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Commonly Treated Diagnoses

  • Oftentimes the collateral damage of cancer treatment can be just as life altering as the diagnosis itself which can result in changes to the affected tissues (hardening/scaring), lymphatic system, nerves, cognitive changes, hormonal changes, etc.  Regardless of where you are in your cancer journey whether you are starting out, mid/end of treatment or years into survivorship I will meet you where you are and come up with a personalized treatment plan to help you reach your health goals that encompass your mind, body and spirit.

  • The lymphatic system is a collection of superficial lymphatics (just under our skin) and deep lymphatics (in our muscles) that drain to lymph nodes. Lymphedema is essentially an abnormal collection of fluid as a result of underdeveloped lymphatics or damage to the lymphatic system/structures. 
    There are two types:

    1. Primary lymphedema - happens as a result of genetics or during development 

    2. Secondary lymphedema - damage or injury to the lymphatic system 

      • Most common after a cancer diagnosis due to surgery and/or lymph node removal

      • The injury or damage to the lymphatic system blocks proper drainage of the lymphatic fluid.

  • Lipedema is an abnormal amount of build-up of enlarged fat cells; distribution varies but typically hips, buttocks and legs.  Sometimes it can impact the arms.  It can be painful to touch and patients may bruise easily.  Sometimes the enlarged fat cells can further compress the lymphatic system which also results in lymphedema but not always.

  • Typically in the setting of cancer treatments there is a variety of surgical interventions which can result in tissue inconsistency, scarring, inflammation, tight fascial bands, etc. all of which can lead to decreased range of motion and functional use of affected area, pain, lymphedema, etc.

  • Presents as a single cord or multiple thin cords underneath the skin of the same armpit that had surgery.

    • Often can trace it to lymph node(s) or surgical incision, “stuck” in scar tissue.  Can be found along the length of the entire arm.

    • Small cords can also be found below or above the breast(s) that are referred to as “Mondor cords.” 

    • It typically happens after surgery or radiation to the lymph nodes or breast(s) but NOT ALWAYS.

    • Usually, I see it during initial OP OT evaluation (typically within 2-8 weeks post-op).

    • Can develop and recur months to years after surgery.

  • Is a type of altered wound healing that results from receiving radiation.

    • Radiation exposure causes inflammation of the tissues and vessels.

    • This inflammation can lead to scar-like fibrous tissue as well as damage blood and lymph vessels. 

    • Typically occurs within the first 3 months post radiation treatment.

    • In a perfect world, I would like to see patients after surgery BEFORE they start radiation so I can get rid of much soft tissue inconsistency and fluid build up to hopefully reduce the amount of radiation fibrosis someone has. 

  • Persistent pain following breast cancer treatment! Disorder with multiple underlying potential causes: nerve injuries, phantom breast pain, pectoralis minor syndrome, musculoskeletal pain syndromes, and myofascial pain syndromes

    • Rockwell/Waltho (2016) updated definition such that:

      • Occurs after any breast surgery

      • At least moderate in severity

      • Possess neuropathic qualities

      • Located on same side breast/chest wall/axilla/arm

      • Last at least 6 months, occurs 50% of time

      • May worsen by movements of shoulder

  • Anytime an incision is made there is unfortunately a risk of scarring.  For some patients sometimes there may need to be repeated or back to back surgical interventions which increase the risk of scarring.  Genetics also play a role in how much scarring someone has post-surgical intervention.

  • Occurs usually after surgery, can vary depending on if the person has received chemotherapy, radiation, immunotherapy or hormone therapy.  Sometimes the area of tissue inconsistency can be painful or tender to the touch, other times it can feel like a lump which can be triggering for someone going through cancer and often it can block the flow of lymphatic fluid.

  • Chemotherapy while helpful in slowing and/or ridding the body of cancer cells also damages healthy tissues and cells including nerves.  Patients report a variety of symptoms such as numbness/tingling in the hands and feet, burning sensations in legs, pain with movement and at rest and other motor and sensory problems in the hands and feet.  These symptoms significantly impact patients' quality of life and can increase their falls risk and decrease their overall safety during their daily activity and mobility.

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