Saturday, April 29, 2017

ENCORE #61! – Low Level Laser Treatment of Post-Breast Cancer Arm Lymphedema

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in August of 2015.

After our last visit to the lymphedema clinic and the response of the staff there when my wife asked about a cure, I will now be focusing the “BC Research Right Now!” entries on the subject of lymphedema treatment.

This first entry is NOT something that the clinic we go to has ever offered, and it may be something I suggest we ask for.

It’s called Low Level Laser Therapy or LLLT. Below you’ll find the description of a recent study using it:

“Low level laser therapy (LLLT) (wave lengths 650-1000 nm) is a…therapeutic intervention for treatment of arm lymphedema. [It] can be administered by individuals trained in the use of the device…[and] is believed to stimulate lymphatic movement and lymphangiogenesis (‘the formation of lymphatic vessels from pre-existing lymphatic vessels’, IOW, ‘growing new lymph vessels’); [increase] macrophage activity, and soften fibrotic tissues; improve contractility in the tissues that assist with lymph transport through the lymphatic vessels. These mechanisms increase movement of pooled fluid from the extracellular spaces into the lymphatic system for transport.

“Studies have evaluated the influence of LLLT on lymphedema in breast cancer survivors with mixed results regarding amount of volume reduction and degree of symptom relief...None of these studies reported complications. Although the number of sessions and exposure time to the laser varied across studies, overall results are supportive of the procedure as a lymphedema treatment and demonstrate the feasibility of conducting studies in breast cancer survivors with lymphedema.

“LLLT offers APNs trained in the use of the device an opportunity to directly provide treatment for their patients with lymphedema. Demonstrated successful use [and] could impact current standards of care and treatment delivery by offering alternatives to current treatment, earlier intervention, and increasing access to a pool of providers.

“Based upon the physiological mechanisms of action ascribed to LLLT, the authors of this article theorized that it should reduce lymphatic-associated swelling. The purpose of the pilot study was to examine the impact of [the treatment], as both a stand-alone and complementary treatment for arm volume, symptoms, and Quality of Life in breast cancer survivors with treatment-related lymphedema and to use data obtained in this study to power future studies.”

The hospital we go to has a cancer center with a strong breast cancer component and they are the place where we discovered massage therapy for the reduction of arm volume – what’s known as “manual lymphatic drainage” and includes both home-massage and wearing a compression garment on the arm.

 The results of the study, while not phenomenal or “world-shaking” do, in fact point to the use of LLLT as an adjunct to typical massage and compression treatments: “a 20 minute dose of LLLT when followed immediately by compression bandaging is potentially as effective in reduction of arm volume as 40 minute sessions of MLD or combined MLD and LLLT followed by compression bandaging . This preliminary finding is noteworthy, as the shorter duration of each LLLT session is less burdensome to patients and less time consuming for therapists.”

Less time wasted – that’s an improvement. We’ll have to see if the clinic we go to offers this treatment!


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