This article is taken from the Autumn 2009 issue of LymphLine, the LSN's quarterly newsletter available to all LSN members.
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£1 million New Funding for Lymphoedema Research at St George's Hospital, London
By Dr Anthony Stanton & Professor Peter Mortimer
Cancer Research UK have awarded Professor Peter Mortimer and colleagues almost £1m for a 5-year research project on breast cancer-related lymphoedema. This will be conducted at St George's Hospital, University of London (Prof Mortimer and Prof Rodney Levick), Guy's Hospital, London (Prof Arnie Purushotham), and Brighton & Sussex University Hospitals (Prof Mike Peters), and 6 additional researchers will be working at these sites. The award is for a study that will follow a group of over 200 patients recently diagnosed with breast cancer for 36 months. By the end of this time most cases of lymphoedema will be evident and we will be able to make comparisons between the lymphoedema and non-lymphoedema groups, and to look retrospectively at these groups at earlier time-points. We have long felt that real progress in the understanding of the mechanism of the swelling, and why lymphoedema develops in some women but not others, will only come from a prospective approach.
Our belief is that some women are especially prone to developing lymphoedema, irrespective of the cancer treatment they receive. Something like 66-75% of breast cancer patients do not develop lymphoedema after axillary clearance surgery (the prevalence of lymphoedema is, perhaps, 25-33%) whereas 5% of patients receiving the sentinel node biopsy will develop lymphoedema, despite receiving such minimal surgery. Furthermore, we found recently in a study of women followed from 6 months until 30 months post-operatively (but not from before the surgery) that there were crucial differences between the eventual lymphoedema and non-lymphoedema groups. Significantly, these differences were present at 6 months - before the onset of the lymphoedema - and in both arms. The new research will examine the lymph drainage and the formation of tissue fluid in the forearm, the strength of the lymphatic pumping mechanism in the arm, and whether the presence of connections between the lymphatic and venous systems in the arm (lymphovenous communications) confer any protective effect.
The award is recognition by Cancer Research UK, the UK's leading cancer research charity, that lymphoedema following breast cancer treatment remains a significant problem. We are hopeful that this study will help identify women at risk of lymphoedema so that better prevention programmes can be developed and a better understanding of how swelling develops in breast cancerrelated lymphoedema will provide insight on other forms of lymphoedema.
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