The survival rate for breast cancer, the most commonly diagnosed cancer among women, is now about 90 percent, increased by nearly 20 percent since the 1970s.
With more women than ever — nearly 3 million — living beyond a breast cancer diagnosis, professor Mary Fisher is looking to decrease arm impairments and other complications that can persist — or even develop — many years after diagnosis.
Surgical removal of lymph nodes places women at risk for a chronic condition called lymphedema, which causes swelling in a person’s limbs. Lymphedema affects anywhere from 10 percent to 30 percent of women, depending on the type of surgery and radiation treatment received.
"The amount of radiation that women receive during radiation therapy is less than for women treated years ago but still remains problematic," said Fisher. "While radiation is often lifesaving, it comes with serious side effects: the tissues in the area exposed to radiation become stiffer and thickened over time."
As tissues stiffen, women can experience a loss of motion, which can limit their ability to participate in sports, complete work or household chores and even their abilities to shower and dress. It can affect what may seem like simple things, such as fitting into a long-sleeved blouse or blazer, Fisher explained.
Many of these side effects can either be prevented or managed effectively, but only if they are addressed in a timely fashion. One model of care, with substantial evidence of effectiveness, is the Prospective Surveillance Model. This method advocates for baseline testing prior to cancer surgery, with follow-ups after the surgical and medical treatments take place. By completing baseline testing, any deficits that might hinder effective medical treatment — such as being able to assume the position necessary for radiation — can be addressed prior to cancer treatment. And the measures taken at this visit become the benchmark that aftercare visits are measured against.
Exercise and physical therapy also play an important role in treating side effects that arise after treatment.
"Multiple studies have investigated the safety of physical activity after breast cancer treatment and found there is minimal risk for the development of lymphedema with most exercise," said Fisher. "With 2.8 million women living beyond a cancer diagnosis in the United States, returning to previous activity levels is important. Early intervention and ongoing surveillance promoted by the Prospective Surveillance Model ensures that these women can get back to what is important to them — living."