Original Title: Traitement du lymphoedème secondaire lié au cancer

Authors' objectives: The Direction de la lutte contre le cancer (DLCC)2 asked AETMIS (now INESSS) to conduct a systematic literature review on the best management of cancer-related secondary lymphedema. This document addresses mainly the efficacy of the different therapeutic procedures. It also presents an exploratory study of the costs associated with the clinical management of secondary lymphedema.

Authors' recommendations: 1. All patients with or at risk for cancer-related secondary lymphedema should be properly informed.An initial mode of information should be established before any cancer procedure and repeated upon hospital discharge. Standardized information should be provided in educational brochures indicating the risks, signs and symptoms of lymphedema, basic hygiene and safety measures, benefits of achieving or maintaining a healthy weight, advisable exercises, and a service point responding to emergencies.2. All health professionals involved in managing patients at risk for cancer-related secondary lymphedema should be given complete information on diagnosis, prevention and the various therapeutic options available, and they should be able to refer these patients to the appropriate resources when necessary.This information should be provided before, during and after the cancer-treatment phase by cancer surgeons, hemato-oncologists, radiation therapists and care teams, including pivot nurses, dietitians, social workers and psychologists. In addition, family physicians should be properly informed of the risks of lymphedema onset, basic hygiene and safety measures, and available community resources.This therefore involves a comprehensive continuing medical education program in which the federations of general practitioners and specialists concerned should participate in collaboration with the Collège des médecins. A similar initiative should be undertaken with the professional orders concerned and interdisciplinary cancer teams.3. Providers of physiotherapy, massage therapy and any other applicable therapy should be duly trained in manual lymphatic drainage techniques specific to lymphedema treatment (Vodder or Leduc technique, etc.) and in techniques for applying multi-layered low-stretch compression bandages.4. A committee of expert clinicians should be formed to establish the best lymphedema management practices for Québec and to develop a program offering a continuum of integrated follow-up care and including the designation or establishment of service points accessible in all the regions of Québec. If such a program were to be developed, consideration should be given to the possibility of including patients with primary lymphedema or with secondary lymphedema unrelated to cancer (due to other surgical procedures or to severe venous problems).This committee, under the responsibility of a government cancer organization, should gather multidisciplinary experts in the field to develop evidence-based consensus statements on:available therapeutic options for the best cancer treatments that also decrease the risk of lymphedema;standardized diagnostic criteria for lymphedema and the choice of a measurement instrument;all preventive measures applicable to at-risk patients in order to prevent or delay the onset of lymphedema;the best therapeutic measures to control lymphedema in Québec;emerging therapeutic approaches, especially liposuction, lymph node transplantation and lymphovenous anastomosis.5. The ministère de la Santé et des Services sociaux, acting through the Direction québécoise du cancer (formerly Direction de la lutte contre le cancer), should examine modalities for the public health insurance plan to cover the costs associated with the different treatment phases of cancer-related secondary lymphedema.

Project Status: Completed

Year Published: 2011

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/traitement-du-lymphoedeme-secondaire-lie-au-cancer.html

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: <p>L'Institut national d'excellence en sante et en services sociaux (INESSS)</p>