head and neck, and pelvic (gynecologic and prostate). However, many other cancer types, such as melanoma, can also be associated with lymphedema.

Lymphedema is defined as an abnormal accumulation of protein-rich fluid, which can cause chronic inflammation and fibrosis of affected tissues.

Anyone with a history of prior cancer therapy who develops swelling, tissue heaviness, or limitations in mobility or range of motion can come to the Lymphedema Center for an evaluation.
It begins with swelling and can lead to discomfort, reduced mobility, skin infections (cellulitis), and pronounced skin changes (including scarring, wounds, and disfigurement).

Treatment for cancer may include surgery, radiation, and/or chemotherapy. All of those modalities can inadvertently damage lymphatic vessels and lymph nodes. This damage reduces the lymphatic system’s ability to perform its role of clearing the debris from cellular activities throughout the body. A syrupy fluid piles up, resulting in heavy tissue that feels full of fluid.

The Greater Baltimore Lymphedema Center at GBMC is part of the Greater Baltimore Center for Rehabilitation Medicine. It is one of largest and most comprehensive lymphedema centers in the country. Patients come from all points of the compass to seek advice and treatment at our center.

Anyone with a history of prior cancer therapy who develops swelling, tissue heaviness, or limitations in mobility or range of motion can come to the Lymphedema Center for an evaluation.

During that initial visit, our team will review the patient’s cancer therapy history, even if the cancer and treatment occurred many years ago. We will get a clear delineation of what often begins as vague, ill-defined symptoms that have progressed over time to the present day. We will conduct a full musculoskeletal, skin, and lymphatic evaluation. The team will determine whether the swelling is indeed caused by lymphedema or instead by one of many other causes.

A treatment plan will be built around a patient’s individual circumstances and personal goals. These goals might vary widely: Some patients simply want to be able to wear comfortable shoes again or a favorite piece of jewelry, while others might want to compete in marathons or competitive skiing. The focus might be specifically on the swelling or include other issues such as range-of-motion, strength, or bowel and bladder control.

At the center of our lymphedema therapy program is Complete Decongestive Therapy (CDT), a therapy that includes manual lymphatic drainage/massage (MLD), compression bandaging, remedial exercise, skin care, and compression garments.

All cancer patients can benefit from early involvement in our Oncology Rehabilitation program. This includes basic support, rehabilitation, and education on efforts to prevent and reduce cancer-related fatigue, pain, and range-of-motion. We seek to improve strength, endurance, and a return to a strong sense of well-being.

Ultimately, oncology rehabilitation is about patient and family education and teaching self-care and prevention tools and methods.

The Greater Baltimore Lymphedema Center at GBMC includes: a lymphology physician and nurse practitioner, lymphedema certified physical and occupational therapists, nurses and wound care specialists, garment fitters, and a professional support team. All are fully engaged in making this experience personal and individualized.

Please call the Greater Baltimore Center for Rehabilitation Medicine at 443-849-6210 for more information or to request a consultation.

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