Navigation Links
Lymphedema Raises Cost of Breast Cancer Care

Painful swelling can require treatments for infections and depression

TUESDAY, March 17 (HealthDay News) -- In breast cancer survivors, lymphedema -- an uncomfortable swelling of the arm and wrist -- can be one of the most vexing side effects of treatment.

Now, a new study has found that women who develop lymphedema fare worse than women without the condition and have higher out-of-pocket medical costs after radiation and surgery.

Breast cancer survivors who develop lymphedema report a lower quality of life, higher levels of anxiety and depression, an increased likelihood of chronic pain and fatigue and greater difficulty functioning socially and sexually, according to a study in the March 16 online issue of the Journal of Clinical Oncology.

Lymphedema also boosted two-year, postoperative medical costs by $14,877 to $23,167, the study found. The additional cost came from office visits, treatments for infections and mental health services, including prescriptions for antidepressants.

One reason for higher out-of-pocket costs: Insurance companies don't always fully cover lymphedema treatments, which can include compression garments and specially trained therapists who provide massages and physical therapy to help the area drain, said Ya-Chen Tina Shih, an associate professor of health economics at the University of Texas M.D. Anderson Cancer Center, in Houston, and an author of the study.

Although federal regulations and about 21 states require private insurance to cover lymphedema treatments after mastectomies, the laws are not specific about what constitutes lymphedema treatment and insurance companies have wide latitude in determining benefit levels, Shih said.

"Right now, it's really up to insurance companies' interpretation for what is appropriate lymphedema treatment," Shih said.

Lymphedema is caused by a buildup of lymphatic fluid, usually as a result of damage to the lymphatic system from radiation or surgery. Melanoma and cancers of the head, neck and pelvic area can also leave people susceptible to the condition, said Dr. Brian Lawenda, clinical director of radiation oncology at the Naval Medical Center in San Diego and a lieutenant commander in the U.S. Navy.

To some breast cancer survivors, lymphedema, which can develop years after radiation and surgery, is as distressing as the initial breast cancer diagnosis, the study found.

Using medical claims information on 1,877 women, researchers found that 10 percent sought treatment for lymphedema. However, that was probably an underestimate of the true incidence, Shih said, because there is no standard definition for lymphedema, doctors may not list lymphedema as a reason for the office visit and not all women seek treatment.

Previous research has shown that up to 50 percent of breast cancer survivors develop lymphedema, with 32 percent having persistent swelling three years after surgery, according to the study.

"It's a terribly overlooked problem," said Robert Smith, director of cancer screening for the American Cancer Society. "Many of these women have significant out-of-pocket expenses, and prolonged and chronic health problems, as a result of it. It's not curable, and once women have lymphedema, unless it's properly managed and treated, it can become progressively worse."

While some have mild cases, for others, the swelling can lead to loss of motion in the affected arm, cysts, skin thickening and infections such as lymphangitis, a bacterial infection of the lymphatic vessels, or cellulitis, an inflammation and infection just below the surface of the skin.

About a third of people with lymphedema get infections, which occur because the fluid backup inhibits the immune system's response, Lawenda said.

The study found that women in the western United States were more likely to have filed lymphedema-related insurance claims than those in the Northeast. Women in all regions of the country probably suffer from the condition equally, Shih said, but more states in the West have passed laws requiring insurance companies to cover treatments.

Standard treatments include keeping the skin clean and moisturized, being careful when clipping nails, wearing compression sleeves to prevent swelling, doing therapeutic exercises and having massage to promote manual lymphatic drainage, Lawenda said.

"It is a condition that's not curable," he said. "However, it is manageable, treatable and will improve."

More information:

The American Cancer Society has more on lymphedema.

SOURCES: Ya-Chen Tina Shih, Ph.D., associate professor, health economics, University of Texas M.D. Anderson Cancer Center, Houston; Robert Smith, Ph.D., director, cancer screening, American Cancer Society, Atlanta; Brian Lawenda, M.D., clinical director, radiation oncology, Naval Medical Center, San Diego; March 16, 2009, Journal of Clinical Oncology, online

Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Vascular Experts Call for Increased Awareness of Growing Problem of Lymphedema
2. Obesity increases lymphedema risk for breast cancer survivors
3. Know Your L-Dex(TM) (Lymphedema Index) Awareness Campaign Attracts Large Numbers of Breast Cancer Survivors at Komen Race for the Cure(R) Events
4. MU study identifies patient strategies for managing symptoms of lymphedema
5. Association for the Advancement of Wound Care Leads World Health Organization Initiative to Establish Guidelines for Wound and Lymphedema Care
6. New study shows positive role physical therapists play in lymphedema diagnois and treatment
7. M. D. Anderson nurse addresses lymphedema in breast cancer patients and survivors
8. Preoperative assessment of cancer patients enables early diagnosis, treatment of lymphedema
9. Hormone may be new drug target for preventing lymphedema, tumor spread
10. Hormone Could Ease Painful Lymphedema
11. DaVita Raises Awareness on World Kidney Day
Post Your Comments:
Related Image:
Lymphedema Raises Cost of Breast Cancer Care
(Date:11/26/2015)... ... November 26, 2015 , ... ... located in central Michigan, have come together on Thanksgiving Day to share the ... available for viewing on the Serenity Point YouTube channel, patients displayed what they ...
(Date:11/26/2015)... and Cambridge, ON (PRWEB) , ... November 26, ... ... the availability of a real-time eReferral system for diagnostic imaging in the Waterloo ... X-rays, mammography, BMD and Nuclear Medicine tests directly from their electronic medical record ...
(Date:11/26/2015)... ... November 26, 2015 , ... ... to discuss bioavailability and the need to integrate dose form selection in early ... with OBN, the membership organization supporting and bringing together the UK’s emerging life ...
(Date:11/26/2015)... ... 2015 , ... PRMA Plastic Surgery is updating their record books yet again ... free flap breast reconstruction surgery! , “What an accomplishment for the PRMA team, says ... and it’s an honor to have served all of these women.” , PRMA is ...
(Date:11/26/2015)... Viejo, CA (PRWEB) , ... November 26, 2015 ... ... users a new set of retro-fused, self-animating trailer titles with ProTrailer: Vintage. This ... style options. These classically-influenced trailer titles work with any font, giving users limitless ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... , Nov. 25, 2015  Linden Care, LLC, a ... treatment outcomes for patients suffering from chronic pain, said ... a Temporary Restraining Order (TRO) enjoining Express Scripts from ... companies. --> --> ... of its legal options. --> ...
(Date:11/25/2015)... USA , Inc., a leader in ... accuracy of its blood glucose meter systems. Last week ... Cardiovascular Disease in Los Angeles , ... 01 meter and the Assure ® Prism multi-user ... measure glucose levels in blood is essential for people ...
(Date:11/25/2015)... 25, 2015 Allergan plc (NYSE: AGN ) ... New York State Attorney General,s Office ... Act, and other statutes with the Attorney General over the ... cease marketing and selling the now generic version of memantine ... no liability, has released its counterclaims against New ...
Breaking Medicine Technology: