The Therapist is in...Overcoming breast cancer complications

The Therapist is in...
Overcoming breast cancer complications
by Shannon Murphy, MPT, BodySense

October is National Breast Cancer Awareness Month, which typically reminds us to focus on early detection, prevention, and research for a cure. But for those people already living with the disease, this month should be a time to recognize what can be done to minimize the effects of treatment. Most people are aware of the hair loss, nausea and nasty symptoms associated with chemotherapy - but not everyone knows about the other side effects of cancer treatment. Radiation and surgical procedures, while improving with technology, can create problems for healthy tissue as they seek to abolish cancer cells. For the many women (and some men) living with breast cancer, a number of syndromes can add to the cancer burden.
Lymphedema (lim-fuh-dee-muh) is a swelling that develops in the arms or legs (typically one limb on a single side, but not always). The lymphatic system works to drain fluid from tissues in the body and transport different molecules through your system -- which is important for immune function. Although lymph transport is separate from blood circulation, it does have some relationship to the venous system (veins). In most cases, lymphedema develops as a side effect of tissue damage, like that which can happen with radiation or surgery. In some cases, cancer tumors themselves block the lymph channels. Regardless of cause, when fluid cannot drain properly, the limb becomes swollen, painful and prone to infection.
Stiff shoulder & cording
In some cases, surgery can be performed to remove cancerous tissue or reconstruct breast shape. While the outcomes can be amazing, surgery creates the risk of scar tissue developing in the shoulder and armpit. Long threads of scar tissue can extend down the arm, forming ropey "cords" that give name to the phenomenon called "cording". These adhesions can make it impossible to reach overhead, twist, or use the arm normally. If left untreated, problems in the neck and back can develop from trying to compensate for lost motion.
Weakness and Fatigue
Cancer and its associated treatments can also lead to extreme exhaustion. Poor sleep, emotional distress, anemia, lack of appetite and decreased activity level can all fuel the sense of fatigue. True muscle weakness can also develop, which further contributes to the downward spiral.
What can be done?
Fortunately, a whole field of specialized rehab has developed out of need to treat cancer complications. Physical & occupational therapists who specialize in lymphedema can use manual techniques, bandaging and compression devices to reduce or eliminate swelling. Soft-tissue work and joint mobilization can break scar tissue, and appropriate exercise prescription can help regain normal use of a stuck arm. Fatigue should be medically evaluated to determine which factors are most easily treatable, and patients should learn how to ask for help with their daily chores. However fatigue also typically lessens for people who participate in moderate levels of physical activity, so light exercise training can be helpful in building both strength and stamina.
A positive outlook is key recovery, and it is comforting to know that there are professionals who can help. But an ounce of prevention is always the better approach - make sure you perform self-exams monthly and don't put off routine medical appointments. They just might save your life!

This series of columns are by Shannon Murphy, MPT, Owner/Director of BodySense PT. 9 Saint Paul St, 3rd Floor, Boonsboro, MD 21713. 301-432-8585 phone, 301-432-1987 fax,