McGill

Lymphedema

Dr. Christine Maheu, RN, PhD

Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.

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Ms. Rosemary Cashman

Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.

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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital

Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.

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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C

Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.

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The lymphatic system is part of the circulatory (blood) system and plays an important role in immunity. It also collects fluid from the tissue spaces and transports it for eventual return to the circulatory system. If the transport function of the lymphatic system is reduced, then swelling may occur in that region of the body. This specific type of swelling is known as lymphedema.

Lymphedema results from damage or impairment of the lymphatic system. People who have or have had cancer may be at risk for developing lymphedema because some of the treatments for cancer or cancer itself may impair the lymphatic system. For example, surgeries that remove lymph nodes, radiation therapy, and some tumours may lead to a reduction in the carrying or transport capacity of the lymphatic system. Lymphedema typically does not cause generalized swelling but instead shows up only in the region that may have been damaged. For example, somebody who had an axillary lymph node dissection for treatment of breast cancer may go on to develop lymphedema in the affected arm, hand or on the lateral trunk. Typically, we think of lymphedema affecting a limb—an arm or leg—but depending on where the lymphatic damage occurs, it can produce facial, genital or trunk swelling. In addition to visible swelling, many survivors also report other symptoms of lymphedema, including a feeling of heaviness, pain, tightness, aching and impaired function of the involved limb.

Vocational implications

Lymphedema may restrict the function of an arm or leg, cause discomfort and affect the appearance of the limbs. For lymphedema in the arms, repeated lifting may be difficult. Lifting items above the head may also pose a challenge. Survivors may also experience reduced range of motion in the affected arm. For lymphedema in the legs, it may be harder to sit or stand for prolonged periods of time.

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Read specific job accommodations for lymphedema