The Experience of Lower Limb Lymphedema for Women After Treatment for Gynecologic Cancer

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Abstract
To describe women's experiences with lower limb lymphedema to inform both preventive and management clinical practices. A retrospective survey. The gynecology/oncology unit of a tertiary referral women's hospital in Australia. 82 women who developed lower limb lymphedema after surgical and radiation treatment for gynecologic cancers. Structured interviews. Psychosocial and emotional impact, physical effects, knowledge, support, treatment modalities. Women identified changes in appearance and sensation in the legs and the triggers that both preceded and exacerbated symptoms. Women described seeking help and receiving inappropriate advice with as many as three assessments prior to referral to lymphedema specialists. Many women implemented self-management strategies. Lower limb lymphedema had an impact on appearance, mobility, finances, and self-image. Increasing longevity after gynecologic oncology treatment requires all practitioners to be aware of known or potential triggers of lower limb lymphedema and the appropriate referral and management strategies available. Women at risk need to know early signs and symptoms and where to seek early care. The role of nursing in acute and community care of women at risk for developing lower limb lymphedema includes (a) engaging women in protecting their legs from infection or trauma pre- and postoperatively, (b) providing nursing care and education during the pre- and postoperative phases, and (c) ensuring that women being discharged are aware of early signs and symptoms of lower limb lymphedema and how to access qualified, specialized therapists so that early and effective management can be initiated.