Paramedical Support

What is lymphatic system?

The lymphatic system helps protect our body from infection. There are lymph nodes all around the body including the armpits, groin, abdomen, chest and neck areas. Lymphatic vessels carry lymph fluid to the lymph nodes where harmful bacteria and viruses are filtered and destroyed.

 

What is lymphoedema?

Lymphoedema is a chronic inflammatory lymphastatic disease caused by mechanical failure of the lymphatic system. Lymphoedema is an increase of lymph fluid content in spaces outside the cell membranes (1). This chronic symptom develops slowly and can appear months or even years after breast treatment.

Breast surgery or radiotherapy can cause damage to the lymph nodes and block the lymphatic flow. Studies show that the incidence of upper arm lymphoedema after breast surgery ranges from 5% to 56% within 2 years of surgery (2).

 

The early signs of lymphoedema

These are some of the early symptoms of lymphoedema. Since it is a chronic condition, these symptoms may come and go:

  • The affected upper limb may feel heavy, painful or ache.
  • Clothing or jewellery may feel tight because of swelling in a limb.
  • The upper limbs may look different; one may be bigger than the other.

 

Management of lymphoedema

At present, there is no cure for lymphoedema. Physiotherapy, such as exercise and manual lymphatic drainage may lower the risk of secondary lymphoedema after removal of lymph nodes from the armpit (axillary dissection) in breast cancer patients(2). With proper daily care, symptoms of lymphoedema can be alleviated. However, if left untreated, swelling of the affected area will be aggravated, restricting limb mobility and eventually causing adverse impacts both physically and emotionally.

 

Lymphoedema care services (Service Price List)

The Hong Kong Breast Cancer Foundation has introduced Lymphoedema Care Services to help people in need to prevent, detect and control breast cancer-related lymphoedema.

 

Who need these services?

Breast cancer patients and survivors, especially those who have undergone lumpectomy, mastectomy, sentinel lymph node biopsy or radiation.

 

Services in the preventive stage

All breast cancer patients and survivors.

 

Services in the treatment stage

This service is offered to those patients who have already developed lymphoedema.

 

Post-operative Exercise

The post-operative exercise helps you feel and function better after breast cancer surgery. The exercise is able to increase your mobility, reduce your pain and lower the risk of lymphoedema.

Target:

Breast cancer patients/family members

Service fee:

Free

Time:

Every Wednesday  12:00noon to 1:00pm

Every Thursday 5:30pm-6:00pm

 

Self-manual lymphatic drainage & exercise class

Conducted in a class setting, participants can learn techniques for self-manual lymphatic drainage, lymphatic exercise and preventive tips relating to diet and lifestyle changes.

 

 

Enrollment:

prior registration required

Fee:

free of charge

 

Measurement of the lymphoedema index

The measurement of the lymphoedema index provides information on the volume of intracellular and extracellular fluid in the affected limbs. It is carried out by passing small electrical currents through the limb and measuring the resistance of the current flows. The analysis can detect any disorder before it is clinically apparent. It is also helpful in monitoring the progress of the lymphatic treatment. This service is performed by our nurses and qualified lymphoedema therapist with the aid of Bioimpedance Spectroscopy (BIS) devices (L-Dex U400).

Service:

appointment required

Fee:

HK$180 per measurement for HKBCF members

HK$280 per measurement for non-HKBCF members

 

Guidelines for lymphoedema index measurement

Prior to undergoing the measurement, one should:

  • hydrate normally
  • empty the bladder before measurement
  • refrain from exercise for 2 hours prior to measurement
  • avoid caffeine intake 2 hours prior to measurement
  • not consume alcohol for 12 hours prior to measurement
  • remove any compression garments before measurement
  • be certain you are not pregnant
  • notify your clinician for further assessment if there is pacemaker or other implanted electronic devices in your body 

 

Lymphoedema management groups

In a small group setting, patients will learn how to improve self-manual lymphatic drainage, exercise skills, tips on lifestyle modifications, proper skin care and information about compression sleeve in order to ease discomfort resulting from lymphoedema.

Follow-up counselling will be provided for patients who are emotionally and psychologically disturbed by lymphoedema. Depending on the severity of individual cases, our nurses and qualified lymphoedema therapist will assess, recommend and make referrals where necessary to lymphoedema specialists for further treatment.

Enrollment:

prior registration required

Fee:

free of charge

 

Enquiry/Registration

Telephone: (852) 2525 6033


References:

  1. Foldi, M. Foldi, E., & Stefan Kubik. (2006) Foldi’s Textbook of Lymphology. For Physicians and Lymphoedema Therapists. 2nd Edition. Elsevier GmBH, Munich, Germany.
  2. Barclay, L. (2010). Early physiotherapy may help prevent lymphodema after breast cancer., BMJ, 340: b5396.

 

10/2015