This week, Bobbi Conner talks with Dr. Katie Schmitt about managing lymphedema in breast cancer survivors. Dr. Schmitt is a Doctor of Physical Therapy and a clinical specialist in oncologic physical therapy, and a certified lymphedema therapist at MUSC Hollings Cancer Center.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Lymphedema is a condition that may occur after breast cancer surgery when lymph nodes are removed. Doctor Katie Schmitt is here to talk about the role of physical therapy in managing this condition. Doctor Schmitt is a Doctor of Physical Therapy and Clinical Specialist in Oncologic Physical Therapy, and she's a Certified Lymphedema Therapist at MUSC Hollings Cancer Center. Doctor Schmitt, tell us about lymphedema in breast cancer survivors.
Dr. Schmitt: Your lymphatic system is your system that runs with your arteries and veins. It helps carry fats, infectious material, heats and it helps the arteries and veins do their job. With lymphedema we know that that system has been affected. So, either there was a lymph node removed or possibly from surgery and radiation. And that results in a backup of this protein rich fluid that's a slow, progressive condition. And that for patients with breast cancer shows up often in the arm or the chest wall.
Conner: What are the most effective ways to manage lymphedema?
Dr. Schmitt: It all depends on your stage of lymphedema. So, there's stage zero and stage one, where there's some swelling and it comes and goes. In those stages, it's really important to focus on exercise, good skin care and possibly using some compression during repetitive activity. For stage two and three, that's where lymphedema does not get better on its own. And that's where patients need to see a certified lymphedema therapist.
Conner: Tell us a bit more about the therapists who specialize in lymphedema.
Dr. Schmitt: So, you're looking for someone with CLT or CLT-LANA after their name. Those are someone who's a certified lymphedema therapist, and it might be an occupational therapist or a physical therapist.
Conner: And once a lymphedema therapist is involved, what exactly might they be working on to help manage this condition?
Dr. Schmitt: We're going to work on something called complete decongestive therapy, where we start out with a very large focus on manual lymphatic drainage, bandaging with compression, and removing that swelling. Once we have that under control, we transition into your general care where we get back to your exercises, your movement, and figuring out with different compression garments, how to manage lymphedema from a day to day aspect.
Conner: Tell us more about manual lymphatic drainage as a technique that might be included in therapy for lymphedema.
Dr. Schmitt: So, we call it MLD for short. And it's a very light touch movement of the skin to help the lymphedema flow from one affected area to a non-affected area. I describe it almost as a very light touch massage that doesn't feel like it should work, but it does, and it's really great and really effective.
Conner: And what is it really doing?
Dr. Schmitt: The movement of the skin from MLD directs the swelling away from the affected area like your armpit, and moves it to the next group of unaffected lymph nodes, so down to the hip so the body can filter the fluid and get rid of it, and it doesn't back up and go into the wrist or the hand. It's kind of like moving traffic across a bridge to the next bridge where the traffic can leave. I think everyone who's had a lymph node removal should know about MLD.
Conner: And when is MLD not advisable for a cancer survivor?
Dr. Schmitt: We do always want to be careful when initiating MLD, because if you have something like a chronic kidney disease or a heart condition, sending all of that fluid back up to the heart might be dangerous. So, we're always working with your physicians to make sure it's safe to initiate MLD.
Conner: Doctor Schmitt, thanks for this information about lymphedema.
Dr. Schmitt: You're welcome.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
