Hospitals told of cancer risk

By MARTIN JOHNSTON

Some leading hospitals lack early treatment services for women suffering a common complication of breast cancer treatment.

Up to a third of patients develop lymphoedema in the arm adjacent to the affected breast.

It is a swelling that can occur at any time after treatment, and can lead to restricted arm function, reduced earning power, poor body image and recurrent infections.

Between 300 and 500 new cases are diagnosed each year in New Zealand.

"The fear of developing lymphoedema in an arm is second only to the fear of having a breast cancer recurrence," says Palmerston North breast surgeon Colin Wilson.

Physiotherapy as part of a comprehensive early treatment service was highly effective and could avoid hospital admissions, said Mr Wilson.

The therapy reduced swelling and discomfort and allowed a return to near-normal arm function.

His own hospital provided this service, but some major hospitals, including Middlemore, did not.

"The key to successful management is patient education, early recognition and prompt referral to a lymphoedema therapist. Early treatment is easier and much more likely to have a good outcome."

The risk of developing lymphoedema relates to the extent of breast cancer-related armpit surgery, which may reduce in future using a technique, now being tested on patients, to diagnose more accurately the spread of cancer to lymph nodes.

Middlemore breast surgeon Professor John Collins said the Auckland region lacked a co-ordained lymphoedema service, although there was a limited service at North Shore and Auckland Hospitals.