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Haidopoulos D, Pergialiotis V, Papageorgiou M, Halaska MJ, Maxova K, Ulrich E, Zapardiel I, Rodolakis A, Gultekin M, Fotopoulou C. Lower Limb Lymphedema Awareness among Gynecological Cancer Patients: An International Survey Supported by the European Network of Gynecological Cancer Advocacy Groups (ENGAGe) Group. Cancers (Basel) 2024; 16:1544. [PMID: 38672626 PMCID: PMC11048365 DOI: 10.3390/cancers16081544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/07/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Patient awareness of postoperative lymphedema in the field of gynecologic oncology has been poorly documented in the international literature. We wished to capture and document the awareness among gynecological cancer survivors about postoperative lymphedema, including aspects such as the adequacy of perioperative counseling, management, and quality of life. METHODS A web-based survey comprising 25 multiple-choice questions was distributed to gynecological cancer advocacy groups within the European Network of Gynecological Cancer Advocacy Groups (ENGAGe) group. The survey was validated in a pilot group of gynecological patients prior to distribution. RESULTS Overall, 386 women from 20 countries completed the questionnaire. Only half of the patients (n = 211) knew what lymphedema is, whereas 52% of the respondents stated that they were never informed at their pre-operative assessment about the potential risk of developing lymphedema. Fifty-three percent of those women who were informed about the risk and management of lymphedema received information through self-initiative, connecting mainly with patient groups or online. Approximately 84% of patients with lymphedema reported that they informed their doctor about their symptoms. Ninety-four patients (55.3%, which is not 55% of the 386) were treated for lymphedema. Forty-five women out of 136 reported that lymphedema significantly affected their everyday lives. DISCUSSION We report a large lack of awareness and a significant gap of knowledge about the risks and treatment options related to postoperative lymphedema among gynecological cancer survivors. Institutional practice routines and awareness among professionals need to be urgently recalled and adapted to adequately inform and support gynecological cancer patients.
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Affiliation(s)
- Dimitrios Haidopoulos
- First Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 2 Lour Street, 11522 Athens, Greece; (D.H.); (A.R.)
| | - Vasilios Pergialiotis
- First Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 2 Lour Street, 11522 Athens, Greece; (D.H.); (A.R.)
| | - Maria Papageorgiou
- "Erifyle" K.E.F.I. Gynecological Cancer Advocacy Group, 11526, Athens, Greece;
| | - Michael J. Halaska
- Department of Obstetrics and Gynaecology, Third Faculty of Medicine, Charles University, Faculty Hospital Kralovske Vinohrady, 11000 Prague, Czech Republic; (M.J.H.); (K.M.)
| | - Katerina Maxova
- Department of Obstetrics and Gynaecology, Third Faculty of Medicine, Charles University, Faculty Hospital Kralovske Vinohrady, 11000 Prague, Czech Republic; (M.J.H.); (K.M.)
| | - Elena Ulrich
- N.N.Petrov Research Institute of Oncology, 197758 St. Petersburg, Russia;
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital-IdiPAZ, 28046 Madrid, Spain
| | - Alexandros Rodolakis
- First Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 2 Lour Street, 11522 Athens, Greece; (D.H.); (A.R.)
| | - Murat Gultekin
- Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey;
| | - Christina Fotopoulou
- Department of Surgery and Cancer, Gynaecologic Oncology, Imperial College London, London W12 0HS, UK;
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Kobayashi N, Ozaki A, Kotera Y, Kaneda Y, Bhandari D, Takamatsu K, Kasai T, Arai M, Takasaki J, Saito H, Sawano T, Kanemoto Y, Sato H, Tsubokura M, Kurokawa T, Tachibana K, Wada M, Tanimoto T, Ohtake T, Ejiri T, Shimmura H, Kanzaki N. Long-term Experience on Breast Cancer-related Lymphedema in the Coastal Area of Fukushima, Japan After the 2011 Triple Disaster. In Vivo 2024; 38:272-280. [PMID: 38148086 PMCID: PMC10756475 DOI: 10.21873/invivo.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND/AIM Disasters can jeopardize breast cancer care and Japan's triple disaster in 2011 (earthquake, tsunami, and nuclear accident) is no exception. However, detailed information is lacking regarding the care of breast cancer related lymphedema (BCRL) following the disaster. We aimed to explore the process by which local patients become aware of BCRL, the problems faced, and the support they require. We also aimed to clarify the effects of the 2011 disaster on experiences related to lymphedema in the target population. PATIENTS AND METHODS Patients who developed BCRL after breast cancer treatment were recruited from Iwaki city, a municipality located in the southern coastal region of Fukushima (N=16). In-depth, semi-structured, face-to-face interviews were conducted, and the obtained data were appraised using thematic analysis. RESULTS Five themes related to BCRL were identified: 1) the process of becoming aware of BCRL, 2) troubles or worries/concerns due to BCRL, 3) information sources regarding BCRL management, 4) strategies to cope with BCRL, and 5) the adverse impacts of the 2011 disaster on BCRL management. CONCLUSION Except for the disaster context, the themes are in line with those of previous studies conducted in the non-disaster context. Nonetheless, there were limited but non-negligible adverse effects of the 2011 disaster on long-term local BCRL management. The findings of this study demonstrate the necessity for individualizing coping strategies against BCRL among healthcare professionals in the Fukushima coastal area and beyond.
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Affiliation(s)
- Naomi Kobayashi
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan;
- Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham, U.K
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo, Japan
| | - Divya Bhandari
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Katsumori Takamatsu
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Tadashi Kasai
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Megumi Arai
- Department of Nursing, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Junko Takasaki
- Department of Nursing, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Hiroaki Saito
- Department of Internal Medicine, Soma Central Hospital, Soma, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Yoshiaki Kanemoto
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Hiroyuki Sato
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Tomohiro Kurokawa
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | | | - Masahiro Wada
- Department of Breast Surgery, Utsunomiya Central Clinic, Utsunomiya, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Tohru Ohtake
- Department of Breast Surgery, Fukushima Medical University, Fukushima, Japan
| | - Tomozo Ejiri
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Hiroaki Shimmura
- Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Norio Kanzaki
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
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