A pragmatic evaluation of community-based lymphoedema services for individuals at risk of, or living with, cancer-related lymphoedema.

PURPOSE: This study examined the long-term effects of standard care lymphoedema treatment, delivered by cancer support centres in community-based settings, on quality of life and self-reported symptom severity among individuals with cancer-related lymphoedema (CRL).

METHODS

A single-group pre-post pragmatic study design was adopted. Survivors of cancer referred to community-based cancer support centres were recruited. Participants received a minimum of 3 standard care lymphoedema treatment sessions at the centres with a certified lymphoedema clinician at baseline (T1), 1 month (T2) and 6 months (T3), where core treatment strategies included lymphoedema education to enable self-management, skin care and weight management. Assessments of quality of life and symptom severity were conducted at each visit using limb specific versions of the Lymphoedema Quality of Life (LYMQoL) questionnaire (i.e. arm LYMQoL, leg LYMQoL) as applicable for each person, and a researcher-developed tool of self-reported symptom severity.

RESULTS

One-hundred and twenty survivors of cancer were recruited (mean age (± SD) 59 (± 12y); 90% female). Forty participants (33%) completed the T3 assessment. Linear mixed-model analyses demonstrated significant improvements in arm-CRL QoL (n = 78) and leg-CRL QoL (n = 18) from T1 to T3 (p < 0.05), with small (Cohen's d = 0.24) and large (Cohen's d = 0.85) effect sizes respectively. All 7 self-reported symptom ratings, including pain, swelling and functional restriction, improved from T1-T3.

CONCLUSION

Standard care lymphoedema treatment, when delivered in community-based cancer support centres, was associated with improvements in QoL and self-reported symptoms among survivors of cancer with arm and leg lymphoedema at 6 months.