Lymphedema
Conditions
Keywords
Prevention, lymphedema, acupuncture, self-management
Brief summary
Introduction: Breast cancer women who are treated with axillary node dissection are at increased risk for lymphedema - the lifetime risk in these women is estimated at 15-50% and the risk can significantly increase with chemotherapy and radiation therapy Objectives: 1. To evaluate the feasibility and effectiveness of implementing the integrative therapy program (ITP) intervention. ITP consists of self-management education in conjunction with acupuncture. 2. To determine if ITP affects quality of life, self-efficacy, lymphedema knowledge, pain, and early detection and management of lymphedema. Design: the exploratory study aims to evaluate the feasibility and benefits of the integrative therapy program (ITP) intervention post-operatively for 18 months. Subjects: Women with breast cancer treated with axillary node dissection with normal baseline pre-operative bioimpedance (L-dex U400) score. Sample size: 30 subjects
Detailed description
Recruitment and Intervention: The study participants are recruited by their breast surgeon after they undergo axillary node dissection surgery. 4-6 weeks following surgery, the participants will receive a combination of acupuncture and self management education . Contents of self-management education include: 1. Lymphedema knowledge: functions of the lymphatic system, anatomy of the lymph nodes and direction of the lymphatic drainage, risk factors that could precipitate lymphedema, the signs and symptoms of lymphedema and infection, and lymphedema resources. 2. Selfcare techniques:healthy diet (eating whole food encouraged), neck, shoulder and chest wall stretching exercises, walk daily, self-manual lymphatic drainage with deep breathing techniques, and self-acupressure over eighteen months following their surgery. Outcome measurements include: L-Dex U400 measurement, arm circumference, pain scale, self-efficacy, and lymphedema knowledge, and Functional Assessment of Cancer Therapy-Breast FACT-B.
Interventions
OTHERITP
The study participants will receive weekly acupuncture treatment plus education on self-management for 10 weeks after axillary node dissection, then a total of five follow up acupuncture treatments once every 3 months at 6, 9, 12, 15, and 18 months. The education and self management will be reinforced monthly by telephone visit. Acupuncture points include: LI 4, LV3, HT3, SP9, GB 20, KD 3, Yintang, and Ashi points
Sponsors
Huntington Memorial Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Subjects must be able to read and understand the informed consent form and have the capacity to give consent. 2. Adults age 18 and older 3. Subject with a newly diagnosed stage I-III breast cancer with a documented pre-operative baseline L-Dex U400 who underwent axillary lymph node dissection within 4-6 weeks prior to enrollment. 4. Subjects must be able to return to the study site for the duration of the study (18 months).
Exclusion criteria
1. Subjects who do not read or understand the informed consent are ineligible. 2. Subjects who have any contraindications to the affected upper-limb exercises, which include congestive heart failure, cardiac arrhythmia, deep vein thrombosis, infectious disease complications such as cellulitis and lymphangitis. 3. Women with double mastectomy with axillary node dissection bilaterally. 4. Women with a prior history of axillary surgeries in the ipsilateral side and/or primary lymphedema 5. Women with metal implants (e.g. shoulder replacement) or cardiac implants (e.g. automated implanted cardiac defibrillator (AICD) or pacemaker). 6. All subjects with objective or subjective signs and symptoms of lymphedema. 7. Women of childbearing age who are pregnant.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bioimpedance (L-dex U400) | 18 months | use L-dex machine |
| Arm circumference measurements of the upper limbs using at 4 cm interval | 18 months | measure the circumference in centimeters |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-Efficacy Scale | 18 months | questionnaires |
| Lymphedema Knowledge Scale | 18 months | questionnaires |
| Quality of Life (Functional Assessment of Cancer Therapy-Breast) | 18 months | survey |
| Wong-Baker FACES Pain Scale | 18 months | 1-10 scale |
Countries
United States
Outcome results
None listed