Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

How Big of a Problem is Lymphoedema? (#37)

Melanie L Plinsinga 1 , Louise Koelmeyer 2 , Kira Bloomquist 1 3 , Debbie R Geyer 4 5 , Hildegard Reul-Hirche 1 6 , Sandi Hayes 1
  1. Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
  2. Department of Health Sciences, Macquarie University, Sydney, New South Wales, Australia
  3. Center for Health Research, Copenhagen University Hospital, Rigshospitalet, Denmark
  4. Cremorne Medical Practice, Sydney, New South Wales, Australia
  5. Lymphoedema Association Australia, Sydney, New South Wales, Australia
  6. Physiotherapy department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia

More than 20,000 Australians are diagnosed with breast cancer and 6,500 with gynaelogical cancer each year. Lymphoedema is a prevalent, intractable health issue that may develop as a consequence of these cancers. The disease itself, or treatment for the disease, may reduce lymphatic transport capacity or increase lymph load. This in turn may lead to increases in extracellular fluid in the affected area (that is, stage 0-1 lymphoedema), and if left untreated, may progress to visible size changes, and deposition of fatty and fibrotic tissue (stage 2-3). Lymphoedema adversely impacts function and quality of life, and has been associated with poorer prognosis. There is no known cure, and available treatment options are costly, time-consuming and lifelong, with treatment burden higher for those with stage 2 and above lymphoedema, compared with stage 0 and I. The individual and social burden imposed by lymphoedema demands greater research in all areas of lymphoedema – prevention through management. However, measuring lymphoedema is complex, particularly in the lower limb setting, and choice of measurement influences what we think we know about prevalence, progression and prevention and management strategies. Nonetheless, despite ‘noisy data’ some signals shine bright. Lymphoedema is common; at least 20% of women with breast cancer and at least one in three women with gynaecological cancer develop this chronic condition. Higher number of lymph node removal, more extensive surgery and receipt of adjuvant therapy represent treatment characteristics consistently associated with increased risk of developing lymphoedema. Lymphoedema is impactful – it adversely influences those living with the condition, and the personal ramifications have a flow on effect to use of healthcare resources and overall public health.