How to help a patient with lymphostasis after chemotherapy. Condition after chemotherapy

"How to remove chemistry from the body?" - the oncological patient repeatedly asks himself a question.

Rehabilitation after chemotherapy is a difficult and time-consuming process, it is a necessary measure for the human body, since the body is too weakened after this treatment.

In order to recover quickly, you will need to correct your lifestyle, give up bad habits, change your diet, strictly follow the prescriptions of rehabilitation doctors, and the mood with which all this will be done is important. The support of loved ones and relatives will significantly lift the spirit of the patient.

A person diagnosed with a malignant neoplasm is weakened not only physically, but also morally, therefore, the help of a psychotherapist, spa treatment, accompanied by herbal medicine, is most often required.

Before you figure out how to quickly recover from a course of chemotherapy, you need to understand what causes intoxication and how it manifests itself.

Associated symptoms with chemotherapy

In oncology centers, new drugs are widely used that minimize the development of unwanted effects. Premedication is carried out that can protect the mucosa of the gastrointestinal tract. Cytostatics, hormonal agents, targeted therapy for breast cancer are being improved.

However, each organism is individual, the degree of cancer development, its metastases, age, weight of the patient play a decisive role in the occurrence of side effects.

Frequent complaints are:

1. Nausea, vomiting, heartburn, upset stool.
2. Malaise, headache, dizziness.
3. Violation of visual acuity.
4. Loss of hair, disappearance of skin pigmentation.

This may be due to both chemotherapy treatment and existing ailments: gastritis, esophagitis, gastroduodenitis, colitis.

immune suppression

The transferred use of chemotherapy drugs does not pass without a trace for human organs and tissues. Toxins accumulate in both cancer and treatment. Their removal is a must. The activity of the cells is suppressed by drugs so that the growth and development of the tumor stops, and its involution occurs.

However, against the background of oppression of the neoplasm, healthy cellular forms are affected - cells responsible for immunity.

Due to the weakened immune response, the patient has a high risk of developing severe complications from concomitant diseases. It would seem that simple bronchitis, acute respiratory viral infections, mild pneumonia can be cured in 5-10 days, but in people who have undergone chemotherapy therapy, not only the recovery time can be lengthened, but also severe consequences or relapse can occur.

Blood indicators

According to blood tests, you can evaluate the effectiveness of the treatment and the state of health in general. If a person has overcome the first stage - the primary reactions of chemotherapy, then after it comes the second - the stage of hidden manifestations.

Undoubtedly, the indicators in the biochemical, clinical detailed (the number and degree of maturity of cells are indicated) blood test will change. There is a shift of the leukocyte formula towards less mature cells. There is leukopenia, thrombocytopenia, anemia. All this is associated with damage and death of the blood germ in the bone marrow.

Manifestations can be: spontaneous bleeding of internal organs, the appearance of hematomas, edema, infiltration and tissue destruction, a violation in the cellular structure of the lining of the mucosa of the gastrointestinal tract, as well as all tissues that are constantly dividing.

In order for blood cells to recover, in medicine, substitution therapy is used in the form of a transfusion of washed red blood cells, platelet mass, fresh frozen plasma, and bone marrow transplantation.

infectious agents

In the human body, there are pathogenic and conditionally pathogenic microflora. Conditionally pathogenic is a set of bacteria, viruses that contribute to the normal functioning of organs, but only at a certain titer.

If the amount exceeds the norm, unwanted changes occur. So after chemotherapy therapy, the fungi are activated, and candidiasis occurs.

Staphylococcus multiplying, settles in certain areas of the vascular wall - inflammation, necrosis, the formation of microcracks in capillaries and arterioles appear. As a result, sepsis develops.

Normally, platelets are involved in the hemostatic process, their layering on top of each other clogs the bleeding site. However, they do not have high selectivity and are able to settle in narrow spaces of blood vessels, places of inflammation, fatty infiltration - thrombosis occurs.

You should carefully consider the elevated temperature, even if it is subfebrile. Perhaps this is evidence of a developing inflammatory infectious process, in which fungi, viruses, bacteria can participate.

Therefore, it is very important to control the state of health, as well as compliance with the doctor's recommendations, which can be performed not only in the clinic's hospital, but also at home.

Recovery after chemotherapy

Most often, patients who have an individually selected medication, dosage, premedication, which protects organs that can be adversely affected by the active substances of chemicals, do not require rehabilitation.

If the therapy was performed urgently, “without wasting time”, despite the serious state of health, as well as the psycho-neurological status, then such people need recovery.

In a hospital setting, use:

1. Installation of enteral probes, with severe cachexia.
2. Hemosorption, plasmasorption.
3. Installation of cystostomy, nephrostomy.
4. Percutaneous, transhepatic drainage in case of jaundice.
5. Stimulants of hematopoiesis. Transfusion of blood components.
6. Pain therapy (narcotic analgesics).

Food

Basic Recovery After Severe Chemotherapy at Home provides for a special mode of life and nutrition, which includes a full sleep, walks in the fresh air. Food should be balanced in terms of the content of proteins, vitamins, microelements, only in this case the forces will be restored.

To remove toxic substances, the diet must be filled with fruits, vegetables (raw / stewed), all types of fermented milk products, it relieves the symptoms of poisoning by binding free radicals, tissue decay products.

Useful: chicken and quail eggs (admissible in raw form, if there is no pathology associated with the gastrointestinal tract), low-fat varieties of poultry and fish, beef, veal, rabbit, cereals.

Nutrition of a weakened human body should be in small portions, this is important, since cell functions are restored slowly and an aversion to food may develop. Frequent intake is important - up to 6-7 times a day.

We'll have to forget about sauces, canned products, smoked, spicy, marinated. This type of food retains fluid in the body, and swelling occurs, stress on the heart muscle, kidneys. Compliance with the drinking regime - drink water / juice / freshly prepared compote per day at the rate of 35 ml per 1 kg of weight.

Spa treatment

Complete care, attentiveness of medical personnel, psycho-emotional relief will help relieve stress in an oncological patient.

It is important to select the optimal sanatorium with special recovery programs, psychological support courses for this category of people. Personal selection of climatic conditions, thermal springs are welcome.

Healing Fitness

Complexes of exercise therapy, physiotherapy, hardening with water will strengthen the immune system, improve lymphatic drainage function, thus, chemical compounds and substrates of tumor decay are removed faster.

Sports activities in the form of cardio, gymnastics will improve physical condition. The intensity of the loads is selected strictly individually by a specialist.

Phytotherapy

Recipes are widely used: steamed oats in milk, the use of infusion from flax seeds, tincture of aloe leaves, scrolled through a meat grinder.

Plants of plantain, lungwort, peppermint, heart-shaped linden, nettle, birch buds - promote cellular regeneration, restore secretion, motility of the stomach and intestines, have healing properties for the gastrointestinal mucosa, female genital organs.

Inclusion in the diet:

• grenade(choleretic, analgesic, anti-inflammatory effect);
• sesame(contains a large amount of calcium, vitamin B12);
• tea with melissa(acts as an anti-nausea, antiemetic agent);

Alternative medicine preparations help to improve the state of the body, eliminate pathological symptoms. They should be taken in combination with the main therapy and only after consulting the attending doctor.

After a course of chemotherapy, patients experience a sharp decrease in all indicators of the body's work. First of all, it concerns the state of the hematopoietic system and the blood itself. Sharp changes occur in the blood formula and its composition, which are expressed in a drop in the level of its structural elements. As a result, the immunity of patients is greatly reduced, which is expressed in the susceptibility of patients to any infectious diseases.

All internal organs and systems experience the effects of toxic damage from chemotherapy drugs that contain poisons that kill rapidly growing cells. This type of cells are malignant, as well as cells of the bone marrow, hair follicles, mucous membranes of various organs. They suffer before everyone else, which is expressed in a change in the well-being of patients, exacerbation of various diseases and the appearance of new symptoms, as well as a change in the appearance of the patient. The heart and lungs, liver and kidneys, gastrointestinal tract and genitourinary system, skin and so on are also affected.

After chemotherapy, patients experience allergic reactions, skin rashes and itching, hair loss and baldness.

The peripheral and central nervous system also suffers, which is expressed in the appearance of polyneuropathy.

At the same time, the appearance of general weakness and increased fatigue, depressive states is noted.

Immunity after chemotherapy

The state of human immunity is influenced by many factors, including the composition of the blood and the number of various types of leukocytes in it, including T-lymphocytes. After chemotherapy, the patient's immunity decreases sharply, due to a drop in the level of leukocytes responsible for the body's immune response against various infections and pathological agents of internal and external origin.

Therefore, after a course of chemotherapy, patients are treated with antibiotics so as not to become victims of infectious diseases. This measure, of course, does not improve the general condition of the patient, which is already reduced by the use of chemotherapy.

The following measures contribute to the increase in immunity after the end of treatment:

1. Taking antioxidants - vitamins that stimulate the immune system. These include vitamins C, E, B6, beta-carotene and bioflafonides.
2. It is necessary to eat with food a lot of fresh vegetables, fruits, herbs and berries, which contain antioxidants - currants, strawberries, bell peppers, lemons and other citrus fruits, raspberries, apples, cabbage, broccoli, brown rice, germinated wheat, parsley, spinach, celery and so on. There are antioxidants in grains and legumes, in unrefined vegetable oils, especially olive.
3. It is necessary to include in preparations rich in selenium, as well as products in which this trace element is contained. This element helps to increase the number of lymphocytes, and also improves the production of interferon and stimulates immune cells to produce more antibodies. Selenium is rich in garlic, seafood, black bread, offal - duck, turkey, chicken cow and pork liver; beef, pork and veal kidneys. Selenium is found in brown rice and corn, wheat and wheat bran, sea salt, wholemeal flour, mushrooms and onions.
4. Small, but regular physical activity improves immunity. These include morning exercises, outdoor walks, cycling, swimming in the pool.
5. Chamomile tea is a simple remedy for boosting immunity. A tablespoon of dried chamomile flowers is brewed with a glass of boiling water, cooled and filtered. The minimum amount of chamomile infusion is two to three tablespoons three times a day before meals.
6. Echinacea tincture or Immunal preparation is an excellent tool for strengthening immunity. Alcohol infusion should be drunk with a small amount of liquid. The initial dose is considered to be forty drops, and then the tincture is consumed in the amount of twenty drops every hour or two. The next day, you can take forty drops of tincture three times a day. The longest course of treatment is eight weeks.

Liver after chemotherapy

The liver is one of the most important human organs, while performing many different functions. It is known that liver cells are most susceptible to the negative consequences of the introduction of chemotherapy of all other organs. This is due to the fact that the liver takes an active part in metabolic processes, as well as excretion from the body along with bile and neutralization of various harmful and toxic substances. It can be said that from the very beginning of chemotherapy, the liver is a conductor of the drug, and after treatment it begins to function in the mode of protecting the body from the toxic effects of drug components.

Many chemotherapy regimens have a strong toxic effect on the liver. In some patients, the effect of drugs, expressed in eighty percent of liver damage, is observed.

The liver after chemotherapy can have several degrees of damage, there are four main degrees - mild, moderate, high and severe. The degree of damage to this organ is expressed in the level of changes in the biochemical parameters of its functioning.

With liver damage, there is a violation of metabolic processes in the cells of the organ, toxic changes in cell structures, impaired blood supply to liver cells and exacerbation of previously existing liver diseases. In this case, the immune abilities of this organ are violated. It is also possible the occurrence of carcinogenesis - the appearance of tumor processes in the liver.

After chemotherapy, it is mandatory to undergo a biochemical blood test, the decoding of which shows how damaged the liver is. This takes into account the level of bilirubin and enzymes in the blood. Patients who have not abused alcohol, have not had hepatitis, and have not worked in hazardous chemical plants may have normal blood counts. Sometimes, in patients, biochemical analysis data can worsen by three to five times relative to the norm.

You can reassure patients that the liver is an organ that regenerates quickly and successfully. If, at the same time, an appropriate diet and drug therapy is applied, this process can be significantly accelerated and facilitated.

Hepatitis after chemotherapy

Hepatitis is a group of inflammatory diseases of the liver, which is predominantly viral (infectious) in nature. The cause of hepatitis can also be toxic substances that are found in excess in cytostatics.

Hepatitis after chemotherapy occurs against the background of damage to liver cells. Moreover, the more affected this organ, the greater the likelihood of hepatitis. Infections penetrate into the weakened liver, which lead to the development of inflammatory processes.

The possibility of hepatitis is also associated with a low level of immunity after chemotherapy, which causes poor resistance of the body to diseases of an infectious nature.

The symptoms of hepatitis are:

1. Appearance of fatigue and headache.
2. The occurrence of loss of appetite.
3. Appearance of nausea and vomiting.
4. The occurrence of elevated body temperature, up to 38.8 degrees.
5. The appearance of a yellow skin tone.
6. Change in the color of the whites of the eyes from white to yellow.
7. Appearance of brown urine.
8. Discoloration of feces - they become colorless.
9. The appearance of sensations in the right hypochondrium in the form of pain and tightness.

In some cases, hepatitis can come and go without symptoms.

Hair after chemotherapy

Hair falls out after chemotherapy, and some patients become completely bald. Chemotherapy drugs damage the follicles from which hair grows. Therefore, hair loss can be observed all over the body. This process begins two to three weeks after the transfer of chemotherapy is called alopecia.

If the course of oncoprocesses in the body has slowed down, there is an increase in the patient's immunity and an improvement in his general condition and well-being. There are good hair growth trends. After a while, the follicles become viable and the hair begins to grow. Moreover, this time they become thicker and healthier.

However, not all chemotherapy drugs cause hair loss. Some anti-cancer drugs only partially dehair the patient. There are drugs that have a targeted effect only on malignant cells, and allow you to keep the patient's hairline intact. In this case, the hair becomes only thin and weakened.

After completing the course, experts advise using the following recommendations:

1. Use the drug "Sidil". But you should not buy the drug yourself, because it has a number of side effects. It is best to consult your doctor about the use of this drug.
2. Do a daily head massage using burdock oil. Oil is applied to the scalp, massage is done, then a cellophane cap is put on the head, and a towel is wrapped on top. After an hour, the oil is washed off with a mild shampoo. Burdock oil can be replaced with hair growth products containing vitamins and ceramides.

Stomach after chemotherapy

Chemotherapy drugs damage the lining of the stomach, causing patients to experience a number of unpleasant symptoms. Appears nausea and vomiting, heartburn and acute burning pain in the upper abdomen, flatulence and belching, weakness and dizziness. These symptoms are signs of gastritis, that is, an inflammatory or degenerative change in the gastric mucosa. In this case, there may be a deterioration in the tolerance of certain foods, as well as a lack of appetite and weight loss.

To restore the proper functioning of the stomach, it is necessary to follow the diet recommended by specialists and take prescribed medications.

Veins after chemotherapy

The patient's veins after chemotherapy experience the consequences of exposure to toxic drugs. The early (immediate) complications include the appearance of phlebitis and phlebosclerosis of the veins.

Phlebitis is an inflammatory process of the walls of the veins, and phlebosclerosis is a change in the walls of the veins of a degenerative nature, in which the walls of the vessels thicken.

Such manifestations of vein changes are observed in the elbow and shoulder of the patient after repeated injections of chemotherapy drugs - cytostatics and / or antitumor antibiotics.

To avoid such manifestations, the above drugs are recommended to be injected into a vein at a slow pace, and also to finish the infusion of the drug by injecting a full syringe of a five percent glucose solution through the needle left in the vessel.

In some patients, chemotherapy drugs have the following side effect on the veins - inflammatory processes begin in them, which lead to the formation of blood clots and the appearance of thrombophlebitis. Such changes, first of all, concern patients whose circulatory system is prone to the formation of blood clots.

Lymph nodes after chemotherapy

After chemotherapy, some patients may become inflamed and enlarge the lymph nodes. This is due to the increased sensitivity of the follicles of the lymph nodes to the toxic effect of cytostatics.

This happens for a number of reasons:

1. Due to damage to the cells of the lymph nodes.
2. By reducing the number of blood elements (leukocytes and lymphocytes), which are responsible for the body's immune response.
3. Due to the reaction of the body to the penetration of the infection into the body.

Kidneys after chemotherapy

During chemotherapy, kidney damage occurs, which is called nephrotoxicity. This consequence of treatment is manifested in necrosis of cells of the renal tissue, which is the result of accumulation in the tubules of the parenchyma of the drug. First of all, there is a lesion of the tubular epithelium, but then the processes of intoxication can penetrate deep into the glomerular tissue.

A similar complication after chemotherapy has another name: tubulo-interstitial nephritis. At the same time, this disease can develop in an acute form, but then, after long-term treatment, move into a chronic stage.

Damage to the kidneys, as well as kidney failure, affects the occurrence of long-term anemia, which appears (or worsens) due to a violation of the production of renal erythropoietin.

After chemotherapy, there is the presence of varying degrees of renal failure, which can be established after laboratory tests of blood and urine. The degree of this dysfunction is influenced by the level of creatine or residual nitrogen in the blood, as well as the amount of protein and red blood cells in the urine.

Feeling good after chemotherapy

After chemotherapy, patients experience a sharp deterioration in well-being. There is severe weakness, increased fatigue and fatigue. The psycho-emotional state of the patient changes for the worse, depression can be observed.

Patients complain of constant nausea and vomiting, heaviness in the stomach and burning in the epigastric region. Some patients experience swelling of the hands, face, and legs. Some of the patients feel severe heaviness and dull pain in the right side in the area of ​​the liver. Pain can also be observed in the entire abdomen, as well as in the joints and bones.

There is numbness of the arms and legs, as well as impaired coordination during movement, changes in tendon reflexes.

After chemotherapy, bleeding of the mucous membranes of the mouth, nose and stomach increases sharply. Patients have manifestations of stomatitis, which are expressed in severe dryness of the soreness of the oral cavity.

Consequences after chemotherapy

After undergoing a course of chemotherapy, patients begin to feel the various consequences of the treatment they have undergone. Patients are faced with a deterioration in well-being, the occurrence of general weakness, lethargy and increased fatigue. There is a loss of appetite and a change in the taste of foods and dishes, diarrhea or constipation occurs, severe anemia is detected, patients begin to worry about nausea and even vomiting. The patient may be disturbed by oral mucositis (pain in the mouth and throat) and stomatitis, as well as various bleeding.

The appearance of the patient also undergoes changes. Hair usually falls out after chemotherapy. The appearance and structure of the skin changes - it becomes dry and painful, and the nails become very brittle. There is severe swelling, especially of the limbs - arms and legs.

The mental and emotional processes of the patient also suffer: memory and concentration of attention deteriorate, periods of clouding of consciousness are observed, difficulties with the thinking process appear, the general emotional state of the patient is destabilized, depressive states are observed.

The peripheral nervous system is also heavily affected by drugs. Feelings of numbness, tingling, burning or weakness are observed in various parts of the body. First of all, such transformations concern the hands and feet of the patient. When walking, pain in the legs and the whole body can occur. There may be loss of balance and falls, dizziness, cramps and muscle twitching, difficulty holding or lifting objects. Muscles constantly feel tired or sore. There is a decrease in hearing acuity.

The transferred chemotherapy affects the decrease in sexual desire, as well as the deterioration of the patient's reproductive functions. There is a disorder of urination, the occurrence of pain or burning, as well as a change in the color, smell and composition of urine.

Complications after chemotherapy

Complications after chemotherapy are associated with general intoxication of the body through the use of drugs. There are local and general complications, as well as early (immediate) and late (long-term) consequences of chemotherapy.

Examination after chemotherapy

Examination after chemotherapy is done for two purposes:

1. Determine the success of the treatment.
2. Find out the degree of damage to the patient's body by the toxic effect of drugs and prescribe the appropriate symptomatic treatment.

The examination procedure includes a laboratory study of blood tests: general, biochemical and leukocyte formula. It is also necessary to pass a urine test to determine the level of protein.

Additional examination after chemotherapy may include ultrasound diagnostics and x-rays.

Tests after chemotherapy

During the course of chemotherapy, patients undergo tests at least twice a week. This concerns, first of all, a blood test and its research. This measure is due to the need to monitor the patient's condition during chemotherapy. If the results of the tests are satisfactory, the course of treatment can be continued, and if the results are poor, the doses of the drugs can be reduced or the treatment should be stopped altogether.

After chemotherapy, patients also undergo tests that are aimed at monitoring the patient's condition after chemotherapy. First of all, a general blood test, a biochemical blood test and a leukocyte formula are performed. This group of analyzes allows you to fix the level of damage to the body after chemotherapy, namely, vital organs and systems, and take appropriate measures to normalize the patient's condition.

Common after chemotherapy is a change in all blood parameters. The level of leukocytes, erythrocytes and platelets decreases. ALT and AST levels rise, as do bilirubin, urea, and creatine levels. The level of total protein in the blood decreases, the amount of cholesterol, triglycerides, amylase, lipase and GGT changes.

Such changes in the composition of the blood show damage to all organs and systems of varying severity after a course of chemotherapy.

What to do after chemotherapy?

Many patients who have been treated with cytostatics begin to wonder: “What should I do with my health after chemotherapy?”

First of all, it is necessary to determine what symptoms bother the patient after the completion of chemotherapy. They need to be told to specialists who monitor the patient's condition after chemotherapy. The attending physician, having familiarized himself with certain symptoms, may refer the patient to a narrower specialist for advice and appropriate treatment.

Specialists of a narrower profile, as a symptomatic treatment, may prescribe the intake of certain medications, as well as vitamin-mineral complexes and immunity-supporting therapy.

Along with alleviating the patient's condition with the help of medicines, it is necessary to set the goal of restoring the functions of damaged organs and systems. First of all, this concerns the function of hematopoiesis, the immune system, the work of the digestive system of the stomach, intestines, liver, as well as the function of the kidneys. It is very important to restore the microflora in the intestine, thereby stopping the course of dysbacteriosis. In this case, it is necessary to pay attention to the elimination of symptoms of general intoxication of the body, as well as weakness, depression, pain, swelling and loss of appetite.

Restorative therapies include:

• The transition to proper nutrition, which includes the whole range of products useful for the body.
• Feasible physical activity - hiking in the fresh air, morning exercises.
• The use of massages, physiotherapy and so on to improve health.
• Using the methods of traditional medicine and herbal medicine to restore the body.
• The use of psychotherapy methods to improve the psycho-emotional state of the patient.

Treatment after chemotherapy

Treatment after chemotherapy is based on the appearance of the most disturbing symptoms in patients. The choice of therapy, as well as the appropriate drug treatment, can only be made after the results of laboratory blood tests and, if necessary, other tests.

The means that improve the patient's condition after a course of chemotherapy include:

1. Changing the diet of the patient and following a certain diet.
2. Being at rest, the ability to restore strength.
3. Walks in the fresh air, feasible physical activity, for example, therapeutic exercises.
4. Getting positive emotions and positive impressions from others, working with a psychologist.
5. Certain physiotherapy procedures.
6. Drug treatment of side effects.
7. The use of traditional medicine.
8. Spa treatment.

Pregnancy after chemotherapy

Pregnancy after chemotherapy is considered a controversial issue. If chemotherapy is accompanied by medical protection of the ovaries, then this increases the chances of a woman becoming a mother in the future. But many patients remain infertile, even despite enhanced treatment for this problem. This is because after each course of chemotherapy, the chances of pregnancy are reduced several times.

The toxic effect of drugs affects the ovaries and inhibits their functioning. Such an effect is felt the more clearly, the closer the area of ​​​​influence of chemotherapy is to the ovaries.

During chemotherapy, two methods of surgical protection of the ovaries can be used:

1. Displacement of the ovaries from the area of ​​action of the drugs.
2. With general chemotherapy, the ovaries can be removed from the body and preserved until the woman is healthy. After that, the ovaries return to their original place.

Experts recommend starting pregnancy planning at least one year after the end of the course of chemotherapy. This is due to the need to restore the body of a woman after intoxication and the removal of toxic substances. Otherwise, if the terms of conception are not observed, irreversible changes in the fetus may occur even in the prenatal period and the birth of a child with deviations in health and development.

Sex after chemotherapy

Sex after chemotherapy is a rather difficult act. This is caused, first of all, by the deterioration in the general state of health and well-being of patients. Hormonal changes lead to a decrease in the strength of sexual desire, and in many cases, its temporary absence.

Women may experience changes in the microflora of the vagina, which is expressed in the appearance of thrush, which is accompanied by unpleasant symptoms. In this case, sexual intercourse will cause discomfort and pain, which negatively affects the desire to have sex.

In men, as a result of chemotherapy, there are difficulties with the onset and maintenance of an erection, as well as anorgasmia - the absence of orgasms.

Despite the fact that many women do not have periods after chemotherapy, it is necessary to follow the rules of contraception when having sex. Since there is always a risk of getting pregnant, and this would be undesirable immediately after the end of chemotherapy.

In men, toxic products of chemotherapy drugs penetrate the semen and can affect the conception and birth of a child with developmental anomalies that will have congenital malformations.

Periods after chemotherapy

The toxic effect of chemotherapy drugs inhibits the activity of the ovaries. This is manifested in the violation of the menstrual cycle, the occurrence of its instability. Some patients may experience a complete cessation of menstruation. This leads to the appearance of temporary infertility in women.

In order to restore reproductive functions after chemotherapy, the patient must undergo appropriate hormonal treatment so that menstruation reappears. In some cases, the body never restores its reproductive functions, which means an early entry into menopause (menopause) and the complete absence of menstruation forever.

Life expectancy after chemotherapy

It is impossible to accurately predict how long a patient will live after undergoing chemotherapy. These assumptions depend on many factors, including:

• Stage of the oncological process.

At the first or second stage of the disease, a complete recovery of the body after chemotherapy and the absence of relapses of the disease are possible. At the same time, patients can lead a full life and twenty, and thirty years after the end of treatment.

The third and fourth stages of oncological diseases do not give bright forecasts: patients after chemotherapy in this case can live from one to five years.

• The degree of damage to the body after chemotherapy.

The consequences after the transferred treatment are of unequal severity for all patients. There are complications from zero to fifth degree of toxic damage to the patient's body.

With mild to moderate effects, patients can recover sufficiently to continue a full life for a long time. At the same time, of course, it is necessary to radically change your lifestyle, making it healthy from the physical and psychological aspects.

Severe degrees of damage to the body can cause serious consequences for the health of the patient. In this case, a lethal outcome can occur within a short time after chemotherapy, as well as within one year after treatment.

• Changing the patient's lifestyle.

Those patients who really intend to live long begin to take care of their health. They change their diet towards wholesome and healthy food, change their place of residence to more environmentally friendly areas, begin to engage in physical activity, resort to methods of strengthening immunity and hardening. Bad habits - alcohol, smoking and others are also ostracized. Those wishing to lead a full-fledged lifestyle may resort to a change in professional activity and place of work if this greatly affects the patient's quality of life. All of the above measures can lead not only to an increase in life expectancy after chemotherapy up to ten - twenty - thirty years, but also to complete elimination of the signs of the disease.

• The psychological attitude of the patient to recovery is very important. It has been noticed that those patients who really tune in to a full life after undergoing chemotherapy live a long time without observing relapses of the disease. The psychological attitude towards recovery is very important for the life expectancy of the patient. After all, not in vain, it is believed that many diseases, including cancer, are of a psychosomatic nature.
• A huge role is played by a change in the psychological situation in the place of residence of the patient and his work. It is known that negative emotions are one of the main causes of somatic diseases, including cancer. Immune and recovery processes in the body are directly related to the mental state of the patient. Therefore, being in an atmosphere of positive emotions, support, participation and attention is one of the factors for increasing the duration after chemotherapy. It is important to change the atmosphere in the patient's home and work in such a way that it has a positive effect on his condition.

It is also of great importance to enjoy life and bright, pleasant impressions. Therefore, it is necessary to think about such activities and hobbies for the patient that would give patients pleasure and fill their life with meaning.

Disability after chemotherapy

Disability after chemotherapy is issued in case of establishing an uncertain prognosis for the patient's condition. In this case, the high risk of recurrence, for example, the possibility of metastases, is of great importance.

If, after the surgical treatment, no further radiation treatment and chemotherapy are prescribed, this means that the patient's prognosis for recovery is high. At the same time, there are no complications that lead to persistent violations of the functioning of the body and limit the life of the patient. In this case, disability is not issued due to lack of grounds.

If the patient needs to undergo severe treatment for a long period, he may be assigned a group II disability for a period of one year. Chemotherapy can be of varying severity, this affects the disability group, which can be the third.

It should be noted that disability is not assigned immediately after the surgical intervention, but after three to four months from the initial moment of treatment and longer. This applies to working patients, and pensioners, and the non-working category of patients. Registration of disability cannot be longer than four months after the chemotherapy treatment of the disease.

At the same time, the patient passes a medical commission, which issues a conclusion about the obvious unfavorable clinical and labor prognosis for the patient. This does not depend on the timing of the patient's temporary disability, but must be done no later than four months from its occurrence. Only citizens who have permanent disabilities and who need social protection are sent to the commission.

Chemotherapy is one of the main methods of cancer treatment. Despite the effectiveness of the actions, it is worth noting that the consequences of such treatment affect the entire body and remind of themselves for a long time after the course. Internal organs suffer from toxic substances that destroy not only cancer cells, but also healthy ones. Often, after chemotherapy, poor health accompanies the patient for a long time. The task of the attending physician is not only to conduct the course of medication itself, but also to monitor and alleviate the condition after chemotherapy.

The main indicators of the deterioration of the body:

• nausea, vomiting;
• reduced immunity;
• general weakness, malaise;
• allergic reactions;
• puffiness;
• pallor and itching of the skin;
• hair loss;
• violation of the central nervous system, depression;
• numbness of the limbs;
• violation of internal organs and systems.

The state of internal organs

gastrointestinal tract

Taking chemical preparations in the form of tablets, first of all, affects the mucous membrane of the stomach and intestines. After that, unpleasant symptoms appear, characterized by a violation of the functions of the digestive organs. Nausea, vomiting, diarrhea. Frequent flatulence and heartburn. It is accompanied by a decrease in appetite and, as a result, weight loss.

Liver cells are most susceptible to damage, as it takes part in the process of removing harmful substances from the body, starting from the very beginning of the course of treatment. In case of malfunctions in functionality, metabolic disorders, increased cell toxicosis and exacerbation of chronic diseases are observed. A slight increase in size is possible.

Violation is observed in the intestines, provoking its swelling and constipation. To improve the condition, it is necessary to adhere to the necessary diet and the prescribed course of treatment.

Immunity and lymphatic system

Immunity directly depends on the state of the blood and the cells in it. Reduced content directly affects the protective function. The body is prone to various forms of infections and bacteria. The doctor prescribes a course of antibiotics, while loading the liver. To alleviate the condition and protect the body, it is necessary to increase the amount of consumption of antioxidants-pharmaceutical vitamins.

Diversify your meals with fresh vegetables and fruits. Drinking plenty of medicinal herbs will provide a boost in immunity and the rapid elimination of toxins. To increase the number of leukocytes in the blood, it is necessary to consume foods containing selenium products containing selenium, mushrooms, garlic, seafood, pet liver, wholemeal flour.

Lymph nodes after a course of treatment may increase in size and have pain when pressed.

Venous system

The veins and arteries of the body take a hit if the drugs enter the body through a dropper at the time. Thrombus formation is possible. The walls of blood vessels may become inflamed or thickened. Most often this occurs at the injection site. To avoid such consequences, the drug must be administered slowly, and at the end of the procedure, a 5% glucose solution should be injected through the needle for the previous injection.

For better and faster removal of harmful substances, it is recommended to drink plenty of fluids after the procedure. Here, the kidneys, which filter fluid in the body, take the hit. Kidney failure, exacerbation of chronic ailments, nephritis, anemia - all this can be caused by taking chemicals. There is frequent urination, sometimes painful. The color of the urine may be darker than usual and have an unpleasant odor.

External Consequences

Hair

Complete or partial hair loss is not only a physical inconvenience to the patient, but also causes emotional stress. After that, the follicles are damaged and the hair can fall out not only on the head, but throughout the skin. If the treatment is successful and the cancer cells no longer multiply, the recovery process is very fast and the hair resumes its growth again. Moreover, it was noticed that their condition is much better than before therapy.

Experts recommend performing a head massage to improve blood circulation using burdock oil. If you are prescribed chemotherapy, you can buy a wig that suits you in advance. Take it to your hairdresser so that he can adjust the styling and then such a process will not bring inconvenience.

Leather

The condition of the skin may vary slightly. Some areas are itchy and red. Dryness and flaking of the skin is caused by metabolic disorders. Topical treatment in the form of soothing creams should be added to the general recommendations. Be sure to consult with your doctor before use.

Proven harm from exposure to open sunlight. This promotes the development of cancer cells. Before going outside, you should protect exposed areas of the body with clothing, sunscreen and wear a hat, preferably with a large brim.

General state

After medical procedures, a person experiences a general deterioration in the condition of the whole organism. It can last from several days to 2-3 months. Weakness, constant feeling of fatigue, increased fatigue are the consequences of the influence of the drug. Pain in the extremities is accompanied by constant swelling. Often worried about headaches and back pain. Aches in the joints.

Hearing loss, bleeding gums and sore throat. Impaired coordination of movement, dizziness, forgetfulness and inattention. Psycho-emotional instability can cause bouts of depression. After a course of chemotherapy, there is a reduced sexual desire. Pregnancy in women occurs if, during treatment, doctors provided medical protection for the ovaries.

How you feel after chemotherapy depends on:

• degree of oncology;
• the number of procedures performed;
• human habits;
• his way of life;
• age.

A healthy lifestyle, diet, light physical activity and full adherence to the doctor's recommendations will alleviate the patient's condition after the procedures and ensure an easy and quick recovery.

There are primary and secondary lymphostasis. Primary lymphostasis is due to a congenital anomaly of the lymphatic system, mainly the absence of lymphatic capillaries or insufficiency of the lymphatic vessels.

The cause of secondary lymphostasis is often inflammatory diseases or tumors that affect the lymphatic vessels. The most common cause of lymphedema is surgery and / or radiation therapy, leading to damage (injury) to the lymphatic system.

Improving the transport function of the lymphatic channel leads to a violation of the outflow of lymph and, first of all, to the accumulation of fluid (edema) and proteins - products of cellular metabolism in the surface tissues. The accumulation of protein substances stimulates an increasing density of the tissue, which leads to a further deterioration in the outflow of lymph. If lymphostasis is not treated, then against its background, the rapid development of infectious complications, chronic inflammatory processes, scarring and proliferation of connective tissue is possible.

WHERE CAN LYMPHOSTASIS DEVELOP?

Most often, secondary lymphostasis affects the upper and lower extremities, for example, after the removal of a tumor of the breast, prostate or ovaries, due to the removal or irradiation of the lymph nodes. Often there is also lymphostasis of the trunk and genital organs. In the case of a tumor in the head region, lymphostasis of the head/neck may occur.

HOW TO TREAT LYMPHOSTASIS?

Lymphostasis not only significantly impairs the quality of life of patients, but is often accompanied by pain. If lymphostasis is not treated, the volume of the affected limb increases, the tissues become dense to the touch. With a running process and the absence of adequate treatment, infectious complications can join, and there is also a risk of tumor malignant transformation (lymphoangiosarcoma).

The main goal of treatment is to stop the progression of the disease, reduce the possibility of complications, and improve metabolic processes.

COMBINED REHABILITATION PHYSIOTHERAPY

Since the damaged lymphatic channel does not sufficiently cope with the transport function, the outflow of lymph must be supported from the outside. Therefore, regular manual lymphatic drainage, which a medical worker conducts and doses depending on the stage of lymphostasis, is an important prerequisite for creating conditions for better lymph outflow and softening of compacted areas.

Immediately after the procedure, it is necessary to create compression in the area of ​​lymphedema in order to avoid a new accumulation of lymph. To do this, depending on the condition of the patient, various bandages or compression underwear are used. These therapeutic effects are collectively referred to as "combined rehabilitation physiotherapy".

SKIN CARE AND ACTIVITY

Along with therapeutic measures, the patient's own desire to help himself also plays an important role. First of all, it is necessary to carefully care for the skin and regularly engage in therapeutic exercises, since dosed physical activity helps to maintain muscle tone and thereby supports lymph circulation.

So far, only the appointment of selenium has proven itself as an additional drug therapy for lymphostasis. Medicinal preparations of inorganic selenium (eg Selenase®) not only lead to a reduction in edema, but, above all, prevent the development of erysipelas - a bacterial inflammation of the skin in the damaged area.

Selenium is an important trace element that supports the function of selenium-containing enzymes (glutathione peroxidase), as well as selenoprotein contained in plasma. In both proteins, selenium is bound to the protein in the form of the amino acid selenocysteine. A selenium-containing enzyme is also 5-deiodase, which catalyzes the conversion of tetraiodothyronine (T4) into the active thyroid hormone triiodothyronine (T3).

Glutathione peroxidase is an integral part of the antioxidant defense system of cells. In the presence of a sufficient amount of substrate, i.e. reduced glutathione, glutathione peroxidase converts various hydroperoxides into the corresponding alcohols. It has been shown in cellular or subcellular model systems that the integrity of cellular or subcellular membranes mainly depends on the integrity of the glutathione peroxidase system. A synergistic effect with vitamin E has been shown. Selenium, as an integral part of glutathione peroxidase, can reduce the degree of lipid peroxidation and membrane damage.

Selenium-containing glutathione peroxidase affects the metabolism of leukotriene, thromboxane and prostacyclin. Selenium deficiency suppresses immune defense reactions, especially nonspecific, cellular and humoral immunity. Selenium deficiency affects the activity of certain liver enzymes, increases chemical or oxidative damage to the liver, and the toxicity of heavy metals such as mercury and cadmium.

The minimum dose of selenium necessary for a person depends on the chemical form of the element entering the body and the composition of the diet. The US National Research Council recommended a daily dose of 70 micrograms of selenium for men and 55 micrograms of selenium for women. The German Nutrition Committee has recommended up to 100 micrograms of selenium daily.

Selenium deficiency can occur in isolated cases in situations of increased consumption (pregnancy and lactation), with prolonged parenteral nutrition or a special diet (phenylketonuria), in patients on dialysis or with gastrointestinal diseases (chronic inflammatory bowel disease, tumors of the gastrointestinal tract). intestinal tract, cirrhosis, hepatitis), renal failure, in cases of acute inflammatory response, the use of carbamazepine, phenytoin, valproic acid and in persons exposed to heavy metals or oxidizing agents.

Cases of selenium deficiency are associated with the development of endemic cardiomyopathy (Keshan disease) and endemic osteoarthropathy with severe joint deformity, as well as skeletal muscle myopathy. Epidemiological studies indicate a correlation between the level of selenium in the blood and the frequency of cardiovascular diseases (cardiomyopathy, arteriosclerosis, myocardial infarction), as well as oncological diseases (especially the digestive tract, chest and liver). Selenium (200 mcg/day) has been shown to reduce mortality from skin cancer, as well as lung, prostate, and colorectal cancer.

When an insufficient (below optimal) amount of selenium enters the body, the activity of glutathione peroxidase decreases, but distinct clinical symptoms are not observed.

Selenium deficiency can be detected by reduced levels of selenium in the blood or plasma, as well as decreased activity of glutathione peroxidase in whole blood, plasma, or platelets.

The required dose of Selenase® in the treatment of lymphedema is determined by the level of selenium in the blood that can be achieved as a result of therapy (blood selenium levels can be monitored in the laboratory; reference values: 0.1 - 0.2 µg / g).

Since most patients are diagnosed with very low blood selenium levels prior to initiation of Selenase®, higher doses are recommended initially. In case of acute lymphedema, it is recommended to take 1000 micrograms per day (2 vials of 10 ml) for 3 consecutive days, then from the 4th day until the onset of clinical improvement, 500 micrograms / day (1 vial of 10 ml). In chronic lymphostasis, therapy is recommended for 6 weeks at a dose of 300 mcg per day. After improvement of the condition, the dose is reduced. In this case, with a body weight of 75 kg, as a rule, 100 mcg of selenium a day is sufficient, which should be taken in the morning on an empty stomach.

Overdose (intoxication) with the drug

Symptoms of acute overdose are garlic breath, fatigue, nausea, diarrhea and abdominal pain. With chronic overdose, changes in the growth of nails and hair, as well as peripheral polyneuropathy, are observed.

Treatment of overdose: gastric lavage, induction of diuresis or high doses of vitamin C. In severe overdose (0 times), elimination of selenase by dialysis is recommended.

Studies involving patients operated on for tumors in the head show that sufficient selenium supply has a preventive effect on the size, clinical course and dynamics of lymphedema. Therefore, it is necessary to normalize the level of selenium before surgery or radiation therapy.

Selenase must not be mixed with reducing agents, such as vitamin C, since in this case the precipitation of elemental selenium is not excluded. Elemental selenium is insoluble in water and is not biologically available. These data also apply to drugs that were used shortly before the introduction of selenase. Selenase should not be mixed with juice. Selenase and vitamin C should be taken at least 1 hour apart.

ADVICE FOR PATIENTS WITH LYMPHOSTASIS

(with existing lymphedema or with the threat of its development)

The skin in the area of ​​lymphedema is more prone to dryness than healthy skin. Due to the wearing of compression bandages and products, the skin additionally loses moisture and fat, which must be replenished.

• Use bath oils (for example, Balneum Plus, Hermal, Germany), as well as fragrance-free and preservative-free creams and lotions that effectively cleanse and soften the skin, restore its barrier-protective function
• Even with minor skin lesions and insect bites, immediately treat the skin with antiseptic agents (for example, betadine, iodovidone, octasept or octenisept). In extreme cases, you can use a drink with a high alcohol content (such as vodka).
• Avoid sunburn
• For heavy sweating of the feet, use a special powder to reduce sweating.
• Fingernails and toenails should be trimmed evenly.
• In case of reddening of the skin in the area of ​​lymphedema, which is not caused by any damage, consult a doctor immediately (danger of developing erysipelas!).
• Carry antibiotics with you when traveling on holiday
• Do not visit the sauna and bath.
• Do not rest in an area prone to insect bites
• Eliminate strength sports (the effect of sports activity is enhanced by compression)
• Prefer wellness exercise!
• Avoid kneading massage in the area of ​​lymphedema

• Do not wear high heels and lace up shoes
• Do not walk barefoot outside the walls of your home
• Don't wear tight underwear
• Do not sit cross-legged for a long time

In the area of ​​lymphostasis, the skin is prone to dryness. At first, this manifests itself in peeling, then noticeable wrinkles form on the skin, and later it can crack. Increased peeling can also be a sign of a fungal disease.

Take better care of your skin

small red spots

May appear as a result of a local reaction of intolerance, in particular, after the use of ointments and creams. If the cause is an insect bite, disinfect immediately.

Large, well-defined red spots

The cause of their appearance may be an inflammatory infectious process, mainly erysipelas (erysipelas). It begins suddenly and may be accompanied by severe pain, fever, and a painful condition.

Urgent medical consultation required

Red spots with blurry borders

They are often observed in chronic chronic lymphostasis and indicate progressive changes in tissues.

Rough, patchy patches of skin

They indicate a long-term pathological change in tissues, called induration or fibrosis.

It is necessary to treat lymphostasis more intensively

Attention! They may be a sign of the progression of the underlying disease or the involvement of new areas and tissues in the pathological process.

Suspicion of thrombosis or embolism. It occurs most often on the legs, rarely on the hands.

Need a doctor's consultation

Red nodules, blisters

• may be a sign of a herpes virus infection
• may appear due to an increase in interstitial pressure (ulceration and ulcers, possibly with fluid leakage).

Urgent consultation of the doctor is necessary!

They occur most often with lymphostasis on the legs due to fluid pressure due to gravity. They are usually harmless, but are a sign of progression of lymphedema.

Pronounced vascular network

A branched vascular pattern occurs after radiation therapy, but may also be due to mechanical causes of lymph stagnation. Also occurs in case of spontaneous hemorrhage.

A doctor's consultation is required!

Fine and deep furrows

They often occur with progressive lymphostasis due to the alternation of tissue sections of different degrees of compaction, and may also appear due to wearing too tight clothing or improperly selected compression stockings.

Note! Diagnosis and treatment are not carried out virtually! Only possible ways of preserving your health are discussed.

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Lymphostasis

Salvation from cancer requires great sacrifices, it only says “cut out the tumor”, in fact, even a tiny tumor is removed “in a single block” with adjacent tissues and lymph nodes of several levels. A breast cancer tumor up to 5 cm with axillary lymph nodes suspicious for metastases is removed along with the gland and axillary, subclavian and even subscapular subcutaneous fat. A huge lymphatic collector is removed, which carries lymph from half of the organs of the chest and arm, but nothing remains in return. And where should the fluid go if there are no lymph nodes anymore, and only a postoperative scar remains on the way to the thoracic lymphatic duct?

Today, it is possible to remove small breast tumors with part of the organ, but the operation that partially preserves the organ still requires the removal of metastasized lymph nodes and mandatory postoperative radiation. Seriously damaged soft tissues become much denser with the formation of scars, and again the lymphatic fluid stagnates in the vessels, because there is nowhere for it to move - there are no lymph nodes. And this happens not only during breast surgery, but during irradiation of the uterus or removal of lymph nodes in the inguinal and retroperitoneal regions with testicular tumors, sarcomas and melanomas of the lower extremities.

How does lymphedema occur?

Surgical or radiation exposure to the lymph nodes that drain lymph fluid from the extremities leads to the predicted lymph stagnation for such a situation. This condition has long been called "elephantiasis" by the people, and in the medical literature, stagnation of the lymph is called "lymphostasis", and the edema that occurs in connection with this is "lymphedema".

After surgery on the axillary, inguinal, femoral, retroperitoneal lymph nodes, edema is inevitable, but its severity depends not only on the volume of the operation, but also on the individual characteristics of the tissues. As a rule, delicate and sensitive tissues respond to injury with large scars. Postoperative scarring affects large blood vessels, slowing down the blood flow in them, which complements the severity of edema. It is especially difficult to deal with the pathological condition in the initial varicose veins of the lower extremities.

After radiation treatment of cancer of the cervix or body of the uterus, scar tissue grows at the site of the destroyed tumor, and every year it becomes denser, involving an increasing area in the process, up to the pelvic bones. On the one hand, the scar is benign, but the resulting violations are too significant. The development of connective tissue in the area of ​​surgery and radiation involves the nerve trunks, which causes pain and movement disorders in large joints.

Chemotherapy also contributes, since drugs are mainly administered intravenously, the inner shell of the vessel is damaged, the vessel is partially or completely obliterated - its lumen is narrowed by cicatricial changes in the endothelial membrane. Venous blood flow is disturbed, which responds with edema of the underlying anatomical regions. Anticancer hormonal drugs taken for years contribute to the formation of blood clots. The cancerous tumor itself initiates an increase in blood viscosity. There is a reason for the development of lymphostasis, and far from the only one, each of these reasons complements and aggravates lymphatic edema.

How does lymphedema develop?

Lymphedema begins almost immediately after surgery, with radiation therapy it increases gradually over several weeks and even months. First, the hand or foot swells, they look like a water cushion, as a rule, the fingers are less affected than the back of the hand or foot. The fingers move, and the fluid flows slightly, and the branched vascular network helps. Then the swelling extends to the forearm to the elbow or lower leg. The spread of edema to the shoulder or thigh is already the III degree of lymphostasis.

The spread of edema is painful due to stretching of the tissues and compression of small nerve endings by excess fluid. There is a feeling that with an awkward movement, the skin may burst, so patients try not to move the limb, which does not help at all, and may even increase the edema. Lowering the limb helps blood flow, but if the arm can be carried high, then the leg cannot lie on the pillow indefinitely. The first time after resting in an elevated position, the swelling decreases, but over time it works less and less.

Gradually, the germination of the inflamed skin and subcutaneous tissue with connective tissue occurs, replacing them with a scar structure. A small injury to the skin constantly oozes clear lymph, which is why the wound heals for weeks. Local immunity is reduced, therefore, staphylococcal infection often develops - erysipelas, which significantly aggravates the existing lymphostasis. Staphylococcus settles for years, and each recurrence of erysipelas complements the defects in the soft tissues of the limb.

And it is no longer the tumor that becomes the reason for assigning a disability group, but lymphedema and a hand hanging because of it with a whip or a barely moving "elephant" leg.

Why lymphostasis interferes with life

Lymphostasis is not only a cosmetic defect, it is vascular and nerve damage, leading to limited functionality. At first, when lymphatic edema of the limb only appears, it is protected so as not to increase blood flow to the tissues and, due to this, an increase in pain. Gradually, anatomical disorders and a protective regimen with restriction of movements lead to a progressive decrease in muscle strength, up to atony and subsequent muscle atrophy. And if the leg is forced to walk somehow, then the arm is protected, so atrophy of the upper limb appears faster and is more pronounced.

Despite the strong recommendations of the surgeon-oncologist immediately after the operation to begin to develop the limb, this is not done. Why? Firstly, it’s scary, suddenly something is damaged, the operation was recent. Secondly, consultation and training by a physiotherapy specialist, who is not on the staff of a state oncological institution, is necessary. In this early period of lymphostasis formation, when the edema is still reduced after rest, there is no access to the necessary preventive care and early rehabilitation.

Thirdly, the patient is psychologically not at all ready for independent active actions, the emotional state does not correspond, it is impossible to remember the order of exercises due to stress. The help of an exercise therapy specialist is needed - physiotherapy exercises, which every day will help to do exercises, overcoming pain and fear. This is the only way to form stereotypical behavior that helps to minimize the manifestations of lymphatic edema.

After the operation, women are given very correct "Reminders for the prevention of lymphostasis", which describes what can and cannot be done. But against the background of severe stress associated with the detection of cancer, as well as in the postoperative period, intellectual capabilities are temporarily reduced, the woman is confused, she does not control herself enough to force herself to do the exercises and follow "what is possible and impossible."

What to do with lymphostasis?

It is necessary to start with a consultation on the selection of compression underwear that creates external pressure and prevents increased swelling of the limb. Elastic bandaging is the last century, it is impossible to optimally bandage your leg on your own, but there is nothing to say about the arm. Bandage pressure is uneven, while there should be a certain gradient: more pressure at the bottom and less at the top, so that the liquid can flow out and not stagnate. Today, special gloves and stockings, T-shirts and tights are available that create optimal pressure.

It is necessary to immediately begin physiotherapy exercises with a specialist. Only an outsider will help not to feel sorry for yourself - a methodologist or exercise therapy doctor. Some time after daily exercises under the supervision of a specialist, you can switch to independent exercises, but as long as life goes on in pain, there is no need to build illusions, nothing will work alone without control and even “authoritative pressure”. This is how a person works, he pities himself, especially with such a serious occasion.

Rehabilitation should begin in the surgical ward and continue throughout the period of prophylactic chemotherapy, as long as there is a negative effect on the vessels. A rehabilitation specialist will add hardware methods for eliminating lymphatic edema in time. Lymphostasis is considered incurable because the majority of patients for treatment fall into the IV stage of lymphedema, when cicatricial changes are formed, and trophic changes in the soft tissues occur, when the muscles are already atrophied and the joint is “locked” by contracture.

You should not understand the treatment of lymphostasis only as exercises and a handful of pills that improve the circulation of fluids. There are a variety of hardware techniques, each has its own therapeutic niche and its optimal time: pneumomassage, LED therapy, hydrocolonotherapy, manual lymphatic drainage and much more. The swelling of the limb is affected by the treatment, social and physical activity, psychological state, profession, concomitant vascular diseases, endocrine disorders, and even the season.

Lymphostasis is disability, and in the long term - the impossibility of independent maintenance or movement. There is a limb, it is in place, but it does not work - this is a functional amputation of the limb. To prevent this from happening, it is necessary immediately after the operation to begin active prevention of saving the arm or leg. Call us to find out about the possibilities of the Yusupov Hospital in the fight against lymphostasis and the maximum preservation of limb function.

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Lymphostasis in cancer patients

The branch of medical science that studies the causes, symptoms, methods of diagnosis and treatment of malignant neoplasms is called oncology. Lymphostasis, its treatment and prevention are one of its areas. Signs of the disease may appear both before the operation and after it.

Lymphostasis in oncological diseases

Lymphostasis develops when there is a discrepancy between the production of lymphatic fluid and its outflow. There are such forms of lymphostasis: primary and secondary. The cause of primary lymphostasis are congenital anomalies in the development of the lymphatic vessels. Lymphostasis in cancer patients is a secondary form of the disease.

The cause of lymphostasis in cancer is the defeat of the lymph nodes by metastasized atypical cells or the interruption of the outflow of lymph during surgery. Not in all cases, edema of the limb develops after the operation. If patients in the postoperative period take anticancer drugs, follow the doctor's recommendations, then lymphostasis may not develop, or it will pass within 2-3 months.

Quite often, lymphostasis of the breast and upper limb develops after a radical mastectomy (removal of the mammary gland). In the advanced stages of ovarian, uterine or prostate cancer, lymphostasis of the lower extremities occurs. With oncology, lymph stagnation can also occur if radiation therapy is prescribed to patients. Sometimes, scars form at the site of exposure to x-rays, which compress the lymphatic vessels. The cause of lymphostasis may be cancer of the lymphoid tissue.

Methods for the diagnosis and treatment of lymphostasis in cancer patients

The diagnosis of "lymphostasis" in oncology usually does not cause doubts in the doctor after questioning and examining the patient. However, in order to determine the tactics of treating patients, the following diagnostic studies are prescribed:

Doppler ultrasonography (ultrasound);

Diagnostic methods such as isotope lymphography (lymphangioscintigraphy) and lymphangiography with contrast are not considered appropriate in cancer patients. It is necessary to find out the source of the appearance of metastases. For this, depending on the presence of signs of damage to internal organs, appropriate diagnostic studies are performed.

Treatment of lymphostasis in cancer patients is carried out after establishing the cause that caused the edema. To do this, after the operation, an active drainage is placed, through which the lymph flows into a special receiver. Patients are prescribed medication. Reduced lymphostasis after chemotherapy. A good lymphatic drainage effect is observed after gymnastic exercises, Nordic walking and swimming. Care should be taken when conducting any type of massage and physiotherapy procedures for cancer patients.

Lymphostasis can be a sign of cancer, a complication of surgical or radiation treatment. For its prevention after surgery, active drainage is placed, exercise therapy is prescribed to patients. If the patient follows the recommendations of the doctor, lymphostasis in cancer patients may not develop. To do this, you need to contact a specialist when the first signs of the disease appear.

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Lymphostasis after radiotherapy

Lymphostasis appeared shortly after radiation therapy, moderate, did self-massage, was practically not treated - did not grow.

In the axillary region, there was a "seroma" - a cavity at the site of the drainage, which was repeatedly punctured, but remains as a multi-chamber cyst with serous contents 6.6x3.6 cm - the dimensions do not change.

There are no enlarged lymph nodes.

Ultrasound, mammography and PET in January, there are no signs of relapse.

2. Can a cystic formation in the axillary region interfere with lymph drainage?

3. What could be the reason for the increased lymphostasis almost a year after the treatment.

5. Is it advisable to purchase a pneumomasseur at home and how often should massage be done?

In a favorable clinical situation - a course of complex compression therapy (manual massage + pneumocompression + arm bandaging + possible options)

Edema reduction - selection of a compression sleeve.

Self-supportive compression therapy.

Ilyukhin Evgeny Arkadievich

Where should I go with my illness?

Lymphostasis

Lymphostasis is a disease that develops due to a violation of the formation of lymph and its normal outflow along the lymphatic main tracts. According to the latest WHO data, this pathology, also called lymphedema, or lymphatic edema, occurs in 10% of the world's population.

The disease is characterized by the following features: progressive swelling of tissues, an increase in the volume of the affected limb, coarsening and damage to the skin with ulcers. Chronic lymphedema leads to the development of elephantiasis, which causes disability.

Causes of pathology

Causing such a dangerous disease as lymphedema, the causes may be different, and the range of provoking factors is wide. The accumulation of lymphatic fluid in the tissues can be the result of heart failure, renal pathology, when the main ducts and highways of the body cannot cope with the outflow of lymph.

Also, the causes of lymphostasis can be hidden in chronic venous insufficiency, thrombophlebitis syndrome, arteriovenous fistulas. If the amount of fluid removed from the tissues is excessive, an expansion of the lymphatic vessels develops, their tone decreases, the operation of the valves is disrupted - all this leads to lymphovenous insufficiency.

The main causes of lymphostasis:

• pathologies of the lymphatic system (in most cases - congenital lymphedema);
• obstruction of the highways of the lymphatic system after injuries, burns or surgical interventions, after removal of the mammary gland;
• compression of the lymphatic capillaries by tumors or inflammatory foci.

Lymphedema after mastectomy (removal of the breast due to cancer) is observed in 10-40% of patients who have undergone this operation. If the intervention caused the development of pathology, then lymphedema of the upper extremities usually occurs. During the operation, axillary lymph nodes are often removed, which can undergo metastases. After a mastectomy, the patient should be registered with a phlebologist and a lymphologist.

Allocate primary and secondary forms of pathology.

Primary lymphostasis, that is, congenital lymphedema, develops for the following reasons:

• congenital anomalies in the structure of the lymphatic ducts and highways;
• underdevelopment of capillaries;
• valve failure;
• hereditary predisposition.

Paired limbs are usually affected. If lymphatic edema of the arm occurs, signs of lymphostasis may also appear on the second. Congenital lymphedema can be diagnosed as early as adolescence.

Secondary lymphostasis occurs after injuries or pathologies of the lymphatic system, which was originally normally formed. In women, the condition may worsen after a mastectomy. Secondary lymphedema develops mainly on one limb. In most cases, the disease affects the area from the lower leg to the knee and has an inflammatory-infectious or post-traumatic etiology (nature).

Symptoms of lymphostasis

Depending on the stage of lymphedema, the manifestations and symptoms of the disease may be as follows:

1. Mild stage - mild swelling that appears in the evening and disappears overnight. Swelling of tissues increases with excessive physical exertion, with sedentary or standing work. If lymphedema of the legs is at the initial stage, it should be treated with conservative methods.
2. The middle stage is not passing edema. Fluid accumulates in the tissues constantly, chronic lymphedema develops, the symptoms of which are as follows: on the edematous surface, the skin is stretched, inflammation leads to the growth of connective tissue. These symptoms may be accompanied by pulling pains in the legs, the appearance of convulsions. As a result of loads, lymphostasis is aggravated, the affected limb does not tolerate long-term physical activity, it gets tired.
3. Severe stage - elephantiasis, the formation of cysts and fibrous nodes. Severe lymphostasis develops, its symptoms are a significant change in the contours of the affected limb. The development of contractures leads to a limitation of the functionality of the arm or leg, tissue nutrition is disturbed, ulcers, inflammatory infiltrates, and eczema appear on the skin.

This is how lymphedema proceeds, the stages of which can pass from one to another, in the absence of timely diagnosis and therapy. In this case, the signs of lymphostasis increase starting from the fingers of the limb, then capturing all the large sections of the connective tissue. So, the lymphostasis of the lower leg cannot proceed separately from the lymphatic edema of the foot.

In general, the symptoms of lymphedema are as follows:

• change in the shape and volume of the affected limb;
• the formation of folds on the skin that do not move when probing;
• feeling of tension and fullness in the affected areas of the body;
• It's a dull pain;
• skin changes;
• lymphorrhea (lymph leakage);
• inability to form a skin fold on the diseased limb.

Secondary lymphostasis develops quickly, unlike the congenital form, which can be asymptomatic for years. The patient may notice the first signs of the disease after an injury or surgery. Secondary lymphedema can only be corrected in conjunction with the treatment of the underlying disease that caused it.

Lymphostasis of the lower extremities

Lymphostasis of the legs is the most common type of this pathology. The factors provoking the disease can be hidden in advanced varicose veins, pathologies of the renal and cardiovascular systems. Lymphatic edema of the legs occurs more often due to a strong load on the lower limbs, if they are already subject to changes as a result of concomitant diseases.

In pregnant women, lymphatic edema of the legs develops due to impaired lymph circulation, but pregnancy in this case is not the root cause of the disease. Most likely, the primary lymphedema, which had been asymptomatic for many years, worsened and manifested itself during this period.

Dysfunction of the outflow of lymph leads not only to swelling of the tissues, but also to its slagging. The level of acidity of the skin increases, which leads to its thickening, a decrease in protective functions. The limb becomes vulnerable to attack by bacteria, infectious processes, inflammations and ulcers develop on the affected leg.

Lymphostasis of the hand

Such a pathology as lymphedema of the upper extremities affects predominantly the female population. In most cases, lymphostasis of the upper extremities in women develops after a mastectomy.

Pathology appears when the lymphatic vessels are injured or completely removed during the operation. This disrupts the outflow of lymph from the upper limbs, which leads to violations. If lymphostasis of the upper extremities develops after a considerable time after the operation, or the area of ​​edematous tissue becomes hard and poorly palpable, medical intervention is urgently needed - a recurrence of the tumor process is possible. Treatment of hand lymphostasis should be complex, the success of therapy depends on the stage of the disease and on timely identified comorbidities.

Which doctor deals with the treatment of lymphostasis

Lymphedema is treated by lymphologists and vascular surgeons. It is important that the therapy is carried out by a competent specialist, since lymphatic edema is fraught with complications.

It is better to treat lymphedema in a specialized clinic, adapted for high-quality diagnostics and equipped with all the conditions for hardware and drug treatment of the disease.

Diagnostics

Treatment of lymphostasis involves a preliminary full diagnosis of the body. Examination methods recommended for suspected pathology:

• Ultrasound of the veins and capillaries of the lower extremities;
• Ultrasound of the internal organs of the abdominal cavity;
• Ultrasound of the internal organs of the genitourinary system and small pelvis;
• blood tests - general and biochemistry;
• general urine analysis;
• lymphography - to determine the level of patency of the lymphatic highways;
• magnetic resonance or computed tomography - to detect and evaluate changes in tissues.

If lymphedema is diagnosed, treatment should be started immediately, without waiting for complications.

Lymphedema treatment

Consider how to treat lymphostasis so that the therapy is effective. The goal of treatment is to restore the normal outflow of lymphatic fluid from the affected limbs.

• Lymphatic drainage massage, carried out manually or on a pneumocompression apparatus.
• Physiotherapeutic procedures - magnetotherapy, laser therapy.
• Wearing compression knitted underwear, selected in size and taking into account the desired degree of compression.
• Compliance with a diet based on limiting salt intake.
• Remedial gymnastics, swimming.
• Drug therapy, including phlebotonic preparations that have a lymphotropic effect, enzymes, immunomodulating agents. Dosages should be selected by each individually attending physician.
• Local treatment of inflammatory and infectious processes of the skin.

If lymphedema is diagnosed, treatment with folk remedies can only give a supporting effect, but cannot be considered as the main method of therapy.

Here are some ways to keep the body in remission and improve lymph flow:

• Tar treatment. You need to take one onion, bake in the oven and peel. Add a fly in the ointment to the softened root crop. Apply the composition to the affected limb in the form of a compress and leave overnight. In the morning it is recommended to eat a teaspoon of royal jelly with the addition of honey. The course of treatment is 2 months.
• Herbal therapy. The oral preparation is prepared as follows: sandy immortelle, Icelandic moss, birch and oak bark, horse chestnut are mixed in equal parts. Two tablespoons of the collection are poured into 0.5 liters of boiling water, the composition is boiled for several minutes. Decoction drink 100 ml 4 times a day.
• Garlic-honey tincture. Pass three hundred grams of peeled garlic through a meat grinder, pour it with liquid honey. The composition must stand for 7 days. Use 1 tbsp. l. three times a day for two months.

It is necessary to treat lymphostasis with folk remedies in combination with the main therapy.

Massage

The procedure should be carried out by a qualified specialist, choosing the technique individually, depending on the condition of the diseased limb.

With the help of manual massage or pneumocompression performed on the apparatus, it is possible to stimulate lymph flow, facilitate blood circulation in the affected area of ​​the body and relieve tissue swelling, at least partially.

The course of massage sessions is usually 10 days, it should be carried out regularly.

Prevention

Remember: prevention is better than cure for lymphedema, especially in the legs. The disease can be prevented by observing the following rules:

• timely treat infectious foci and wounds;
• provide therapy for chronic diseases of the renal and cardiovascular systems;
• engage in the treatment and prevention of varicose veins;
• with a neoplasm in the breast - choose the method of mastectomy with the removal of only the sentinel lymph nodes, without using total removal.

An important question becomes how to cure lymphostasis, if the disease has already been diagnosed. Cases of complete recovery from lymphedema are rare, basically the pathology has to be treated throughout life, trying to keep the body in a stable remission stage.

The prognosis in the treatment of lymphedema is serious, all patients with such a diagnosis should be registered with an angiosurgeon. Refusal of therapy leads to an even greater spread of edema, tissue infection and limb dysfunction. Therefore, it is important to recognize lymphedema in time. At the first signs of persistent edema, you should immediately contact a specialized clinic. The earlier therapy is started, the higher the chance of preventing dangerous complications.

Lymphostasis. How to help yourself?

What is lymphedema?

Lymphostasis is soft tissue swelling resulting from the accumulation of protein-rich fluid in the lymphatic vessels. It most commonly occurs in the arm and leg, but can also affect the head, neck, chest, abdomen, and genitals. Lymphostasis can be significantly reduced and managed with manual lymphatic drainage massage and combined decongestant therapy. Therapy includes compression bandages, skin care, and exercise. Most patients see significant results within the first two weeks of therapy.

The problem of lymphostasis

If you are experiencing any of the following symptoms, it may be lymphedema. Remember, early detection is the key to preventing and minimizing the effects of the disease:

lower limbs

• leg swelling,
• Shoes got tight
• Swelling at the base of the fingers
• Numbness and tingling
• Sensation of warmth in the affected limb.

upper limbs

• Swelling or hardness of the breast after removal of the tumor,
• The bra got tight
• Swelling, pressure, heaviness in the arm,
• Rings or bracelets began to crush,
• Feeling of warmth in the hand.

What causes lymphedema?

One cause of lymphedema is surgery to remove lymph nodes, usually during cancer treatment. Lymph nodes filter the fluid that flows through them, trapping bacteria, viruses, and other foreign matter, which are then broken down by white blood cells. Without normal lymph drainage, fluid can accumulate in the injured arm or leg, leading to lymphedema.

Drugs, radiation therapy, and trauma to the lymph nodes can also cause the disease. This type is called secondary lymphostasis.

Primary lymphostasis appears at birth or develops during puberty. The reason for it is not known.

What can be done?

Treatment of lymphedema depends on its cause and includes compression therapy, massage, proper nutrition and skin care. In addition, you are also involved in the process and can help yourself, enhancing the effect of treatment, as well as for prevention.

Raising an arm or leg that is swollen can help facilitate the drainage of lymphatic fluid. Whenever possible, raise the limb above the level of the heart. Do not put pressure on the armpits or groin area, and do not hold the limbs without support for very long, as this may increase swelling. Light exercise can help reduce swelling. Using the muscles during exercise helps the lymphatic fluid circulate naturally. But exercise also increases blood flow to the muscles. If you have swelling, it is important to properly bandage the affected limb while exercising.

After surgery or radiation therapy

If you have had surgery to remove some of the lymph nodes, use the affected arm or leg as much as possible. Most people recover weeks after surgery and are able to return to their normal activities. Patients can start prophylaxis of lymphedema immediately after surgery, chemotherapy, radiation therapy, or after completion of cancer treatment.

When removing lymph nodes in the arm

Treatment of hand lymphostasis after removal of lymph nodes or radiation therapy, as part of cancer treatment, is primarily in monitoring your condition, even several years after surgery. Seek medical attention immediately if symptoms of infection such as redness, pain, or swelling increase.

Do not do blood tests or measure blood pressure on the affected limb. Always talk to your health care providers about this.

Wear gloves when gardening or doing other housework.

When removing lymph nodes in the groin

Wash your feet daily in warm, but not hot, water. Use a mild soap, preferably one that has moisturizing properties. Use a moisturizer regularly.

Wear comfortable shoes.

Wear compression stockings.

Treat any cuts, scrapes, insect bites, or other injuries.

Use sunscreen and insect repellent to protect your skin from sunburn and insect bites.

Read about the effective complex treatment of lymphostasis on the website of the ISC Lymphology Clinic.

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