Lymphoedema surveillance after groin node dissection
Philippa Lloyd Gynaecological oncology clinical nurse specialist, St Bartholomew’s Hospital, Barts Health NHS Trust, London
Philippa Lloyd reviews the management options for patients who have been treated for vulval cancer, including nurses’ role in advising women about risk-reducing lifestyle strategies
Groin node dissection for vulval cancer places women at significant risk of lower limb lymphoedema. Lymphoedema is an important issue for cancer survivors and efforts need to be made to prevent or reduce its occurrence. No recent studies have made breakthroughs in lymphoedema prevention related to vulval cancer surgery, other than studies of early-stage disease aimed at electing to avoid complete groin node dissection surgery. Risk-reducing lifestyle strategies such as skin care, exercise, positioning and massage therefore remain the mainstays of preventive care for women who have undergone groin node dissection surgery.
Early identification of lymphoedema is important, and a lymphoedema surveillance model using a perometer or bioimpedance machine could possibly identify and monitor skin changes in this group, but equipment is expensive and requires good organisation and expert resources to track patients over time.
It is unknown whether other methods of self-reporting, such as questionnaires, could be beneficial. Greater collaboration with patients is required to determine what is acceptable and feasible in relation to identifying and monitoring lymphoedema after groin node dissection. It is important to reduce the burden of lymphoedema to improve women’s quality of life.
Cancer Nursing Practice. 12, 7, 18-24. doi: 10.7748/cnp2013.09.12.7.18.e946Correspondence
This article has been subject to double blind peer reviewConflict of interest
Received: 05 January 2013
Accepted: 10 April 2013