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Lower limb lymphedema in gynecological cancer survivors—effect on daily life functioning

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Abstract

Purpose

Lower limb lymphedema (LLL) is a common condition after pelvic cancer treatment but few studies have evaluated its effect on the quality of life and its consequences on daily life activities among gynecological cancer survivors.

Methods

We identified a cohort of 789 eligible women, treated with pelvic radiotherapy alone or as part of combined treatment of gynecological cancer, from 1991 to 2003 at two departments of gynecological oncology in Sweden. As a preparatory study, we conducted in-depth interviews with gynecological cancer survivors and constructed a study-specific questionnaire which we validated face-to-face. The questionnaire covered physical symptoms originating in the pelvis, demographic, psychological, and quality of life factors. In relation to the lymph system, 19 questions were asked.

Results

Six hundred sixteen (78 %) gynecological cancer survivors answered the questionnaire and participated in the study. Thirty-six percent (218/606) of the cancer survivors reported LLL. Overall quality of life was significantly lower among cancer survivors with LLL. They were also less satisfied with their sleep, more worried about recurrence of cancer, and more likely to interpret symptoms from the body as recurrence. Cancer survivors reported that LLL kept them from physical activity (45 %) and house work (29 %) and affected their ability to partake in social activities (27 %) or to meet friends (20 %).

Conclusion

Lower limb lymphedema has a negative impact on quality of life among gynecological cancer survivors, affecting sleep and daily life activities, yet only a few seek professional help.

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Acknowledgments

This study was funded by grants from the Swedish Cancer Society, The Cancer Research Funds of Radiumhemmet, The King Gustav V Jubilee Clinic Cancer Foundation, Gothenburg, and The Swedish State under the ALF agreement, Gothenburg. We would like to thank all cancer survivors and all other women who participated in the study. We would also like to thank Dr. L Lundgren and Mr. A Nygren, B.A., for their skillful linguistic revision.

Conflict of interest

The authors indicated no potential conflicts of interest. We have full control of all primary data and agree to allow the journal to review the data if requested.

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Authors and Affiliations

  1. Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden

    Gail Dunberger, Helene Lindquist, Tommy Nyberg & Gunnar Steineck

  2. Department of Gynecological Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Ann-Charlotte Waldenström

  3. Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden

    Gunnar Steineck

  4. Department of Gynecological Oncology, Karolinska University Hospital, Stockholm, Sweden

    Elisabeth Åvall-Lundqvist

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  1. Gail Dunberger
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  2. Helene Lindquist
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  3. Ann-Charlotte Waldenström
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  4. Tommy Nyberg
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  5. Gunnar Steineck
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  6. Elisabeth Åvall-Lundqvist
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Corresponding author

Correspondence to Helene Lindquist.

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Dunberger, G., Lindquist, H., Waldenström, AC. et al. Lower limb lymphedema in gynecological cancer survivors—effect on daily life functioning. Support Care Cancer 21, 3063–3070 (2013). https://doi.org/10.1007/s00520-013-1879-3

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  • DOI: https://doi.org/10.1007/s00520-013-1879-3

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