Anita Rebecca and Mohamed Shafi.
Hamad Medical Corporation (HMC) provides international standard of care under best practices and clinical guidelines for hundreds of people with lymphedema each year.
The National Center for Cancer Care and Research (NCCCR)’s Oncology and Lymphedema Physiotherapy Outpatient Department located at Qatar Rehabilitation Institute(QRI) is the first and only provider of lymphedema treatment in Qatar.
In 2020, the department received 620 patients compared to 400 in 2018, out of which 355 were female breast cancer survivors.
“The NCCCR’s Oncology and Lymphedema Physiotherapy Department was established in 2013 and cares for patients transferred from across HMC’s network of hospitals, as well as from primary health centers, and private healthcare providers in the country following the rules and regulations of referral system of HMC,” said Head of Oncology and Lymphedema Physiotherapy Department, Mohamed Shafi.
“The treatment of cancer has advanced significantly over the past few decades in the country, similarly new treatment methods or services are available for lymphedema. The department has developed first-of-its-kind in the Middle East best practices and clinical guidelines for the care of primary and secondary lymphedema by developing a dedicated lymphedema clinic and has made an impact on the population of Qatar aligning with Qatar’s National Health Strategies,” said Shafi who is also a Cancer Rehabilitation Specialist.
He added that the lymphedema team works closely with multidisciplinary teams running specialized clinics which includes the breast cancer related lymphedema clinic, head and neck lymphedema clinic and vascular related lymphedema clinic. In order to address the needs of the patients who are employed and the increased number of referral, the Department has extended its services through the evening clinic.
Lymphedema is a chronic condition characterized by localized fluid retention and tissue swelling and is caused by a compromised lymphatic system. It commonly affects the upper limbs and legs, but can also occur at the face, neck, abdomen, and other parts of the body. The condition can be primary or secondary, with primary lymphedema caused by the abnormal development of the lymph system and secondary being the result of damage to the lymph system. The condition is a common side effect of some cancer treatments, including surgery and radiation therapy.
According to a LANA Certified Lymphedema therapist, Anita Rebecca, surveillance and early careful management can reduce its symptoms and help prevent the condition from getting worse. This has led to the implementation of the evidence based “prehabilitation” where the education on lymphedema and post-operative precautions and exercise recommendations are given before the patient with breast cancer goes for breast surgery.
“At the clinic, treatment plans are customized for each patient and generally include meticulous skin care, decongestive exercises, lymph drainage, which is a form of massage that stimulates the lymph vessels, compression bandages and garments. Patient education and nutrition counselling are also an important part of the treatment plan,” she said. She also said that several advance methods such as Pneumatic Compression Pump which inflate and deflate to decongest and manage swelling is presently used. The Department is in the process of implementing advanced tools like bio impedance spectroscopy, an effective surveillance technique than standard tape measurement in detection and early treatment of lymphedema.
In addition to caring for patients, HMC is also focused on raising awareness among medical professionals and the general public about lymphedema. The Department recently held events for doctors and other healthcare professionals as well as among cancer patients and the public to raise awareness about lymphedema and the importance of early treatment.
According to Anita, another milestone for the Department was overcoming the barriers and challenges faced during the COVID-19 pandemic.
“To ensure the continuity of quality of care delivered to the patient whereby reducing the physical and psychosocial burden of the patient, the team implemented the tele-rehabilitation through the technical support provided by HMC. A quick response from the team led to the development of Online Resource Educational Videos of education, exercises, manual lymphatic drainage and compression bandaging in multilingual languages including Arabic, English and Hindi,” she said.
