NEW YORK (Reuters Health) - Many women who experience abnormal
swelling of the arm or shoulder area following treatment for breast
cancer -- a bothersome condition called lymphedema -- suffer in
silence, a new survey indicate.

Others don't follow the treatment advice of their doctor or use
"alternative" treatments, which they may not discuss with their
doctors.

Lymphedema is a common, chronic condition that often develops after
breast surgery involving removal or damage to the lymph nods in the
armpit. It occurs when excess lymphatic fluid accumulates, leading to
swelling, rash, redness and blistering that causes tenderness,
numbness, or aching in the arm, chest wall and breast.

"Lymphedema has a profound impact on health and well-being, but often
goes undiagnosed and untreated by physicians and patients," said Jane
Armer in a statement. "Understanding the ways that people self-manage
the chronic symptoms of lymphedema is essential to facilitate an
improvement in the use of treatments and quality of life."

Armer, at the University of Missouri-Columbia and the Ellis Fischel
Cancer Center, and colleagues asked 40 breast cancer survivors with
lymphedema how they manage the condition and discovered that the most
common strategy was to not treat the symptoms at all. For 12 out of 14
symptoms, patients reported taking no action 29 percent to 65 percent
of the time, the researchers found.

"I was perhaps most interested in the finding that the most frequent
symptom management response was 'no action'," Armer told Reuters
Health. "This informs me as both a nurse and a researcher that more
needs to be done in understanding effective management approaches for
lymphedema and educating patients and health professionals about
available management alternatives."

For those that did do something about their lymphedema, most often
(about 47 percent of the time) they used doctor-recommended techniques
-- typically non-drug approaches like simple lymph node drainage and
wearing compression garments.

Others turned to drug treatments such as antibiotics and over-the-
counter painkillers, while still others favored "lay symptom
management" -- strategies not recommended by healthcare providers but
which include common sense, folk, complementary or alternative methods
-- like resting, drinking water, or applying heat or ice to combat arm
swelling.

According to Armer, patients increasingly are using these types of
therapies and most don't talk to their doctor about it.

"It is essential that women communicate with their health care
providers (both primary care providers and specialists) about the
treatment alternatives they have sought and are using for their health
conditions. Only in this way can their self-management and overall
health be optimized," Armer said. "Two-way communication between the
patient and all members of the health care team is vital."

http://www.reuters.com/article/healthNews/idUSTRE4AH66C20081118