A lifelong challenge
Massage is best therapy for breast cancer survivors with lymphedema

By Pam Mellskog
© 2009 Longmont Times-Call

LONGMONT — Despite the relatively common occurrence of lymphedema — the swelling of a limb — in breast cancer survivors with major lymph node removal, misperceptions still cloud the condition’s treatment.

“A lot of people think it can be tapped, like maple syrup,” said Jodi Winicour, a certified lymphedema therapist and physical therapist at Longmont United Hospital.

Instead, she uses manual — light, rhythmic massage — to gently flush the retained fluid from the swollen arm to a healthier section of the lymph system for re-circulation in the body.

This specialized massage technique for lymphedema patients debuted about 20 years ago. LUH’s Health Center of Integrated Therapies introduced it in 2001.

Though not often painful or life threatening in breast cancer survivors, lymphedema can cause discomfort and a disrupted sense of normalcy, according to patients.

“I was trying on a short-sleeved shirt, and I looked at myself, and I thought, ‘When did my arm get so fat?’” said Jo Geiger, 68.

The retired registered nurse and massage therapist was diagnosed with breast cancer in her right breast in 1990, the left breast in 1992 and had both removed.

Like so many other survivors, her doctor removed the cluster of about 25 Jelly Belly-sized lymph nodes in her armpit areas to determine if the cancer had spread beyond her breast.

Doctors screen cells from the lymph system to gauge the cancer’s reach because this system works like a sieve to catch cancer cells along with bacteria, viruses and other waste products, according the Mayo Clinic Web site.

“I think of lymph nodes as those security guards that drive around in gated community neighborhoods to identify intruders and then call the police — the immune system,” Winicour said.

The lymphatic system carries off undesirables through the lymph vessels, which lead to lymph nodes. Lymphocytes — infection-fighting cells that live in the lymph nodes — filter these wastes and ultimately flush them from the body.

Lymphedema occurs when, in the case of some biopsied breast cancer survivors, the flushing system gets damaged and clogged.

About half of those who undergo this type of invasive biopsy never develop telltale lymphedema-related swelling, according to the National Lymphedema Network.

NLN reports that even fewer, between 4 percent and 10 percent, suffer the condition if they qualified for sentinel node biopsy. Doctors began using SNB in 1991 to harvest far fewer nodes and reduce the kind of collateral damage that causes lymphedema.