Evidence Update: Update on GA Tech Research at TurningPoint
LymphaTech Research Update Georgia Tech has been partnering with TurningPoint for a little over a year to research and develop a new low-cost, high-accuracy lymphedema measurement and monitoring tool using the Microsoft XBOX Kinect. To date, we have scanned over 120 TurningPoint patients, and the results we have collected so far are looking very promising. The LymphaTech volume and circumference measurements correlate well with those of the Perometer and support the use of modern 3D scanning technology for quantifying and tracking limb geometries. We are currently using the patient data collected from TurningPoint to build and refine the mathematical models and algorithms that will be used to compute the relevant clinical measurements. Our initial goal is to collect a data set of 200 patients to finalize the first version of the model, so we are well over half-way done! Excitingly, the work we have done thus far at TurningPoint has allowed us to apply for additional grants to expand the scope of our testing and the breadth of our applications. We have been able to increase the study to three additional clinical sites for patient testing, including the AVON Breast Center at Grady Memorial Hospital. We were also recently recruited to use the LymphaTech system as part of a Global Task Force and Bill and Melinda Gates Foundation project to treat and monitor lymphedema in developing countries worldwide. The research we have performed at TurningPoint has contributed to cutting-edge advances in the standard of lymphedema care and is making a global impact! Mike Weiler, Ph.D. Co-Founder and CEO, LymphaTec hational Science Foundation Graduate Research Fellow Georgia Institute of Technology
Evidence Update: Therapeutic Benefits of Massage during Chemotherapy
Benefits of Therapeutic Massage during Chemotherapy Patients with cancer commonly experience disease or treatment side effects, including pain, fatigue, nausea, and anxiety. An expanding body of literature supports the use of therapeutic massage as an adjunct to conventional therapies to manage these side effects. A recent research study examined cancer patients’ perceptions of pain, fatigue, nausea, and anxiety provided during chemotherapy. The study included 58 patients who were receiving chemotherapy and/or biotherapy. Patients had a choice of a 20-minute hand and/or foot massage by a licensed massage therapist while they received chemotherapy. There was a statistically significant reduction in each of the following variables: pain, fatigue, nausea, and anxiety following massage. Results demonstrated a high level of satisfaction with therapeutic massage as part of their care. In order to be controlled for bias, further research should include comparison to a control group that did not receive the massage. This study, however, contributes to the building body of research that documents the benefits of massage for cancer patients, during and after treatment. Robinson JG. Therapeutic Massage During Chemotherapy and/or Biotherapy Infusions: Patient Perceptions of Pain, Fatigue, Nausea, Anxiety, and Satisfaction. Clin J Oncol Nurs. 2016 Apr;20(2):E34-40.
Evidence Update: Financial Burden of Breast Cancer
The Financial Burden of Breast Cancer A recent study examined the financial impact of lymphedema following a diagnosis of breast cancer. Researchers in Australia surveyed 361 women who had either breast cancer without lymphedema (209 patients) or breast cancer with lymphedema (152 patients). The results showed that both breast cancer and lymphedema result in significant out-of-pocket financial costs borne by women during and after treatment. For breast cancer patients with lymphedema, 80% indicated that their breast cancer diagnosis had affected them financially compared with 67% of patients without lymphedema. For patients with lymphedema, 56% indicated that lymphedema affected them financially and that costs increased with lymphedema severity. The cost of compression garments formed a large proportion of these costs, as well as attendance at physical therapy and treatment of cellulitis in patients with more significant lymphedema. Researchers noted the significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors. While this study was conducted in Australia, it applies equally to breast cancer patients in the United States. Insurance often does not cover compression garments and patients face significant out-of-pocket costs for therapy to treat lymphedema. The cost for management goes up when lymphedema is more significant. The education and surveillance for early detection offered to all our patients by TurningPoint helps maintain lymphedema, when it occurs, at as low a level as possible. This reduces the physical, emotional and financial impact of the condition. TurningPoint also reduces barriers to lymphedema care by providing financial assistance for treatment and garments for patients in financial need. Boyages J et al. Financial cost of lymphedema borne by women with breast cancer. Psycho-oncology. 2016 Aug 1. doi: 10.1002/pon.4239. [Epub ahead of print] Â
Evidence Update: Joint Pain and Aromatase Inhibitors
Joint Pain and Aromatase Inhibitors Aromatase inhibitors (AIs) have now been established as successful adjuvant therapy for breast cancer survivors who are post-menopausal and whose cancer is estrogen-receptor-positive. These include anastrozole (Arimidex), letrozole (Femara) and exemastane (Aromasin). Unfortunately, nearly half of women taking AIs report joint pain, or arthralgia. It is estimated that 20-30% of patients discontinue AI treatment due to joint pain. The pain and/or stiffness is usually symmetrical (i.e., on both sides) and often affects hands, feet, knees, hip and back. In a recent publication, researchers searched for and evaluated studies that examined the effect of several different ways of managing arthralgia related to AIs. Five types of interventions were identified that have been studied: pharmacological (drug) approaches, acupuncture, nutritional supplementation, relaxation techniques and physical exercise. Pharmacological approaches, including duloxetine (Cymbalta), immunotherapy and changing between AI options showed promise in relieving arthralgia symptoms. Acupuncture was promising in reducing pain in four studies. Two studies showed a possible positive impact of Yoga and Tai Chi on AI joint pain, function and quality of life. Several studies looked at exercise, primarily walking, and found a trend to decreasing pain with exercise, but this decrease was not statistically significant. Bottom Line: There may be several approaches to managing AI-related joint pain. Your medical oncologist will be helpful in choosing what is right for you. Acupuncture, yoga and tai chi appear to be helpful. Exercise, such as walking, shows promise in helping manage AI pain, but further study is needed. Keep in mind, that there are many other benefits of regular exercise for breast cancer patients (see this month’s nutrition section!). Consider joining us for this month’s education event ‘Bones, Joints and Breast Cancer’ and don’t forget that TurningPoint has a weekly Yoga class! Yang GS, et al. Interventions for the Treatment of Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Cancer Nurs. June 21, 2016. [Epub ahead of print]
