Lymphoedema Early Intervention Program
Project description
Icon Cancer Centres around Australia have been providing complimentary lymphoedema screening service for patients with breast cancer and other cancers. The screening service aims to identify those at risk of developing lymphoedema and implement management plans to prevent progression.
Accurate and precise non-invasive monitoring using the SOZO device (Bioimpedance spectroscopy) can identify those at risk, allow monitoring and referral for therapy to restore function, reduce side effects and prevent progression of lymphoedema and complications. If subclinical lymphoedema is detected through screening, a referral can be made to an accredited lymphoedema therapist. When detected early, intervention can prevent progression of lymphoedema by 95%. Without early intervention, patients who experience progression to moderate or severe lymphoedema and face increased risk of complications including cellulitis, lymphorrhoea, ulcers and rarely lymphangiosarcoma.
Lymphoedema services in southern Tasmania have until recently been limited to the public sector and with high demand wait times can be extremely long. The Lymphoedema screening service at Icon Cancer Centre Hobart has been limited initially by a referral pathway to a lymphoedema service and access to trained staff. We have been fortunate to partner with Flex Physiotherapy who have 2 lymphoedema physiotherapists able to offer intervention treatment for the patients we identify at risk using the SOZO screening tool.
Expansion of the Lymphoedema screening service would provide education to patients and the community regarding risk factors for lymphoedema, screening and self-management videos designed in collaboration with our lymphoedema physiotherapy colleagues. These tools could be used as an adjunct to their formal assessment and management on the program. We also hope to audit the program's success, measure patient reported outcomes (PROMs) and undertake a health cost-utility assessment.
Outcomes
The Lymphoedema Early Intervention Program, which provides complimentary screening for patients with breast and other cancers, can lead to:
Increased access to regular lymphoedema screening
Identification of at-risk patients earlier
Improved monitoring and management of lymphoedema
Prevention of longer-term complications
Enhanced self-management
Improved quality of life
Impact on the healthcare professional
Improve sustainability of the service by increasing the number of trained staff, formalising clinic structure as demand for the service increases. Formalisation of existing referral pathways will improve patient flow in the clinic.
Development of more comprehensive education materials on self-management strategies. Patients identified to be at risk for clinically significant lymphoedema development will require referral for specialist intervention. Stratification factors to determine which patients will benefit from self-management strategies will reduce the burden of referral on the limited lymphoedema physiotherapists in Hobart.
Impact on the healthcare institution
Lymphoedema Screening is offered as a complimentary service to patients with breast cancer throughout many Icon Cancer Centres. It is seen as an integral part of the holistic care of patients with breast cancer. There is compelling data to show that early identification and management of those at risk of developing lymphoedema can radically reduce poor outcomes and improve patient experience.
We see this as an essential part of the service we offer patients and feel strongly about developing strategies to improve sustainability of this service into the future. Data generated, educational materials and patient reported outcomes from our centre’s experience may be useful for other institutions looking to establish a SOZO lymphoedema screening clinic.
Proposer
ICON Cancer Centre Hobart
2 Melville Street
Hobart Tasmania 7000
Project contact person:
A/Prof Louise Nott
louise.nott@icon.team
Project team members:
Matthew Rundle (Pharmacist, Site Manager)
Katrina West (Nurse Practitioner)
Emma Sorbian (Lymphoedema Physiotherapist)
Dr Sunit Sarkar (Medical Oncologist)
Dr Raef Awad (Radiation Oncologist)
Patricia Appleyard (Senior Oncology and Radiation Oncology Nurse)