New approaches to reducing lymphatic pain in breast cancer patients

Among the 7.8 million women diagnosed with breast cancer worldwide, at least 33-44% suffer from lymphatic pain. Breast cancer survivors usually suffer from lymphatic pain in the upper torso or upper extremity, and the use of pharmacologic analgesics is not successful.

In a recent publication in Women and Children Nursing, a team of researchers from the United States and Spain have expanded our understanding of this particular type of pain through evidence-based knowledge and perspectives on accurate assessment and therapeutic-behavioral intervention.

“Historically, the concept of cancer-related pain has been used to study chronic pain associated with the presence of a cancer or its treatment. Cancer-related pain is defined as persistent pain that persists for more than three months after active treatment for cancer,” said lead study author Jeanna Qiu, a postdoctoral fellow at Harvard Medical School. “Traditional studies of chronic cancer pain have focused on the occurrence and severity of general bodily pain anywhere in the body. This approach fails to distinguish different types of pain after cancer treatment, such as lymphatic pain due to lymph fluid accumulation and inflammation, general body pain, pain after mastectomy, chemotherapy-induced peripheral neuropathy, or arthralgias associated with hormone treatment.”

Because of this, opportunities are missed to study the physiologic and psychosocial mechanisms underlying different types of pain and to develop effective treatments for it.

To do so, the research team provided evidence for the etiology of lymphatic pain, conducted objective and subjective assessments of lymphatic pain, and provided evidence for the effectiveness of behavioral interventions to promote lymphatic flow and reduce inflammation in lymphatic pain.

Lymphatic pain refers to the accompanying pain, or sensation of aching pain, soreness combined with swelling. Pharmacologic agents such as NSAIDs, opioids, antiepileptic drugs, ketamine and lidocaine have very little effect on lymphatic pain.

According to the lead co-authors, this study provided much-needed knowledge about accurate assessment that allows physicians to distinguish between different types of pain.

Detailed data also highlighted the effectiveness of behavioral interventions to stimulate lymph flow, such as the use of The-Optimal-Lymph-Flow program. The-Optimal-Lymph-Flow Program is one of the available behavioral interventions for the treatment of lymphatic pain, which is supported by an web application. The intervention is based on physiologic (fluid accumulation and inflammation) and cognitive principles (low self-efficacy for pain control) that promote lymph flow.

Therapeutic exercises for lymph flow include deep breathing with muscle tension, pumping lymph with muscle work, and limb exercises.

The program also focuses on diet and complete water balance.

The comprehensive knowledge and evidence from this study can be directly applied in clinical practice to reduce lymphatic pain in women undergoing breast cancer treatment.

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Published: 17.10.2024

Updated: 17.10.2024

Medical author, Medical editor:

Stepan Yuk

Medical expert:

PhD. Olexandr Voznyak