Sheila Ridner, M.S.N. helps study participant Mazo Freeman put a compression garment on her arm to help reduce the swelling from lymphedema and prevent further damage. In some patients, the compression sleeve has to be worn all day. Freeman has been diagnosed with lymphedema in her left arm. (photo by Dana Johnson)
Nursing doctoral student researching symptoms associated with lymphedema
A Ph.D. candidate in the School of Nursing has been awarded a training grant from the National Institutes of Health (NIH) to investigate the physical and psychological symptoms associated with lymphedema caused by treatment for breast cancer.
Sheila Ridner, M.S.N. is the primary investigator of a comparison study looking at 64 people who have been treated for breast cancer and have been diagnosed with lymphedema, and 64 breast cancer survivors who don’t have the condition.
Patients enrolled in the study are asked a series of questions about physical, emotional, and quality-of-life issues.
“I am looking at symptom clusters associated with the swelling,” Ridner said. “Women tell us that they can experience pain, disturbed body image, it may interfere with their sex lives, it may interfere with their job.”
Ridner’s mother has lymphedema, which is partly what motivated Ridner to focus her dissertation on the condition.
“She plays the piano, and when her arm is really swollen the fine motor movement in her fingers is pretty much gone,” she said.
Ridner says it can be a devastating issue for many patients. “Women who have it often tell you it’s far worse than having had breast cancer, and that’s a pretty serious statement,” said Ridner.
Lymphedema is the accumulation of fluid in the arm on the same side in which a patient was treated for breast cancer.
“It is not a condition that is caused by a problem in surgery or radiation; this is just a problem that is a result of current methods of breast cancer treatment,” Ridner added. “It damages the lymphatic system. A lymphatic system that has been damaged by breast cancer treatment may not be able to move that fluid out.
“We don’t know why about 70 percent of people don’t get lymphedema and about 30 percent do. There is no clear answer as to what pushes you into the 30 percentile.”
All women participating in the trial will have their arms examined, and the fluid in the affected arm will be measured using a lymphometer. The lymphometer works by placing electrodes on the patient’s hand and foot to determine the amount of fluid in the arm. If the reading is over a certain amount, Ridner says it can be determined that 99.9 percent of the population has much less fluid than they do.
“I will take the data from both groups and statistically analyze it to see what symptoms or issues set the lymphedema group apart from those who don’t have it,” she said.
Ridner says the findings can be used to educate women about what they may experience if they develop lymphedema, and also to look at what other interventions may be offered to help patients cope with the condition.
Though Ridner is not researching what causes lymphedema, her research looking at the physical and emotional symptoms associated with the condition may eventually offer some clues.
“There are many more unanswered questions than answers,” she said. “The only definitive thing we do know is that if a woman notices swelling in the arm or the hand, it is imperative to be seen by someone trained in lymphedema therapy.
Ridner is still enrolling people with lymphedema in the study. To learn more about participating call 322-0831.