Meme kanseri ilişkili lenfödem: Egzersiz yapmak için bir engel midir?

Yıl 2017, Cilt: 10 Sayı: 3, 238 - 251, 24.12.2017

Ayşe Arıkan Dönmez Sevgisun Kapucu

https://doi.org/10.26559/mersinsbd.317653

Cited By: 1

Öz

Meme kanseri tedavisinin en yaygın komplikasyonlarından
biri olan lenfödem; ağrı, etkilenen
ekstremitenin hareket yeteneğinde azalma veya kayıplara neden olarak bireyleri
fiziksel, fonksiyonel ve psikososyal açıdan olumsuz yönde etkilemektedir. Meme
kanseri ilişkili lenfödem yönetimi uzun yıllardır
tartışma konusu olmuştur ve bu tartışma halen güncelliğini korumaktadır.
Fiziksel aktivite ve egzersizin meme kanseri ilişkili lenfödem yönetiminde terapötik etkisi ile
ilgili çok az kanıt olmakla birlikte lenfödem tedavisinin önemli
bir komponenti olduğu kabul edilmektedir. Geçmişte
meme kanseri ilişkili lenfödem gelişimini azaltmak veya tetiklememek adına
etkilenen ekstremiteye yönelik tekrarlı ve yorucu üst ekstremite
egzersizlerinden kaçınılması gerektiği düşünülürdü. Çünkü sağlık profesyonelleri
arasında da üst ekstremiteye yönelik yapılacak egzersizlerin lenfödem
gelişimini tetikleyebileceği veya var olan lenfödemin şiddetini olumsuz yönde
etkileyebileceğine dair görüşler mevcuttu. Ancak yapılan araştırmalar sonucunda
bu görüşlerin kanıta dayalı olmadığı ortaya çıkmıştır. Sağlık
profesyonellerinin sahip olduğu bu düşünceler ve hastalara yapmış oldukları tür
önerileri egzersiz türü, sıklığı, şiddeti vb. gibi konularda korku, gerginlik
ve endişe yaşamalarına neden olarak egzersiz yapmalarını engelleyebilmekteydi.  Günümüzde ise kanıt gücü yüksek randomize
kontrollü çalışmalar ile egzersiz tedavisinin lenfödem gelişimine veya mevcut
lenfödem tablosunun ilerlemesine neden olmadığı kanıtlanmıştır. Meme kanseri hastalarında
özellikle tedaviye bağlı olarak gelişen lenfödemin önlenmesi ve yönetimine
yönelik girişimler ile hastaları fiziksel ve psikolojik olarak olumlu yönde
etkileyerek bireylerin yaşam kalitelerine önemli bir destek sağlanabilir. Bu
doğrultuda farmakolojik olmayan yaklaşımlardan biri olan egzersiz programları
ile bireylerin kendini fiziksel ve psikolojik yönden daha rahat hissetmelerine
katkı verilebilir. 

Anahtar Kelimeler

Meme kanseri, lenfödem, egzersiz, lenfödem yöntemi

Kaynakça

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