University of Pittsburgh starts early screening for LE

Binney, Atila is a woman, and she published the study on 17 patients, using the laser--she's the one University site listed on the Rian list, so I'd emailed her. Her results were not impressive, and we couldn't believe she got a study of 17 patients published--talk about under-powered.

So, she likes technology developed by Australians, and while the laser stuff is not appreciated: still loving Andrea Cheville's slide at the NLN:

"Even if the laser has tissue effects: SO WHAT??" 

Andrea Cheville made a compelling case that no study proves that the laser works, and adopting it would divert resources from modalities, like CDT, that do work.

Here's the Soran study:

http://www.ncbi.nlm.nih.gov/pubmed/20445997

The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema.

Dirican A, Andacoglu O, Johnson R, McGuire K, Mager L, Soran A.

Department of Surgery, Division of Surgical Oncology, Magee-Womens Hospital University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Abstract

BACKGROUND: Breast-cancer-related lymphedema (BCRL) is a chronic disease, and currently there is no definitive treatment for it. There are some therapeutic interventions targeted to decrease the limb swelling and the associated problems. Low-level laser therapy (LLLT) has been used in the treatment of post-mastectomy lymphedema since 2007 in the US. The aim of this study is to review our short-term experience with LLLT in the treatment of BCRL.

METHOD: Seventeen BCRL patients referred to our lymphedema program between 2007 and 2009 were enrolled in this study. All patients had experienced at least one conventional treatment modality such as complex physical therapy, manual lymphatic drainage, and/or pneumatic pump therapy. LLLT was added to patients' ongoing therapeutic regimen. All patients completed the full course of LLLT consisting of two cycles. The difference between sums of the circumferences of both affected and unaffected arms (DeltaC), pain score, scar mobility, and range of motion were measured before and after first and second cycles of LLLT sequentially.

RESULTS: All patients were female with a median age of 51.8 (44-64) years. DeltaC decreased 54% (15-85%) and 73% (33-100%), after the first and second cycles of LLLT, respectively. Fourteen out of seventeen experienced decreased pain with motion by an average of 40% (0-85%) and 62.7% (0-100%) after the first and second cycle of LLLT, respectively. Three patients had no improvement in pain after LLLT. Scar mobility increased in 13 (76.4%) and shoulder range of motion improved in 14 (82.3%) patients after LLLT. One patient developed cellulitis during LLLT.

CONCLUSION: Patients with BCRL received additional benefits from LLLT when used in conjunction with standard lymphedema treatment. These benefits include reduction in limb circumference, pain, increase in range of motion and scar mobility. Additionally, two cycles of LLLT were found to be superior to one in this study.

PMID: 20445997 [PubMed - as supplied by publisher]

Unimpressive, 17 patients over two years, who had various treatments, and followed for how long?

Sorry, this is what happens when I'm not closely reading the details: I'm sure she's not misquoted, as she was very excited about her study when she emailed me: I emailed back my concers--no reply!

Kira

Thank you Linda! I was watching the youTube ones, and the links are great!

Sounds like you had a great holiday.

I only watched the first lecture, so I'll do the hour--have you watched them?

Kira

Michelle, the L-Dex measures fluid in the tissues, and the company says it should not be used to diagnose lymphedema. I heard a lecture on it at the NLN conference, and it's most sensitive use is with mulitple readings.

http://www.impedimed.com/products/l-dex-u400/

L-Dex® U400
ImpediMed's L-Dex® technology utilizes the characteristics of frequency dependent current flow to quantify changes in extracellular fluid in the patient's limb. These changes can assist the surgeon or oncologist in clinically assessing early signs of lymphedema. The L-Dex technology is specific for extracellular fluid and is unaffected by changes in the patient's weight due to a change in fat mass or muscle mass. As fluid accumulates, the L-Dex value increases on the scale. The L-Dex number provides an instant tool for assisting in the clinical assessment of lymphedema progression as well as an easy way to track change in the patient over time.

L-Dex values for a normal patient without lymphedema will fall in the range of -10 to +10. The presence or absence of lymphedema is assessed by comparing the patient's L-Dex test to this range and to their past L-Dex tests.

Note: This device is not intended to diagnose or predict lymphedema of an extremity.

Note: L-Dex® values that lie outside the normal range may indicate the early signs of lymphedema and values that have changed +10 L-Dex units from baseline may also indicate early lymphedema. The L-Dex scale is a tool to assist in the clinical assessment of lymphedema by a medical provider. The L-Dex scale is not intended to diagnose or predict lymphedema of an extremity.

So, it has limitations, and multiple readings are the best use of it--Mei Fu PhD used it in her research and found it insensitive, so she got a perometer (very, very expensive.)

I only had three nodes removed, and a lumpectomy--so statistically my risk was low, but I got lymphedema three weeks out of surgery, and it never resolved.

It's great that your number was low, but it's even better that you received information before surgery.

Hope you never join the "swell club"

Kira