HMC Offers New Options for Treating Lymphedema

HOLYOKE — While the treatment of cancer has advanced significantly over the past few decades, it remains an arduous path for oncology patients. So it’s important for medical staff to not only alleviate any side effects, but also make follow-up appointments as easy as possible. Holyoke Medical Center has announced major steps in doing both.

One of the side effects of cancer surgery and radiation may be damage to the lymph nodes. The lymphatic system is an integral part of the body, serving several functions, not the least of which involves the body’s immune system. This is one reason why patients undergoing radiation therapy are often at a higher risk for infection.

Julé Sherman was recently certified in lymphedema therapy. Sherman, an occupational therapist at HMC, completed an intensive course in January, giving her, and the hospital, additional tools to combat serious side effects of cancer treatment. She also treats lymphedema stemming from a wide variety of other conditions.

Lymphedema is a chronic condition in which excess fluid accumulates in the tissue, causing swelling. When the lymphatic system is unable to keep the lymph moving properly, it builds up. Because lymph removes bacteria and helps fight infection, lymphedema left untreated can lead to serious complications.

Sherman treats lymphedema through a special technique of gentle, rhythmic massage, which stimulates the flow of lymph. She then applies compression garments or bandaging to enhance the pumping action of the lymph vessels by providing increased tissue pressure. In this way, the compression encourages lymphatic flow and also aids in softening fluid-swollen areas.

From her experience as an occupational therapist and a certified hand therapist, Sherman became intrigued with how to work with chronically swollen areas.

“In my work with hands, I’ve dealt with a lot of swelling, which can impede treatment,” she said. “So I became interested in effective methods to reduce swelling.”

Sherman also educates patients on skin care and self-massage as well as exercises that promote lymph flow. She noted that proper skin care is crucial, as even the smallest cut could lead to infection when the lymphatic system is compromised.

While many cancer patients may suffer from lymphedema, it occurs most often in those treated for breast cancer. This is because, during surgery for breast cancer, physicians remove at least one lymph node from the underarm area to see if the cancer has spread. When lymph nodes are removed, the lymph vessels that carry fluid from the arm to the rest of the body also must be taken out because they are wrapped around the nodes.

This removal alters how lymph fluid flows in the upper body, making it harder for fluid to flow out of this area. If the remaining lymph vessels cannot drain enough of the fluid, the excess builds up and causes swelling.

Radiation treatment to the lymph nodes in the underarm can also affect the flow of lymph fluid in the arm and breast area, further increasing the chance of lymphedema.

Sherman works closely with the Oncology Department. Maureen Nomakeo, the nurse manager of the Oncology Department, said that Sherman’s certification in this area adds a whole new component to patient care.

“It means we now won’t have to refer lymphedema patients to other facilities,” she said. “We can keep everything in the same place for patients, which will be less stressful for them.”

Nomakeo added that some lymphedema treatment centers have six-month waiting lists, but with Sherman being certified, Holyoke Medical Center patients will also have quicker treatment, as well as a more convenient place to go. “It saves them a step and creates less of a hassle for patients,” she said.

To contact Sherman, call HMC’s Occupational Therapy Department at (413) 534-2555.