Lymphoedema Early Intervention
Pre and Post Cancer | Risk Reduction | L Dex | Bioimpedance Spectroscopy | Lymphoedema Prevention
After cancer treatment, many people worry about the possibility of lymphoedema. The good news is that catching it early makes a big difference. That’s why we use Lympoedema Index (L-Dex screening) to monitor people who are at risk of developing lymphoedema. L-Dex is a gentle and non-invasive test that can pick up changes in fluid levels before swelling is noticeable. With this early insight, we can work together on simple, personalised strategies to reduce your risk of developing clinical lymphoedema.
Our team is here to guide, support, and reassure you every step of the way.
““Peace of mind through early detection.”
Risk Factors for Cancer Related Lymphoedema…
Surgery.
Surgery to remove many of the lymph nodes from the armpit (axillary lymph node dissection), groin/pelvis or neck carries a higher risk. Removing only a few lymph nodes (sentinel node biopsy) carries a lower risk of lymphoedema occuring.
Radiotherapy.
If you have had radiotherapy to an area with lymph nodes (such as the breast, armpit, pelvis, neck, or groin). Individuals who have had radiation as well as surgery are a higher risk of lymphoedema than radiation alone.
Chemotherapy.
Certain chemotherapy drugs can increase lymphoedema risk, especially in combination with radiation and surgery.
Type of Cancer.
Lymphoedema more commonly develops after head and neck cancer, breast cancer, prostate and gynaecological cancers. However any cancer that affects your lymph nodes can increase your risk.
Post operative oedema (swelling).
Having a higher body weight at the time of diagnosis or surgery increases the risk, no matter what type of surgery you have.
Inactivity.
Inactivity or lack of movement of the at risk body part increases the risk of lymphoedema as the muscles help return swelling back to the heart. Tightness and scar tissue in the groin, arm pit or neck can also slow lymph movement leading to lymphoedema so it is important to have this addressed with a physiotherapist.
Early Intervention FAQ’s
Why are L Dex measures important?
If you are concerned about developing lymphoedema and want to have the best chance of reducing your risk of this chronic condition, Bioimpedance Spectroscopy (L-Dex) monitoring is the best test available.
Extensive research has been conducted into lymphoedema prevention methods and early detection. The largest randomised control study on this compared the use of tape measurement monitoring to L Dex over a 3 year period. The PREVENT study found that 92% of people who were monitored with L Dex measurements did not go on to develop chronic lymphoedema compared to 80% of those who underwent tape measurement only monitoring.
Click here to find out more about the prevent study
How is an L Dex measurement completed?
The U400 L-Dex test is simple, safe, and painless.
You’ll be asked to remove shoes, socks, and any jewellery on your arms and legs. While you lie comfortably on a bed, small electrode pads are placed on hands and feet. The device then sends a very low-level electrical current through your body — you won’t feel a thing — to measure fluid levels.
The test takes just a few minutes and gives us important information to help monitor and protect against lymphoedema.
It is important that before your test you do not:
- Complete vigorous exercise within 2 hours prior
- Drink alcohol within 12 hours prior
- Drink caffeine within 2 hours prior
When should I be measured?
Ideally you should have an L- Dex measurement completed prior to starting cancer treatment. This will let us know your baseline fluid level in your limb.
After this, we complete measures every 3 months for the first 3 years followed by every 6 months until 5 years post operatively.
If you notice heaviness or feelings of tightness in your at risk limb you should also attend for additional measurements.
What is considered a normal score?
The normal range for an L-Dex score is between -10 and +10. Values greater than +10 can indicate lymphedema. Values which have increased by more than 6.5 units from a baseline measurement can also indicate early stages of lymphedema. Our Physiotherapists will consider your history when interpreting the L-Dex values and use the score as an aid in their clinical assessment of lymphedema.
What happens if my score comes back outside of normal?
You will be prescribed a suitable compression garment to wear on your affected limb for 4 weeks, 12 hours per day.
After 4 weeks, your L Dex measurement will be re-taken. If it has reduced and your symtpoms have subsided you will be able to remove the garment.
Is there any conditions where it is not safe for an L Dex to be done?
- Individuals with cardiac pacemakers
- Inidividuals with active implanted devices
- Compromised skin at the front of the ankle or wrist
- Pregnant individuals should check with their medical specialist prior to completing the test
If you are unsure if an L Dex measurement is appropriate for you, please call our clinic prior to booking. Where L Dex is unsafe, tape measure limb volume measurements will be taken to monitor your condition.
Resources
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