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Yoga , Breast Cancer , good stuff

http://breastcanceryogablog.com/2015/01/22/rochelle-roll-back-yoga-pose-for-breast-cancer/

This is terrific ! Many thanks to your team. Keep up the fantastic work!

 

Rochelle Roll Back Yoga Pose For Breast Cancer

January 22, 2015 by Leave a Comment

Rochelle Roll Back Yoga Pose For Breast CancerAuthor: Diana Ross, E-RYT 500, Posted By: Breast Cancer Yoga Staff.

In Breast Cancer Yoga, the use of props are essential for a person to feel safe, supported and nurtured. These specific, reclined, supported, yoga poses combined with deep breaths are intended to support recovery from breast cancer and assist in managing lymphedema and cancer-related fatigue. In our book, “Restorative Yoga For Breast Cancer Recovery” everyone will learn the importance of elongating the spine while opening the chest region using props for support . The mild inversions are used to create an anti-gravitational force in the pose which will renew energy, promote positive thoughts and enhance self esteem.

“Importantly, when props are used correctly, they allow the body to come into a natural and balanced state of alignment. When the body is aligned, the mind feels balanced as well. Once the body and the mind unite, the breath too becomes aligned and brings a deeper, internal state of peace.”

Diana Ross

Benefits:

  • Reduces respiratory & heart rates
  • Increases cervical and axillary lymphatic drainage
  • Aids flexibility of rib cage and thoracic spine and expands pectoral muscles
  • Relaxes the muscles of the chest, allowing blood to flow freely to the heart and lungs
  • Massages the thymus gland which stimulates the immune function
  • Boosts the nervous system, building heat and stimulating metabolism
  • Facilitates lymphatic drainage of breasts
  • Stretches groin, quadriceps and hip flexors
  • Promotes deep breathing by widening the chest
  • Facilitates an inner quiet and calmness

Instructions:

    1. Begin seated with one or two bolsters/blocks behind. Bring right knee out to side with right foot resting on left inner knee (adjust hips to be equal.) Place top of left foot down to stretch ankle.
    2. Lengthen spine, recline back, rest elbows to bolster first. Stay until a release is felt in the thigh muscles.
    3. To expand the chest, drape your back over the bolsters and place head on block/bolster or where it feels good. The arms can go out to “T” position in between bolsters.
    4. If you wish to go even deeper you can remove second bolster/block and release crown of head to earth, and stretch arms over head, elbows soft.
    5. Stay in pose for 5 minutes or longer if it feels amazing.
    6. When finished, come back up, extend both legs forward.
    7. Place cylinder bolster on lap and drape torso over bolster in ROCHELLE ROLL FORWARD.
    8. When done – INHALE, return to STAFF POSE and enjoy ANKLE ROTATIONS.

To experience the benefits of yoga for breast cancer, it is essential that you begin with simple, gentle yoga movements. You should also consult a doctor before you begin practicing yoga. It is also necessary that you follow a yogic diet that consists of a mainly vegetarian diet to enhance the benefits of yoga.

Diana RossAbout Diana Ross:  E-RYT 500 restorative yoga teacher, survivor that cares and founder of Breast Cancer Yoga. Diana is making a difference with Breast Cancer Yogatherapeutic products designed to support you emotionally and physically during breast cancer . We want to give you the attention and personal service you need so please email us at info@breastcanceryoga.com if you have questions.


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Medicinal Herb Comfrey And Its Therapeutic Benefits For Breast Cancer

Medicinal Herb Comfrey And Its Therapeutic Benefits For Breast Cancer.

 

Great stuff !


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Boosting Anti-Cancer Immunity With Berries

Boosting Anti-Cancer Immunity With Berries.

This is great. Please take the time to read this, we can not do enough for our Immune system. Have a fantastic day.


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Yoga Pose For Breast Cancer & Lymphedema

Einen schönen guten Tag. Habe etwas sehr interessantes gefunden auf:

http://breastcanceryogablog.com/category/lymphoedema/

My special thanks to  http://breastcanceryogablog.com/ , it is worth reading .

Yoga For Lymphedema – Shining Warrior Pose (Flow)

October 30, 2014 by 4 Comments

Diana Ross Founder of Breast Cancer Yoga

Yoga and Lymphedema Management:
Practicing continuous flowing movements significantly improves the lymphatic system. When lymph fluid is disrupted because of breast cancer surgery, trauma or infection, excessive lymph fluid builds up. This stagnant fluid can play havoc on the tissues and create swelling. There also can be a reduction of the oxygen absorption in the lymphatic system which increases the chance for infection. Practicing a flowing yoga pumps the lymphatic fluid throughout the body’s channels, rather than allowing it to accumulate or back up. It is great for maintaining healthy breast tissue. To keep this fluid moving, we need to also foster relaxation. It will facilitate renewed or restored strength and flexibility.

Shining Warrior Pose (Flow) For Breast Cancer Related Lymphedema Management:
Shining Warrior Pose increases circulation to arms, shoulders and breast region by opening the ribcage and expanding the chest. These arm movements and conscious breathing activate lymphatic system.

Benefits:

  • Opens and expands pectoral muscles
  • Reduces postsurgical fibrous adhesions and scar tissue
  • Promotes axillary lymphatic fluid drainage which decreases blockages of lymph nodes
  • Softens stiff shoulders and/or frozen shoulders,
  • Aids flexibility of the rib cage and thoracic spine
  • Frees the breath and opens the chest
  • Improves leg strength and flexibility of quadriceps and calf muscles
  • Encourages balance while strengthening ankles
  • Calms the body by  harmonizing the breath to the movement
  • Increases ROM (range of motion) for arms and shoulders

Instructions:

  1. Begin standing. Bring right foot forward, 1 to 3 feet apart, toes and hips facing forward with back foot slightly turned out ( for balance). INHALE , bring hands in front of chest. Come into PRAYER MUDRA with shoulders relaxed.
  2. EXHALE, lift rib cage and lift chest up bringing arms out to side with elbows softly bent ( shoulders remain relaxed). Bend the front knee over the ankle (your front knee should be aligned above the ankle).
  3. INHALE, arms return and hands come back into PRAYER while the front leg straightens.
  4. Continue 5/10 more rounds and then repeat on left side.
  5. INHALE, bring hands in front into PRAYER MUDRA (palms together.)
  6. EXHALE, arms flow out while bending left knee.
  7. Continue 5/10 more rounds.

.Diana RossAbout Diana Ross:  E-RYT 500 restorative yoga teacher, survivor that cares and founder of Breast Cancer Yoga. Diana is making a difference with Breast Cancer Yogatherapeutic products designed to support you emotionally and physically during breast cancer . We want to give you the attention and personal service you need so please email us at info@breastcanceryoga.com if you have questions.

Breath – Blood – Lymph Flow

October 21, 2014 by Leave a Comment

Breast Cancer Yoga Savasana

By: Breast Cancer Yoga Staff.

Breathing Exercises And The Lymphatic System For Breast Cancer Lymphedema Management:The flow of lymph, which is rich in immune cells, improves with proper breathing. Furthermore, the expansion of the lungs air pockets increases the flow of both blood and lymph. This flow reduces infection in the lungs and other tissues. Breathing properly improves the functioning of the body’s organs stimulating digestion, assimilation and elimination.

Another benefit of the breath is how it supports the functioning of the body’s organs such as the improvement of the peristalsis movement which stimulates the liver so the release of bile will activate the detoxification process. By maintaining a large supply of oxygen in the lungs, many organs function better, including the brain.

The most important function of all is the stimulation of the “relaxation response” that results in lower tension and an overall improved sense of well being.

If we can build a regular asana practice with conscious breathing; we will release muscular tension, and consequently the nerves will relax. Here is where restorative poses are most helpful. Supported Bridge, Savasana, Supported Legs Up The Wall, Supported Child’s Pose are a few that are very restorative. When the breath is brought under control is improves the physical such that there is an efficient absorption of oxygen and the elimination of carbon dioxide. This will result in an improved mental and emotional state of mind.

Dawn Breast CancerAbout Dawn Bradford Lange: Co-founder of Breast Cancer Yoga. Dawn is making a difference with Breast Cancer Yoga therapeutic products designed to support you emotionally and physically during breast cancer . We want to give you the attention and personal service you need so please email us at info@breastcanceryoga.com if you have questions.


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Heute habe ich für euch etwas zum anhören.

http://www.stitcher.com/podcast/ndr-1-niedersachsen-gesundheit-heute/e/gesundheit-heute-lymphdeme-34977022


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Lymphatische Filariose: Da ist der Wurm drin

 

http://news.doccheck.com/de/16032/lymphatische-filariose-da-ist-der-wurm-drin/

In den Entwicklungsländern haben mehr als 120 Millionen Menschen Filarien in ihrem Körper. Medizinisch ein Kampf gegen Windmühlen? Sicher nicht, wie Pilotprojekte aus dem westafrikanischen Togo zeigen. Jetzt liegt ein Abschlussbericht vor.

Wie so oft in den Tropen beginnt alles mit einem Stich: Mücken der Gattungen Aedes, Anopheles, Culex und Mansonia übertragen Larven verschiedener Filarien. Bei ihrer Blutmahlzeit gelangen Brugia malayi oder Wuchereria bancrofti in unsere Lymphgefäße und entwickeln sich zu adulten Fadenwürmern. Daraus entstehende Mikrofilarien wandern schließlich in den Blutstrom und infizieren weitere Blutsauger – ein Teufelskreislauf. Bei Menschen führt die lymphatische Filariose über Monate und Jahre hinweg zu immensen Beschwerden.

Rundreise im lymphatischen System

Nach einer Infektion werden zunächst die Lymphknoten und später die peripheren Lymphgefäße in Mitleidenschaft gezogen – vor allem durch aktive und abgestorbene Mikrofilarien. Bei Männern gelten Schwellungen, Entzündungen und Ödeme im Hoden als erste Anzeichen. Schreitet die Krankheit voran, verstopfen mehr und mehr Lymphgefäße. Durch die Abflussstörung entsteht ohne Behandlung schließlich eine Elephantiasis des Beins. In der betroffenen Extremität verhärtet sich die Haut, und schwer heilende Wunden kommen noch hinzu. Betroffene leiden zudem unter sozialer Isolation und Stigmatisierung.

Diagnostik und Therapie

Da Mikrofilarien vor allem nachts auftreten, sollten Blutuntersuchungen ebenfalls zu später Stunde erfolgen. Blutsaugende Mücken, die Vektoren entsprechender Fadenwürmer, sind ebenfalls nach Sonnenuntergang aktiv – darauf hat sich der Parasit eingestellt. Im Blut von Patienten fallen zunächst eosinophile Granulozyten auf. Über immunologische Verfahren lassen sich sowohl Antikörper als auch parasitäre Antigene selbst bestimmen. Zur Therapie stehen mittlerweile drei Arzneistoffe parat: Diethylcarbamazin, Ivermectin sowie Albendazol. Allein die Tatsache hilft Menschen in Entwicklungsländern recht wenig – laut Weltgesundheitsorganisation WHO kostet die Erkrankung in Afrika 400 bis 500 Disability Adjusted Life Years (DALYs) unter 100.000 Einwohnern. Das Modell beinhaltet nicht nur verlorene Jahre durch einen frühen Tod, sondern auch Einschränkungen des normalen, beschwerdefreien Lebens.

Togo macht mobil

Bereits 1997 entwickelte die World Health Assembly, ein Forum der Weltgesundheitsorganisation WHO, deshalb Aktionspläne zum Kampf gegen lymphatische Filariose. Drei Jahre später entstand das„Global Programme to Eliminate Lymphatic Filariasis“. GlaxoSmithKline und Merck versprachen, dringend benötigte Medikamente so lange zu spenden, bis die Krankheit eliminiert worden ist. Daraufhin starteten togolesische Gesundheitsbehörden eine Kampagne, um Fadenwürmer ein für alle Mal zu eliminieren – der westafrikanische Staat ist neben 34 Ländern des Kontinents besonders stark betroffen. Um sich ein genaues Bild zu machen, untersuchten Ärzte Blutproben flächendeckend via Immunchromatografie auf Antigene und speisten alle Daten in „Health Mapper“ ein. Das WHO-Programm zur Verarbeitung von Gesundheitsdaten steht im Netz kostenlos zur Verfügung. Damit gelang es, mehrere endemische Regionen zu identifizieren.

Medikamente für Millionen

Doch wie lassen sich knapp sieben Millionen Menschen mit Arzneimitteln versorgen? Hier spielen Mitarbeiter des Gesundheitssystems, sogenannte Community Health Workers (CHWs), eine zentrale Rolle. Sie zählten Menschen in ihrer jeweiligen Region und meldeten den Bedarf an Medikamenten. Schließlich verteilten sie Präparate an einzelne Haushalte, erklärten aber auch, warum die Einnahme so immens wichtig ist. Wie Arbeiten aus anderen Ländern gezeigt haben, gelingt es über CHWs, die Compliance zu verbessern und Vorbehalte abzubauen. Im Togo verteilten sie Albendazol und Ivermectin. Für Kinder unter fünf Jahren sind beide Präparate jedoch ungeeignet. Da Geburten nicht immer erfasst werden, setzen Mitarbeiter die Grenze bei 90 Zentimetern Körpergröße. Schwangere und Menschen mit schweren Vorerkrankungen erhielten ebenfalls keine Präparate.

Lieferung bis an die Haustür

Ab 2004 erreichten CHWs mehr als 80 Prozent aller Einwohner. Je nach Prävalenz der Erkrankung im Distrikt wurden fünf bis neun Mal Medikamente verteilt. In Sierra Leone stellten Wissenschaftler fest,dass bei vorbehandelten Patienten sogar drei Zyklen ausreichen. Zahlreiche Einwohner hatten gegen die Onchozerkose („Flussblindheit“) bereits Ivermectin erhalten. Um den Erfolg im Togo zu evaluieren, richteten staatliche Stellen in drei endemischen Regionen Labors ein. Bereits vor der Medikation untersuchten Mitarbeiter das Blut von 500 Probanden – immer zwischen 22:00 Uhr abends und 2:00 Uhr nachts, um die aktivste Phase von Mikrofilarien abzupassen. Sie fanden in bis zu 36 Prozent aller Proben Entwicklungsstadien von Fadenwürmern. Durch die Medikation war schließlich nur noch ein Prozent betroffen. In fünf von sieben Distrikten sank die Prävalenz sogar auf null Prozent.

Keine Chance für Lymphödeme

Für Patienten mit weit fortgeschrittener Filariose reichen Pharmakotherapien allein nicht aus. Deshalb beschlossen Regierungsvertreter, mindestens einen medizinischen Mitarbeiter der landesweit 570 Gesundheitszentren darin zu schulen, wie sich Lymphödeme behandeln lassen. Unterstützung kam von den amerikanischen Centers for Disease Control and Prevention (CDC) sowie von der U.S. Agency for International Development (USAID). Kurz darauf begann eine neue Kampagne, um Bürger zu informieren, dass es medizinische Hilfe bei geschwollenen Füßen gibt. Innerhalb eines Jahres erreichte das Programm ganz Togo. Ärzte behandelten 1.083 Patienten, von denen 30 Prozent nicht aus endemischen Gebieten kamen. Drei Jahre nach dem Start ergab eine Evaluation, dass 62 Prozent aller ursprünglich Behandelten weiterhin am Programm teilnahmen. Auch vertrauen immer mehr Togolesen der modernen Chirurgie, und so sank die Quote an traditionellen – wenig erfolgversprechenden – Behandlungen von 38,8 auf 2,8 Prozent.

Gemeinsam stark

Togos Erfolg kam letztlich durch mehrere Faktoren zu Stande: Mit ihrem „National Program to Eliminate Lymphatic Filariasis“ machten Gesundheitsbehörden einen ersten, wichtigen Schritt. Sie setzen auf Community Health Workers, um Vorbehalte in der Bevölkerung zu vermeiden und Bürger vor Ort zu erreichen. Ohne medizinische und finanzielle Hilfe aus den USA hätte das westafrikanische Land aber kaum gewonnen. Bleibt noch, vorhandene Ressourcen effizient zu nutzen, etwa durch Kombinationsuntersuchungen auf Malaria und Mikrofilarien. Vektoren übertragen nicht selten beide Parasiten, und Patienten leiden an Koinfektionen. Bis 2015 könnte Togo die lymphatische Filariose endgültig besiegt haben. Vom etablierten Modell profitieren mittlerweile auch andere Länder. Als Achillesferse gilt die mehrmalige Gabe von Arzneistoffen. Wissenschaftler arbeiten deshalb an Vakzinen, zumindest im Tiermodell hatten sie bereits Erfolg.

Artikel vonMichael van den Heuvel


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Intermittierende pneumatische Kompression und Kostensenkung/ Stanford University School of Medicine

Lymphedema home treatment improves outcomes, reduces costs, researchers find

DEC 3rd 2014

Home therapy helps control symptoms and save on the costs of treating lymphedema, a painful, often debilitating side effect of life-saving cancer treatments, a new study has found.

Patients with swelling caused by cancer-associated lymphedema can both reduce the severity of the disease and the overall cost of medical care by taking therapeutic steps at home, according to a study by researchers at the Stanford University School of Medicine.

The study looked at the prevalence of lymphedema, a common side effect of cancer treatments, and found that the average annual cost of care for a patient with the condition decreased from $62,190 to $50,000 a year when the patient used pneumatic compression devices to treat the swelling.

“Total health-care costs for these patients are very high, but can be profoundly reduced with treatment intervention, in this case a compression device,” said Stanley Rockson, MD, professor of cardiovascular medicine at Stanford and senior author of the study, published online Dec. 3 in PLOS ONE. “This is clearly a compelling argument for increased coverage of similar home-care devices to reduce costs.”

The first author of the study is Kimberly Brayton, MD, JD, a former cardiovascular fellow at Stanford.

Painful, debilitating fluid buildup

Lymphedema is most commonly caused by the removal of or damage to lymph nodes as a part of cancer treatment. It results from a blockage in the lymphatic system, which is part of the immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling, which can be painful and debilitating. These symptoms can be controlled with various treatments, including treatments done at home and outpatient physical therapy. Home treatments for lymphedema include manual lymphatic massage, multilayer bandaging techniques and application of various compressive garments to reduce tissue fluid.

Researchers chose to examine the use of pneumatic compression devices as an example, primarily because it was an easy therapy method to track through health-insurance coding. “We chose one specific intervention, not because it should supersede the others, but just as a representative, readily identified treatment intervention,” Rockson said.

Pneumatic compression devices are inflatable garments that, when applied to the swollen area, inflate and deflate in cycles to help drain lymph-fluid buildup.

Lymphedema, which is incurable, is common among cancer survivors, although it’s unclear exactly how many people suffer from it. The disorder is often ignored and undertreated, said Rockson, who holds the Allan and Tina Neill Professorship in Lymphatic Research and Medicine.

For the study, researchers set out to determine both the prevalence of the disorder and the possible benefits of these home treatments by examining information collected from the health claims database of United Health Care Group/Optum, a private health insurer that operates in 24 states. Those figures were then used to extrapolate nationwide statistics. (The insurance company stripped patients’ personal information from the data used by the researchers.)

The researchers evaluated health care claims and other data collected by the insurer from 2007 to 2013. Results showed that in 2007, 9,025 of the 950,333 cancer patients in the insurance database were diagnosed with lymphedema — a prevalence of 0.95 percent. By 2013, 14,775 of the 1.19 million cancer patients were diagnosed with lymphedema — a prevalence of 1.2 percent.

Increasing rates of lymphedema

Researchers estimated the current number of cancer patients nationwide at 10 million. At a prevalence of 1.2 percent, that would mean about 121,000 lymphedema diagnoses nationwide.

“Cancer rates are expected to continue increasing at significant rates for the next 20 years,” Rockson said. “We can expect to see corresponding increasing rates of lymphedema.”

Researchers also examined health claims in the year prior to and the year following the initiation of  pneumatic compression therapy for lymphedema patients in the insurance company’s database. Results showed that annual costs of medical care decreased from $62,190 in the year prior to the use of the device to $50,000 in the year after they started using the device. During the year following the use of the devices, there was a reduction in the extent to which the patients used all categories of health care, including the frequency of treatment of soft tissue infection, the study said.

“The potential public health implications of these findings are substantial,” Rockson said. “As the American population ages and lymphedema rates increase, effective home therapies are likely to become increasingly important.”

Information about Stanford’s Department of Medicine, which supported the work, is available athttp://medicine.stanford.edu/.

  • Tracie White
    ByTRACIE WHITE
Tracie White is a science writer for the medical school’s Office of Communication & Public Affairs. Email her at tracie.white@stanford.edu.
Stanley Rockson

Stanley Rockson found that home therapy could help reduce the severity of lymphedema, a common side effect of cancer treatment.
Norbert von der Groeben


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Professor Waldemar Lech Olszewski

Einen schönen guten Tag. Heute wollte ich mir die Zeit nehmen einen hervorragenden Wissenschaftler auf dem Gebiet der Lymphologie vorzustellen. Seine Passion, Wissen und Menschlichkeit bewegen mich sehr. Vielen Dank Prof. Olszewski !

Today I would like to take the time to introduce you to one of the best in the field of Lymphology . His name is Professor Waldemar Lech Olszewski. For me, a great comfort to know that his dedication and passion helps us all .  Thank-you Prof. Olszewski.

http://www.wlolszewski.com/

und /and

http://en.wikipedia.org/wiki/Waldemar_Olszewski


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„Verein zur Förderung der Lymphoedemtherapie e.V.”

Heute möchte ich nochmal auf eine gute Sache aufmerksam machen. Ich finde dass es sich durchaus lohnt hier mit eine Mitgliedschaft oder mit einer Spende zu unterstützen. Viele betroffene sind durch diesen wertvollen Verein schon geholfen worden UND eine hervorragende und informative Zeitung gibt’s noch obendrauf,  nämlich Lymphe und Gesundheit. Nimmt euch etwas Zeit und schaut mal die Homepage an, ich danke jetzt schon für eure Unterstützung.

http://www.lymphverein.de/index.html   u n d

http://www.lymphwelt.de/


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Is the problem lymphoedema and its treatment or is it our knowledge?

 

Unglaublich, ich würde sofort um die Welt reisen um diesen Mann kennenzulernen , es muss doch langsam klar werden das alle gemeinsam arbeiten müssen damit etwas global bewegt werden kann. Hut ab Prof. Piller !

 

Editorial: Prof. Neil Piller , Neil Piller is Director Lymphoedema Research Unit, Department of Surgery, School of Medicine, Flinders University, Adelaide, South Australia, Australia.

 

Journal of Lymphoedema, 2014, Vol 9, No 1

Why do we struggle gaining recognition from patients and healthcare systems about the importance of the early detection of signs of lymphatic system failure, when we have tools available to do this? Why do we struggle getting funds for lymphoedema screening programmes, when we have strong indications they work? Why do we struggle with a serious lack of knowledge in the healthcare professional population when it comes to lymphoedema? Why do we see apparently contradictory outcomes reported in the literature in trials, systemic reviews and meta-analyses? Why don’t our healthcare systems seem to care ? So many questions. Maybe it’s us. Maybe its the words we use to describe lymphoedema as one form of chronic oedema. Maybe it’s the lack of — or relatively tight — funding available to undertake reasonably large clinical trials. Maybe we don’t collaborate closely enough, or maybe we just don’t know what to do and neither do the patients. Knowledge starts with education and, certainly, there is very little in medical courses focusing on lymphoedema. Vuong et al (2011) summarised findings from prior papers and discovered that about 50% of the Chairs in physiology departments at medical schools in the US indicated that 30 minutes or less are dedicated to lymphatics teaching with about 40% receiving 1–3 hours, while some only received 15 minutes. Incredibly, more than 60% thought this was sufficient! Furthermore, when lymphatic information was presented, it was only taught under the heading ‘lymphatic information’ 6% of the time. In the remaining 94% instances, it was presented in discussions relating to/as part of another of the bodily systems. So we have much to do in terms of enhancing knowledge then. How can we expect a GP or specialist to effectively deal with a patient presenting with lymphoedema with just this basic level of training? How can we ever expect them to gain an interest when they know so little about the lymphatic system and its disorders? There is significantly more information presented in the area of chronic oedema. Maybe, since lymphoedema is a form of chronic oedema, we could think about changing the term we use? However, on the negative side, we would then lose ‘lymphoedema’ as being associated with damage, malformation or destruction of the lymphatic system. We would also perhaps lose the ability to develop the area of lymphatics and lymphoedemas into a speciality area in the future. The origins of lymphoedema treatments (massage and compression) are many decades old and we are still discovering new things about the structure of the lymphatic system, with new imaging techniques, such as indocyanine green (Pan et al, 2008; 2013). Many treatments are undertaken based on information from trials that often were not conducted with as much control and rigour as they would be today. Trials often include a small sample size and can be heterogenous, leading, as could be expected, to differing or equivical outcomes that when read by practitioners, patients and healthcare system insurers are unlikely to instil confidence in many treatment or management strategies. Results from a recent trial, for example, showed no benefits from compression stockings for the prevention of lower-leg lymphedema after inguinal lymph node dissection (Stuiver et al, 2013), but perhaps the a priori criteria of effects were too high. As another example, a meta-analysis by Huang et al (2013) indicted little or no effect of even one of the mainstays of treatment — manual lymphatic drainage — while a systematic review and meta-analysis on pneumatic compression pumps for breast cancer-related lymphoedema showed that while intermittent pneumatic compression could alleviate lymphoedema, there was no significant difference between routine lymphoedema management with or without a pneumatic pump (Shao et al, 2014). So why this variation in outcomes and uncertainty about treatment? Many review authors indicate it is related to methodology issues and rigour but, more often, related to the study group size. The confusion and uncertainty can be unsettling, but must be dealt with. We can only do better for our patients by working together, combining resources and, therefore, having a stronger voice. I believe one step towards this can be made through our individual links to national and international groups, such as the International Lymphoedema Framework (ILF) and the International Society for Lymphology. At present, the ILF is working with its members and national frameworks to raise the profile of lymphoedema nationally and internationally, and to make lymphoedema a priority on national healthcare agendas. The ILF also aims to help clinicians lobby for appropriate funding or reimbursement for lymphoedema care; address inequality of provision issues; implement and evaluate lymphoedema services based on best practice; and create an international lymphedema community that collectively strives to improve the evidence base for treatment and professional practice.

References

Huang TW, Tseng SH, Lin CC et al (2013) Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol 11: 15

Pan WR, Suami H, Taylor GI (2008) Lymphatic drainage of the head and neck: anatomical study and clinical implications. Plast Reconst Surg 121(5): 1614–24

Pan WR, Wan D, Levy S, Chen Y (2013) Superficial lymphatic drainage of the lower extremity: anatomical study and clinical implications. Plast Reconst Surg 132(3): 696–707

Shao Y1, Qi K, Zhou QH, Zhong DS (2014) Intermittent pneumatic compression pump for breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. Oncol Res Treat 37(4): 170–4

Stuiver M, de Rooij JD, Lucas C et al (2013) No evidence of benefit from class II compression stockings in the prevention of lower limb lymphoedema after inguinal lymph node dissection; Results of a randomised controlled trial. Lymphology 46(3): 120–31

Voung D, Nguyen M, Piller N (2011) Medical Education: A deficiency or disgrace? Journal of Lymphoedema 6(1): 44–9

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