Some recommend physical activity like weightlifting,

but of course every individual case must be judged

by a medical specialist.

http://www.uphs.upenn.edu/news/News_Releases/2009/08/weight-lifting-eases-lymphedema-symptoms/

http://phys.org/news/2010-12-lymphedema-breast-cancer-treatment-weightlifting.html

http://munews.missouri.edu/news-releases/2011/1130-mu-researchers-recommend-exercise-for-breast-cancer-survivors-lymphedema-patients/

http://munews.missouri.edu/news-releases/2012/1022-exercise-and-complete-decongestive-therapy-best-ways-to-manage-lymphedema-mu-expert-says/

http://munews.missouri.edu/news-releases/2012/0809-individualized-care-best-for-lymphedema-patients-mu-researcher-says/

http://munews.missouri.edu/news-releases/2008/1027-armer-lymphedema.php

http://www.eurekalert.org/pub_releases/2008-05/apta-nss052308.php

Regards,

Joachim (not a medic)

Besides the traditional interventions you note above in your question, there are several others that have achieved a sufficient level of evidentiary support based on review and critical appraisal to date of methodologically sound trials, systematic reviews and meta-analyses.

Early Intervention

Researchers at the National Naval Medical Center in Bethesda (MD) [Stout Gergich et al., Cancer 2008] evaluated the benefit of an aggressive early intervention strategy with arm volume assessed preoperatively and then at three-month intervals postoperatively, wherein an increase of greater than 3% in upper limb (UL) volume compared to preoperative volume triggered a diagnosis of subclinical LE requiring conservative treatment, with consequent prescribing of a compression garment intervention for 4 weeks; upon reduction of LE, garment wear was continued only periods of stressful/strenuous with manifest symptoms (heaviness or with visible swelling). The benefits of this early intervention protocol were impressive: using 20- to 30-mm Hg compression garments, the investigators obtained a significant reduction in the affected limb volume to near baseline level, and prevented progression to a more advanced stage of lymphedema for at least the first year postoperatively.

Low-Level Laser Therapy (LLLT)

Mohammed Omar and colleagues at Cairo University [Support Care Cancer 2012] conducted a systematic review of 8 studies (n=230) of the benefit of low-level laser therapy (LLLT) for the management of breast cancer related lymphedema, five studies of which meet sufficient conditions of methodological strength, finding moderate to strong evidence for the effectiveness of LLLT in the reduction of limb volume.

Exercise

A systematic review by Christine Chang and Janice Cormier at the Ellis Fischel Cancer Center in Missouri [Semin Oncol Nurs. 2013] found that exercise (and intermittent pneumatic compression) was an effective therapy safely implementable in appropriate patients as an adjunct to complete decongestive therapy. A far larger systematic review was commissioned by the American Lymphedema Framework Project in partnership with the International Lymphoedema Framework and implemented under the auspices of Marilyn Kwan and colleagues at Kaiser Permanente [J Cancer Surviv. 2011], acknowledging the safety of a slowly progressive resistance exercise program in the management of lymphedema. And the Cochrane Review

of exercise interventions for upper-limb dysfunction due to breast cancer [McNeely et al., Cochrane Database Syst Rev. 2010] found that upper-limb exercise such as shoulder ROM and stretching is helpful in recovering upper-limb movement following breast cancer surgery, and that starting exercise early after surgery (withi.n the first three days) may result in better shoulder movement in the short term, although it may also result in increased wound drainage, possibly requiring the drains to remain in place longer than if exercise is delayed by about one week. It also found that more structured exercise programs, such as physical therapy, when delivered in the early weeks post-surgery are beneficial to regain movement in, and use of the shoulder and arm for daily activities, and all without any increase in the umber of patients developing arm lymphedema.

Other Interventions

In highly specialized cases, various surgical treatments including excisional procedures), lymphatic reconstruction, and tissue transfer, may be of benefit in volume reduction of lymphedema [Cormier et al., Ann Surg Oncol 2012], but the evidence remains provisional to date, as does that on selenium and other CAM interventions although with selenium we note that the apparent absence of harm suggest possible deployment without risk and perhaps with some appreciable benefit in some patients.

Reviewed by:

Constantine Kaniklidis

Director of Medical Research,

No Surrender Breast Cancer Foundation (NSBCF)

European Association for Cancer Research (EACR)

Joachim:

You may not be a medic, but your answers I have found are always excelllent and on target! Always glad to hear from you on any issue.

Thank you, but as mentioned in the Journal Club,

there's a trick. I've got a big bookmark collection

and can do semantic search.

Regards,

Joachim