Le lymphœdème
Authors:
Dr. Christine Maheu, RN, PhD ,
Ms. Rosemary Cashman ,
Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital ,
Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC CancerDr. 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, BC Cancer
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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Partie intégrante de la circulation (système d’approvisionnement en sang), le système lymphatique joue un rôle crucial dans l’immunité. Il recueille également les fluides provenant des espaces des tissus et les achemine en vue de leur réintroduction dans la circulation. Lorsque sa fonction de transport est réduite, un gonflement apparaît dans la partie du corps touchée : c’est le lymphœdème.
Le lymphœdème provient d’une lésion ou d’une déficience du système lymphatique, qui peut être endommagé par les traitements associés à un cancer actif ou passé, ou par le cancer lui-même. Par exemple, l’ablation chirurgicale des ganglions, la radiothérapie et certaines tumeurs peuvent entraîner une réduction de la capacité de transport du système lymphatique. En général, le lymphœdème ne provoque pas de gonflement généralisé. Il est plutôt circonscrit à la région où la lésion s’est produite. Par exemple, une personne ayant subi une dissection axillaire pour traiter le cancer du sein pourra développer un lymphœdème dans le bras touché, sur la main ou sur le côté du buste. La croyance veut que le lymphœdème touche les membres, soit les bras ou les jambes. En fait, en fonction de son emplacement, la lésion lymphatique provoquera un gonflement du visage, des parties génitales ou du tronc. Outre un gonflement visible, de nombreux survivants signalent d’autres symptômes comme une sensation de lourdeur, de la douleur, une oppression, une souffrance continue et le mauvais fonctionnement du membre touché.
Conséquences sur le travail
Le lymphœdème peut compromettre le fonctionnement d’un bras ou d’une jambe, entraîner une sensation pénible et modifier l’aspect des membres. S’il se manifeste dans les bras, le patient aura du mal à les lever plusieurs fois de suite, ou encore à atteindre une hauteur supérieure à celle de la tête. L’amplitude des mouvements du bras touché peut également être réduite. En cas de lymphœdème dans les jambes, il sera plus difficile de rester longtemps en position debout ou assise.
Étape suivante :
L’adaptation du lieu de travail en fonction du lymphœdème
