According to Dr. Sara Imboden in results reported at the San Antonio Breast Cancer Symposium in San Antonio, Texas, early promise was shown in extracorporeal shock wave therapy for limiting the often-vexing problem of lymphedema, arising after axillary lymphadenectomy. Dr. Imboden conducted her research at the University of Bern (Switzerland).
In an ongoing randomized, sham-controlled clinical trial, lymphedema, as measured by median whole-arm water displacement, dropped from 4,200 mL at baseline by 192.5 mL, after 10 once-weekly extracorporeal shock wave (ECSW) sessions — in the first 10 affected patients treated. A 12.5-mL decline from baseline measures was shown in patients who received the sham sessions.
The mean total cross-sectional area of the most swollen part of the arm decreased by 3% in the ECSW group, indicated by quantitative CT measures in comparison to 1.4% in the control group, said Dr. Imboden. From the breast cancer patients in the study a mean of 22 axillary lymph nodes had been removed.
For 10 weeks, the ECSW therapy was performed once per week over the length of the edematous arm at an energy density of 0.25-0.69 mJ/mm2. The same treatment schedule was performed on the control group. However, the shock waves were contained inside the probe. No complications interrupted ECSW therapy during the sessions.
In the next phase of the study, researchers plan to expand the randomized trial to 30 patients. Additionally during the next clinical trials, researchers plan to augment the results with patient reports of symptoms based on questionnaires with extended follow-up to evaluate recurrences and functioning as well as assessing body imagery.
In the treatment of lymphedema no medications have been shown to be effective. Repeated manual lymph drainage and compression bandages are the conventional therapies. With regard to this university-funded study, Dr. Imboden reported no financial conflicts of interest.
Acols (http://www.acols.com) provides education and training in Lymphedema Management. We are the leading school in the United States for lymphedema certification training for healthcare professionals in Manual Lymph Drainage (MLD) and Complete Decongestive Therapy (CDT). Learn more about wound care certification, visit the website today.
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