Benghazi (Libya) women suffering from Breast cancer-related Lymph Oedema
*Momen Abdou Alkhir, **S. L. Mahajan and ***Wahengbam P. Singh
*Lecturer of Radio-physics **Associate professor of Epidemiology ***Professor of Medicine Al Arab Medical University, Benghazi (Libya)
ABSTRACT
Breast cancer is one of the most common malignancies in women. One of the most distressing health problems faced by breast cancer patients is breast cancer related lymph edema (BCRL). Diagnostic criteria and treatments for BCRL vary. To study BCRL patients in terms of their physical and psychosocial health; on availability of information and access to treatment. A focus group of 7 patients and 15 in-depth interviews of individual patients were conducted at Hawari Radiology and Shifa Rehabilitation Centres, Benghazi from November 2006 to May 2007. The age of the patients studied in years was in the range of 39-70 with the mean 55.33 (SD = ±10.47). Majority of the patients i.e., 8(53.33%55) had been diagnosed within the last 5 years. The remaining 5 (33.33%), 1(6.67%) were diagnosed within 6-10, 11-15 and above 15 years respectively. The mean number of years since diagnosis was 5.8 (SD = ± 4.72). Most of the patients i.e. 11 (73.83%) developed the onset of BCRL within last 5 years. The mean number of years since onset of BCRL was 4.8 years (SD = ± 4.37). Highest number of patients i.e. 5 (33.33) had perspective regarding exacerbation of BCRL due to overuse of arm. This was followed by heat in 4 (26.67%) and not wearing compression garment, repetitive actions related to hobbies and aerobics in 2 (13.33%) each. Cold, massage, lifting of weight at work, lack of exercise was the perspective of 1(6.67%) each. Highest number of patients i.e., 8 (53.3%) had perspective regarding amelioration of BCRL due to elevation of arm, followed by wearing compression garment, exercise and rest in 6 (40%), 5 (33.33%) and 4 (26.67%) respectively. Cold and massage was the perspective of 2 (13.33%) each while heat, deep breathing and weight loss was the perspective of 1 (6.67%) each. Following themes emerged from the interviews: Participants thought they were poorly informed about the possibility of developing BCRL and reported both aggravating and alleviating factors for it. All the patients told that their quality of life has decreased physically and psycho-socially. Our study indicated a lack of awareness of BCRL among breast cancer patients and health care professionals which supports the findings of earlier studies. There are only few trained physiotherapists located in main centres in Benghazi for BCRL treatment, limiting the access to rural women. Family physicians should increase awareness of BCRL symptoms in breast cancer patients and try to ensure that BCRL patients are referred to physiotherapists for rehabilitation and counseling.