Main methods of treating upper limb edema in breast cancer.
1.Massage.
It is the most important means of treating lymphedema at present, accelerating the lymphatic fluid return to the affected upper limb through massage. However, massage should be performed by experienced professional masseurs.
2, skin protection and physical therapy.
The main purpose of doing good skin protection measures is to prevent infection, because the tissue interstices of lymphedema are rich in proteins, and a tiny skin break can trigger bacterial infection. Therefore, trauma, blood sampling, injection, blood pressure measurement or intravenous injection in the affected limb should be avoided; avoid carrying heavy objects and prolonged draping of the affected limb; avoid insect bites and prevent skin damage, and skin damage should be treated immediately once it occurs. You can use HYJ inflammatory physical therapy device twice a day, 15-30 minutes of physical therapy each time; wax therapy or hydrotherapy machine also has a similar effect;
3, the affected upper limb functional exercise.
Moderate activity and exercise helps to improve lymphatic circulation. Such as stretching, abdominal breathing can change the pressure in the thorax and promote lymphatic reflux. Upper limb lifting exercise can stimulate lymphatic fluid flow by muscle contraction. However, too strong exercise (such as carrying heavy objects) can overload lymphatic vessels and aggravate upper limb edema.
Remember not to over-exercise, but to do it gradually. Exercise should be done to help restore the function of the upper limb and reduce the occurrence of edema. When exercising, you should adhere to the method of exercising from the distal end of the affected limb to the proximal end of the activity (from the wrist joint to the elbow joint and then to the shoulder joint).
4. Pressure gloves.
Wearing pressure gloves can prevent lymphedema and avoid aggravation of swelling. The compression glove can be pressed on the swollen area to avoid the accumulation of body fluid; it also serves as a support for the affected limb to help the muscles pump away body fluid. The compression glove is specially designed to focus pressure on the distal end of the arm to accelerate the return of lymphatic fluid.
5.Pressure pump therapy.
That is, lymphedema machine therapy. An inflatable cuff is placed on the edematous limb and intermittently inflated to allow the edematous fluid to flow centripetally. These air pressure devices are mostly multi-chamber, sequential, adjustable pressure gradient pumps. The pump pressure decreases centripetally like a wave, squeezing the edema fluid into the bloodstream. This method is effective in the early stages of lymphedema, before the onset of significant subcutaneous fibrosis. This treatment is routinely used in our inpatients, and the circulatory regular pressure is applied to promote lymphatic fluid reflux and prevent upper limb edema.
6. Drug therapy.
There are no effective drugs available for Western medicine. Recent studies have shown that benzopyrone may be a promising class of drugs, which can bind to proteins deposited in the tissue interstitium, enhance the phagocytosis of macrophages, and induce protein hydrolysis to improve symptoms, however, its long-term efficacy needs further study. On the contrary, there are more herbal medicines for the treatment of lymphedema, which will not be described in detail;
7.On top of prevention, daily protection will be more beneficial to the recovery of post-breast cancer lymphedema.
(1) Exercise and the application of elastic splints, with short-term efficiency of 90% and correct massage methods according to lymphatic reflux pathways. Starting from the proximal end, stimulate the lymphatic channels, then move from the upper arm of the affected limb to the forearm to gradually promote the upward flow of fluid. Massage techniques must be gentle, slow, no more than 20 minutes.
(2) Use a suitable elastic support, such as an elastic cuff, which can be worn at night, and an elastic bandage for patients with excessive swelling.
(3) Local cleansing and antibiotic treatment; use gentle massage to promote lymphatic reflux.
(4) Appropriate exercise and sports; encourage patients to adhere to exercise 2 to 3 times a day for at least 6 months, and 1 time a day thereafter.
To conclude, postoperative lymphedema of breast cancer is usually treated with conservative therapy, including balloon compression, massage, limb elevation, elastic protective support, and the use of elastic bandage in the early postoperative period. As its treatment methods vary and its efficacy varies, foreign reports use comprehensive measures and their efficacy is more certain.