Trial sees improvement in treatment of breast cancer survivors who develop lymphoedema

Orla Brennan: 'Lymphoedema can be very debilitating and distressing so it’s very deflating for a patient to hear that after your surgery - which in my case included a full axillary clearance of the lymph nodes - you are not done.' Picture: Brian Arthur

Breast cancer survivor Orla Brennan was deflated to learn she might develop lymphoedema after treatment.

“Initially, I didn’t know much about lymphoedema other than it is the nasty cousin of breast cancer,” she said.

“Lymphoedema can be very debilitating and distressing so it’s very deflating for a patient to hear that after your surgery - which in my case included a full axillary clearance of the lymph nodes - you are not done.” 

An estimated 20,000 people live with lymphoedema in Ireland but a new approach trialled by the HSE has meant no lymphoedema patients needed hospital care during the first six months of treatment. There were just three episodes of cellulitis, an extremely painful side-effect, compared to 49 in the previous year.

Ms Brennan, a swimming coach from Newmarket-on-Fergus in Clare, was diagnosed with cancer in 2021. She was treated at University Hospital Limerick.

“What I have found incredible about the early (lymphoedema) detection service is the patient education,” she said. 

HSE Assistant National Director Geraldine Crowley said a ‘proof of concept’ trial is running at five sites. There are three specialist community clinics and two early detection hospital services.

The clinics have seen “improved quality of life, improved access and high patient satisfaction,” she said. GP visits fell by 86% and visits to public health nurses by 70%.

The early detection services saw “a reduction in the incidence of lymphoedema in breast cancer patients from 25% to 2%,” she said. For next year €8m in permanent annual funding to roll out this model nationally will be sought.

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She released the data to Fine Gael TD Colm Burke. “It is clear to see that the HSE intends to make it easier for patients to receive the adequate care and treatment that they are entitled to and help to combat this disease,” he said.

“It is significant that those suffering from this condition feel supported by the community and the government, and that the best efforts are made.” He highlighted the Lymph Clinic in Cork.

The Irish Cancer Society said: "Following the incredible impact of this initiative, we urge Government to permanently fund the full roll out." 

A spokeswoman added: “Cancer patients should be able to access these services in their community, as well as early detection initiatives within their hospital setting, in a timely manner improving patient outcomes, while reducing demand on primary care services.” 

National services are needed, she said because “we have heard from patients with no local access to lymphoedema services who are dealing with the medical, and often financial, impact as a result”.