Physical Medicine and Rehabilitation Specialist Assoc. Dr. Dilek Eker Büyükşireci said that if lymphedema is not intervened, its treatment becomes extremely difficult in advanced stages and the chance of success decreases.
Breast cancer draws attention as the most common type of cancer in women. While early diagnosis of this type of cancer saves lives, general surgeons, oncologists, radiation oncologists and physical medicine and rehabilitation (PMR) specialists work as a team in the follow-up of patients. Assoc. Dr. Dilek Eker Büyükşireci, one of the doctors of Medicana Health Group, emphasized that FTR is very important in breast cancer treatments and gave warnings.
“If intervention to lymphedema is delayed, treatment becomes difficult”
Emphasizing that early diagnosis as well as early intervention is very important for treatment, Medicana International Samsun Hospital Physical Medicine and Rehabilitation Specialist Assoc. Dr. Dilek Eker Büyükşireci said, “Early diagnosis saves lives in breast cancer. Not only early diagnosis, but also the quality of life of these patients increases significantly with the treatment they will receive in the early period and the risk of problems that may develop due to breast cancer is minimized. It should not be forgotten that physical medicine and rehabilitation specialists are part of the team along with the general surgeon, oncologist and radiation oncologist in the follow-up of patients with breast cancer. In patients diagnosed with breast cancer, especially after surgery, patients should avoid movement of the arm on the side of the removed breast tissue. Again, in these patients, the axillary web syndrome, which may develop due to the removal of axillary lymph nodes, can be seen as a tense band under the armpit and restricts shoulder movements. In both of these cases, it becomes difficult to position the arm especially during radiotherapy and the radiotherapy process of the patients is negatively affected. In these patients, a feeling of heaviness and swelling in the arm may develop due to the spread of cancerous cells to the lymph nodes, removal of the lymph nodes during surgery or radiotherapy to the lymph nodes. This condition is called lymphedema. Lymphedema, which can be seen in patients with breast cancer, can be treated if detected in the early stages, and even before breast surgery, the development of lymphedema can be prevented by evaluating the patients by a physical medicine and rehabilitation specialist and taking the necessary precautions. If lymphedema is not intervened, unfortunately, its treatment becomes extremely difficult in advanced stages and the chance of success decreases.”
“Physical medicine and rehabilitation can be effective against osteoporosis and pain”
Stating the importance of physical medicine and rehabilitation for the comfortable life of patients undergoing breast cancer treatment with the treatment of physical medicine and rehabilitation specialists, Assoc. Prof. Dr. Dilek Eker Büyükşireci said, “It is extremely important to keep vitamin D levels at high levels, especially in patients with breast cancer. It is recommended to supplement vitamin D levels by checking vitamin D levels in the blood, both in terms of cancer prevention and recurrence prevention and in terms of protecting bone health. Since these patients are predisposed to osteoporosis (osteoporosis), especially due to hormonal therapies, it is extremely important for these patients to consult a physical medicine and rehabilitation specialist for bone health. In addition, due to some chemotherapy drugs, damage to the nerve endings may occur in patients with breast cancer and our patients may face complaints of numbness, burning and felting in the hands and feet, which we call neuropathic pain. With some drug treatments or physical therapy applications to be applied to these patients, we can provide significant relief in our patients.”
“Cellulitis may occur in patients with lymphedema”
Mentioning that cellulitis can cause skin infections by leaking the lymphatic fluid called lenfore, which may develop in patients with lymphedema, Assoc. Prof. Dr. Büyükşireci said, “All patients diagnosed with breast cancer are examined by a physical medicine and rehabilitation specialist after the diagnosis and various recommendations are made for postoperative exercises, skin care and prevention of lymphedema. After the surgery; the musculoskeletal problems that occur are treated, patients with high risk of lymphedema are given lymphedema massage that they can do at home and, if necessary, compression garments and the patient is followed up for lymphedema. If lymphedema develops in the process, manual lymphatic drainage treatment and multilayer bandaging is performed by a physiotherapist under the control of a physician, and then followed up with a pressure garment. Patients with lymphedema should definitely be under the follow-up of a physical medicine and rehabilitation specialist physician at regular intervals, as the leakage of lymphatic fluid called lymphorrhea, which may develop in patients with lymphedema, may cause skin infections called cellulitis. With or without lymphedema, it is recommended that our patients with breast cancer protect the arm on the side of the breast that has undergone surgery, pay attention to nail care on that hand, prevent ingrown nails, do not have blood drawn from that arm if possible and do not measure blood pressure. It is also extremely important not to do heavy work with that arm and not to lift weights. Let's not forget that we can increase patient success with a multidisciplinary approach in the fight against breast cancer. Since it is the most common cancer in women, we cannot ignore the musculoskeletal system problems of patients with breast cancer.”
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