Research team
Expertise
My area of expertise lies within lymphology: a particular interest in lymphoedema after cancer, but also primary (congenital) lymphoedema to secondary (acquired) lymphedema due to venous problems or other causes. During my PhD period, my focus was on lymphedema after breast cancer; whereby attention was paid to evaluation methods to assess lymphedema of the arm, but also to the effectiveness of treatment methods (and very specifically manual lymphatic drainage) for breast cancer-related lymphedema, to the degree of functioning and quality of life in patients with lymphedema of the arm after breast cancer. During my post-doctoral research, I will extend my expertise to lower limb lymphedema and investigate methods of evaluating uni- and bilateral leg lymphedema and genital oedema (whether or not congenital or acquired after e.g. gynaecological cancer, urogenital cancer or skin cancer). In addition to the evaluation of lymphedema, research into the management and (conservative) treatment of lymphedema is still central as a second pillar.
The enigma of subjective lymphedema: Why do patients report lymphedema after breast cancer treatment without an objective measurable swelling? The role of sensory processing and subclinical lymphedema – LymphSens Trial.
Abstract
Breast cancer related lymphedema or BCRL is due to its chronicity and impact an extremely dreaded complication after breast cancer treatment. The prevalence rate of objective BCRL is declining due to the major shift into the treatment approach of breast cancer. However, prevalence rate of subjective BCRL is much higher than that of objective BCRL. Subjective BCRL is defined as the diagnosis of BCRL based on the patient's sensation of a difference in size at the arm and/or trunk without any objectively measurable swelling. At this moment, it is not clear how many breast cancer patients experience subjective BCRL and what the underlying mechanisms may be. We hypothesize that four mechanisms might be associated with the presence and the severity of subjective BCRL, including sensory processing problems (1. nociceptive and/or 2. neuropathic and/or 3. central) and the presence of disturbed lymphatic transport without clinical manifestation (4. subclinical BCRL). To understand who and why patients after breast cancer treatment report subjective BCRL, a multi-center longitudinal study will be performed. This will be the first study investigating in 230 breast cancer patients the prevalence rate and underlying mechanisms of subjective BCRL at different time points (starting pre-surgery up to 6 months post-radiotherapy), using state-of-the art and innovative assessment methods for both different types of BCRL and their underlying mechanisms.Researcher(s)
- Promoter: De Groef An
- Co-promoter: De Vrieze Tessa
Research team(s)
Project type(s)
- Research Project
Improving clinical screening, diagnostic and evaluation tools of lower limb lymphedema.
Abstract
Lymphedema is a chronic, debilitating disorder characterized by abnormal tissue swelling, adipose deposition and/or tissue fibrosis. Advances in oncologic treatment have led to an ever-increasing number of cancer survivors over time. As a result, morbidities related to the treatment (such as lymphedema) are likely to increase too. In the scientific community there is a large discrepancy in the reporting of incidence and prevalence data of lower limb lymphedema (LLL), because of a lack of valid and standardized measurement tools. It is unknown, at present, which measurement methods are the most accurate to use for screening, diagnosing or evaluating LLL in clinical practice. Consequently, at this moment there is an urgent need to validate the currently limited guidelines regarding screening, diagnosing (including severity grading) and evaluating unilateral and bilateral LLL and make them more concrete and unambiguous. To meet these needs, and to encourage an international uniformity regarding the management of LLL, the proposed project aims at developing a screening, diagnostic and evaluation set for patients with unilateral or bilateral LLL that can be used in clinical practice, based on directly edema-related measurement tools. Importantly, these sets need to be used in addition to questionnaires assessing problems or limitations in mental, social and general daily functioning as well as quality of life, in order to be able to outline a holistic treatment approach.Researcher(s)
- Promoter: Meeus Mira
- Fellow: De Vrieze Tessa
Research team(s)
Project type(s)
- Research Project