Subcutaneous drainage of chronic refractory edema in cancer patients: case presentation
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Abstract
Edema is a frequent manifestation in patients with advanced diseases. There is a little research on it. The symptomatic impact it generates, the functional limitation, and the decreased quality of life are often underestimate in those affected patients. Many strategies for their management are employed, but the therapeutic response and tolerance are limited in patients with advanced diseases. We present the case of a patient with progressive retroperitoneal sarcoma who develops severe lower limb lymphedema of multifactorial etiology, refractory to treatment, in whom was performed subcutaneous lymphatic drainage with clinical improvement and impact on quality of life. Finally, there is a discussion of the topic and a review of the available literature on the presence of lymphedema in patients with cancer and the different available therapeutic options.
Keywords: cancer painlymphedemapalliative carequality of lifesubcutaneous drainage
References
- Beck M, Wanchai A, Stewart BR, et al. Palliative care for cancer-related lymphedema: a systematic review. J Palliat Med. 2012; 15(7): 821–827.
- Jacobsen J, Blinderman CD. Subcutaneous lymphatic drainage (lymphcentesis) for palliation of severe refractory lymphedema in cancer patients. J Pain Symptom Manage. 2011; 41(6): 1094–1097.
- Julião M, Costa E, Calaveiras P, et al. Treatment of lower extremity edema by controlled subcutaneous drainage at home: a case report. Am J Hosp Palliat Care. 2021; 38(8): 1053–1056.
- Gradalski T. Diuretics combined with compression in resistant limb edema of advanced disease-a case series report. J Pain Symptom Manage. 2018; 55(4): 1179–1183.
- Heng S, Hardy JR. Large volume subcutaneous lymphoedema drainage. Intern Med J. 2016; 46(11): 1346–1347.
- Rodgers S, Birkholz L, Hebert R. Treatment of lower extremity oedema by subcutaneous drainage in a home hospice patient. BMJ Case Rep. 2013.
- Landers A, Holyoake J. Lymphoedema in advanced cancer: does subcutaneous needle drainage improve quality of life? BMJ Support Palliat Care. 2022; 12(e6): e821–e825.
- Lam PT, Wong MS, Tse CY. Use of closed controlled subcutaneous drainage to manage chronic lower limb oedema in patients with advanced cancer. Hong Kong Med J. 2009; 15(1): 65–68.
- Julião M, Calaveiras P, Costa E, et al. Refractory lower limb edema in cancer: subcutaneous drainage. BMJ Support Palliat Care. 2024; 13(e3): e939–e941.
- Fu MR, Deng J, Armer JM. Putting evidence into practice: cancer-related lymphedema. Clin J Oncol Nurs. 2014; 18 Suppl: 68–79.
- Cobbe S, Nugent K, Real S. Pilot study: the effectiveness of complex decongestive therapy for lymphedema in palliative care patients with advanced cancer. J Palliat Med. 2018; 21(4): 473–478.
- Liao P, Rossini K, Sauls R. Upper extremity subcutaneous lymphatic drainage "lymphocentesis" for symptom relief in end-stage breast cancer. Am J Hosp Palliat Care. 2019; 36(2): 111–115.
- Clein LJ, Pugachev E. Reduction of edema of lower extremities by subcutaneous, controlled drainage: eight cases. Am J Hosp Palliat Care. 2004; 21(3): 228–232.
- Keeley V, Crooks S, Locke J. A quality of life measure for limb lymphoedema (LYMPQOL). J Lymphoedema. 2010: 26–37.
