Vim & Vigor - Fall 2017 - Gwinnett Medical Center - 13

as fluid accumulation can be off-putting
to partners; and even simple acts like
choosing clothing, which doesn't fit
properly because of disfiguration from
the condition. Infection is a constant
cause of concern, because the decreased
flow of lymphatic fluid also compromises
the immune system.
The condition prevents people from
working and socializing and keeps
them in constant pain, Repicci says.

Common BUT
UNKNOWN

Lymphedema sufferers number
between 5 million and 10 million in
the United States, Rockson says.
The condition affects more people
than multiple sclerosis, Lou Gehrig's
disease (amyotrophic lateral sclerosis,
or ALS), AIDS and Parkinson's disease
combined, but it is largely unknown
among the public, Repicci says.
"How could we have a disease that
affects up to 10 million people in this
country and yet has such a wall of
silence around it?" he asks. "Even people who have it are unaware of the disease they have," because receiving an
accurate diagnosis can be challenging.
Rockson says the disease is overlooked for several reasons. First,
the condition is generally not lifethreatening, and it often appears in
the context of a life-threatening disease such as cancer.
"It can have a tendency to be underrecognized because, in the mind of the
clinician, it becomes more background
noise," he says.
He cited the reluctance of doctors and cancer surgeons to recognize lymphedema as a complication
of cancer treatment because it seems
like an implicit criticism of the treatment itself.
Finally, and importantly, the
condition "historically hasn't had
what I call 21st-century treatments,"
Rockson says. Available treatments
are effective, but they are not as

simple as going to the pharmacy and
picking up a prescription.

Recovery and
PREVENTION

Most of the available treatments are
physical ones, such as massage to move
fluid from the tissues, compression
techniques to further mobilize the fluid,
and laser-based therapies.
"All are designed to physically stimulate the lymphatic system to be more
active," Rockson says.
People who have been treated for cancer can be monitored and tested during
the first year after treatment to detect
early signs of lymphedema and possibly
prevent the condition. If compression
therapy is used at the optimal time, the
condition can be prevented or reversed.

Telling THE WORLD

Sometimes doctors are unable to diagnose lymphedema because they receive
little training related to the condition
during medical school, Repicci says.
LE&RN is pressing for physician certification programs and training related
to lymphedema.
Bates wants to help LE&RN raise
money for research. In an interview with
the organization, she said her dream was
to go to Congress "and have a chamber
full of people who are suffering from
lymphedema stand up in front of that
committee and say, 'We have lymphedema. We are suffering. Please help us.'"
When that happens, Bates said,
"I want to be there with them to add
my name." ■

CANCER and
GENETICS
Kathy Bates has been diagnosed with
both ovarian and breast cancers, and
the actress told People magazine that
the latter "runs like a river through my
family." She and her relatives are not
alone; families with hereditary breast
and ovarian cancer syndrome (HBOC)
usually have several members with at
least one of those types of cancer.
"Some factors that can indicate
genetic predisposition to these cancers
include cases of premenopausal breast
cancer in the family, multiple family
members developing breast or ovarian
cancer, and occurrences of male
breast cancers," says Cindy Snyder,
RN, an advanced practice nurse in
genetics for the Cancer Genetics and
Risk Assessment Program at Gwinnett
Medical Center.
"Any ovarian cancer has a 10
percent risk of being hereditary,"
Snyder says.
Two genes, BRCA1 and BRCA2,
account for many cases of hereditary
breast and ovarian cancers, but there
are other genes that are associated
with hereditary cancer. When working
correctly, those genes help repair
DNA damage. But mutations in the
BRCA1 and BRCA2 genes can result in
a lack of a repair mechanism for cells,
which makes the cells more likely to
develop genetic alterations that can
lead to cancer. Those who inherit a
BRCA1 or BRCA2 mutation have a
much higher risk than the general
population of developing breast or
ovarian cancer, or both.

APPOINTMENTS

Do You Know Your Risk?
To schedule an appointment for genetic counseling and testing at
Gwinnett Medical Center, call 678-312-3235.

FALL 2017

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