ABC Health dimensions

Lymphoedema

Broadcast 6.30pm on 19/3/2002

Presented by Dr Norman Swan

Lymphoedema affects around 300,000 Australians. For some people there is no known cause (primary lymphoedema) but for many people it is a consequence of surgery which damages the lymphatic system. For example, women who have surgery for breast cancer are at risk of developing lymphoedema in the arm closest to the breast affected because surgeons remove the lymph nodes to check if the cancer has spread.

The outlook used to be bleak for people who develop lymphoedema but now there is better recognition of the condition so that it can be picked up early and treatments such as massage, exercise and laser can help keep it under control.

Lymphoedema Information Day

Saturday April 6 2002
A seminar for people who have lymphoedema, their families and friends, health professionals and anyone interested.

VENUE: Westmead Hospital - Education Block Level 2
(near main entrance)
Corner Darcy & Hawkesbury Roads Westmead NSW 2145

TIME: 9.00am - 4.30am
(Registration from 8.30am)

Lymphoedema Support Line
02 9492 5625

Hello, I'm Norman Swan.

A bit of a theme today in finding more natural ways of fixing yourself up.

Let's start with a disfiguring and disabling condition of the arms and legs, affecting over 200,000 Australians, many of them women.

It's called lymphoedema.

It's mostly a complication of surgery, but in many cases, the cause is unknown.

And until recently, there hasn't been much that helps, although recent research from Australia is suggesting possible answers and at least one myth is being swept aside on the Yarra.

Long summer days bring out the elite rowing crews for extra practice on Melbourne's Yarra River.

But on Tuesday and Thursday evenings, an equally dedicated group of paddlers joins them.

This unlikely crew of women are all paddling for a purpose.

They're Dragons Abreast, a group of women who faced breast cancer and are now determined to live life on the full and not miss a single opportunity to make themselves well.

But strenuous upper body activities like this, for women after breast surgery, used to be frowned upon by physiotherapists and doctors.

What the experts feared was this.

It's lymphoedema, a drainage problem, where lymph, the debris of the immune system, accumulates in an arm or leg.

The so-called lymphatic system, which carries this fluid, can become blocked when it's been damaged by radiotherapy or when lymph nodes have been removed during cancer surgery.

That's what happened to Nan Selleck 25 years ago when she was treated for breast cancer.

NAN SELLECK: It goes up and down.

It's a bit swollen today because I've been out in the garden, but it's never much smaller than this.

It's always about half a stone, I think it weighs.

It's very heavy -- very heavy to carry around, let me tell you.

NORMAN SWAN: Erica Dickenson has also been battling lymphoedema, in her case, since she had surgery for cervical cancer 14 years ago.

Initially only one leg was affected but a second operation resulted in lymphoedema on the other side.

ERICA DICKENSON: It wasn't something that I noticed straightaway.

I noticed it in shoes because I couldn't buy a pair of shoes off the rack because one foot wouldn't fit in.

I keep thinking some days, "How big can my legs actually get?"

I'm amazed that they stretch so far, and it's quite tight too.

When I get the lymph out of it, through massaging and treatments, then I've got more mobility, but it takes a couple of weeks and it will be back up again.

NORMAN SWAN: Over the years there have been a variety of treatments for lymphoedema, which is a sure sign nothing works very well.

For example, Erica uses support stockings, massage and leg pumps, with varying degrees of success.

But recently she's been testing a special exercise machine, and this is just one of several trials being conducted at Flinders Medical Centre in South Australia.

PROF NEIL PILLER, FLINDERS MEDICAL CENTRE: The aerobic exerciser is very good because it's a low impact exercise which encourages a little bit of elevation and it encourages movement from side to side, so it's varying the total tissue pressure and helping the lymphatics work better.

RESEARCHER: So Nan, this is the hand-held laser.

I'm going to apply some treatment in your armpit to help your arms --

NORMAN SWAN: The researchers of the clinic have also been getting good results using lasers.

The aim here is to break up the tough tissue which develops in limbs when lymph has built up over a long period.

PROF NEIL PILLER: The tissues through time, if the lymphatic system is not working, become more and more fibrotic, in other words harder and harder, and that means that the lymphatic system can't work as well.

NORMAN SWAN: In Nan, the laser treatment has resulted in a significant reduction in her arm volume.

RESEARCHER: You can see that from when I last saw you two months ago, your arm has come down a long way.

NORMAN SWAN: To everyone's delight, Nan's arm is continuing to get smaller, even though it's three months since the laser treatment finished.

It looks as though the laser has freed up some of the lymphatic system, allowing it to drain more easily.

NAN SELLECK: I'm really overjoyed because it really has helped.

It's a lot softer, whereas before it was very hard.

So obviously something's happened -- a miracle.

NORMAN SWAN: Results such as these give Neil Piller and his colleagues a sense of optimism, when previously experts took a rather bleak view of lymphoedema.

In addition, better ways of diagnosing it and increased awareness of the problem mean that it can be detected early and hopefully treated before it becomes severe.

PROF NEIL PILLER: We know lymphoedema is progressive.

If it doesn't get any worse than it is today, that's a win.

But, however, we know that we can actually make many lymphoedemas better.

NORMAN SWAN: And even people with long-term lymphoedema, such as Erica, have been encouraged by the results from the Flinders team.

ERICA DICKENSON: I've never looked at it as being something that will probably be fixed, but how to deal with it.

But, you know, I can get up a ladder and I can do anything really -- just a bit slower than other people.

NORMAN SWAN: The pioneers of dragon boat racing for women with breast cancer actually did a proper study and defied the non-believers.

Not only did the women's lymphoedema not get any worse, in some, it improved.

This Melbourne boat is just the latest in many such teams which now exist around the world.

This page last updated August 31, 2006

for details of your nearest group phone 1300 889 566 National co-ordinator: Michelle Hanton Tel (08) 8941 8923 Website: Jan Skorich Tel: (02) 6241 8061 general address: GPO Box 1948 Darwin NT 0801

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