New Review Data on Low Level Laser Therapy
I just received an email from Bob Weiss this morning with new review data on use of the low level laser for LE therapy. There is a PDF available for download on the page at the link below.
http://www.springerlink.com/content/w6r057582t225735/
I have not yet read the full text PDF document but here is the abstract:
A systematic review of the effect of low-level laser therapy in the management of breast cancer-related lymphedema
Purpose: The purpose of this study was to review the effect of low-level laser therapy (LLLT) in the management of breast cancer-related lymphedema (BCRL).
Methods: A systematic review of seven databases for clinical trials for LLLT in the management of BCRL published between 1990 and 2011 was performed.
Results: A total of eight studies on 230 patients were found. The methodological qualities of the selected studies were assessed with the Physiotherapy Evidence Database scale, and the studies were categorized according to Sackett's levels of evidence. Five studies were graded at evidence level II. Two studies were graded at evidence level III, and the remaining study was graded at evidence level V.
Conclusions: There is moderate to strong evidence for the effectiveness of LLLT for the management of BCRL from five small studies of acceptable methodological quality. A dose of 1-2 J/cm2 per point applied to several points covering the fibrotic area can reduce limb volume following BCRL. Further well-designed, large-scale studies are required to determine more precisely how effective LLLT may be in BCRL.
Comments
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Interesting.
Thanks for sharing, LindaLou!
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Linda, my concern about the use of laser therapy for my lymphedema is that I don't think anyone knows what it might due to a quietly nestled tumor cell in the area. It doesn't seem like a good idea to dose one of those with some outside energy I've never heard of any study looking at longterm risk of recurrence with this therapy.
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Has this been done in the US yet ?
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The University of Michigan is offering this treatment now - has anyone had it?
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Purple, this one is for you. Tell me what you think...if anyone else has any info, please chime in. I don't qualify yet. Still under rads n not 2 cm, but in case
http://www.cancer.gov/clinicaltrials/search/view?cdrid=700475&version=HealthProfessional&protocolsearchid=11546020
Is this trial risky? -
Denise and cookiegirl, as Outfield points out above, there has been no study looking at the potential for collateral damage from laser treatment of breast cancer-related lymphedema. There is concern that the laser stimulates the growth of cancer cells, so that stray cells in the treated area could be affected, but no study has yet tracked that.
It's what these laser studies are NOT looking at that's worrisome. There are a lot of studies about laser treatment loosening up range of motion for several diagnoses, and as LindaLou's post mentions, there are some small studies that indicate that volume reduction occurs over the short term. But there's no indication that the reduction is maintained over time, and many women have reported that the laser "stopped working" for them.
But what's really worrisome is that no one has looked long term at the rates of either bc recurrence (laser effect on stray cancer cells) or RIBP for those women who have previously had high-dosage rads. If you don't look, you won't see. Also, of course, there are no longer-term studies showing mainenance of volume loss with continued usage.
Medical trials are often risky by their very nature, Cookiegirl, but all of us have benefitted from the courage (and perhaps the desperation) of women who have signed on to bc trials of drugs and other treatments. Of course some studies are riskier than others, and some are better set up to keep risks as low as possible. In the case of the study you're considering, they say they're looking at the long term effectiveness of laser treatment on LE, but I don't see anywhere that indicates they're also looking at long-term bc recurrence rates or the development of RIBP in those women who might be susceptable to it.
So, brava to those women who volunteer to try new treatments in studies, and brava to the researchers who look at the bigger picture and question closely the long-term safety of the tests they're doing.
Be well!
Binney -
Binney4 - thanks for your input. I was considering it, but that stray cancer cell thing made sense to me. I will wait for more studies and more info before considering it. Denise
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Hi cookiegirl1....my cookie twin
good to see something else in the works!
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Cookiegirl
I actually would not qualify as my LE is even more minor than what the criteria calls for ( currently) but not having radiation, I would be VERY concerned about Binney's comment:
"There is concern that the laser stimulates the growth of cancer cells, so that stray cells in the treated area could be affected, but no study has yet tracked that."I already live with the <incr+> worry of stray cells not hit by rads. I really wouldnt want to do anything to encourage growth. Binney make a good point regarding courage and desperation. Let me first say that I applaud the brave ladies who have gone before us in many studies.
Having said that, I have to think that if I were desperate , with a severe case of LE, I would be much more inclined to go to NY and risk those stray cells !
At this juncture, it sounds like a pick your posion :>( -
Bake sale anyone? Binney and purple TY. I will fill you in on what happened today on the Nervous thread in a while. GREAT NEWS!!! Just have to finish cooking dinner. I am baking bread right now too. Got the name cookiegirl from my BS receptionist. I bake when under stress, and bring assorted baked goods to all my docs and staff. Needless to say, I have been baking a lot lately. Don't forget this Saturday is Doctor Appreciation Day. Cheesecake for RO. I hope they all get fat!!!
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Cookie
If you are interesting in baking, you will have to team up with Carol57...she is our breadbaking queen! :>)
Either way, you would have many happy to do the smelling and the eating.
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