Screening

 

Why screen for lymphoedema?

We know that some medical cancer treatments, such as chemotherapy, surgery and radiotherapy mean that people are at high risk of developing lymphoedema. The risk can be as high as 40% after some treatments. We also know that early supermicrosurgery can prevent the appearance of lymphoedema, meaning that the problems associated with lymphoedema can be avoided. Similarly, if you wish to opt for a non-surgical treatment, early management with compression can help prevent progression and irreversible changes, such as fibrosis and fat hypertrophy. However, not everyone who has high risk cancer treatments to lymph nodes will go on to get lymphoedema. We wish to avoid unnecessary treatment so treating everyone to prevent lymphoedema is not the answer. We believe that screening for the early changes of lymphoedema and only performing supermicrosurgery when these changes appear offers the best balance between early, targeted intervention and avoiding unnecessary operations. Most patients develop lymphoedema within the first three years after cancer treatment, so we believe screening should be focused in this time window.

How do we screen for lymphoedema?

Indocyanine green (ICG) lymphography is an ideal method of screening for early changes of lymphatic dysfunction before the distressing symptoms of lymphoedema have occurred. Studies have shown that ICG lymphography can effectively identify those patients who will go on to get significant lymphoedema. Furthermore, early supermicrosurgery has been shown to cause regression of the signs of lymphatic dysfunction and to prevent the development of clinical lymphoedema.

What is the Oxford Lymphoedema Practice Screening Programme?

At the Oxford Lymphoedema Practice we offer the UK’s first ICG lymphography lymphoedema screening programme. We will offer you an appointment three months after completion of your cancer treatment for an initial consultation and ICG lymphography scan. If the scan is normal, we will then repeat the scan every six months for a further three years to ensure that lymphoedema is detected before the patient is aware of the symptoms. If early signs of lymphoedema are seen on the ICG lymphography, you will be given the opportunity to discuss supermicrosurgery for the prevention of lymphoedema with one of our experienced surgeons. Early surgery can catch lymphoedema before the debilitating swelling of the limb has even started. Using this innovative screening program we aim to completely prevent lymphoedema following cancer treatment.

Please click on the leaflet below to download a pdf.

Normal linear lymphatic channels seen on ICG lymphography

Early dermal backflow changes can be detected before swelling occurs

Dermal backflow progresses as swelling develops and lymphoedema worsens