Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Curr Psychiatry Rep. 2024 Nov;26(11):635-642. doi: 10.1007/s11920-024-01543-y. Epub 2024 Oct 8.
Cancer-related lymphedema (CRL) places an already vulnerable patient population at risk for the development and worsening of psychological distress. The purpose of this review is to highlight factors contributing to distress in lymphedema secondary to breast, head and neck, genitourinary cancers, and melanoma and discuss pertinent treatment considerations.
Multiple factors contribute to distress in CRL, including changes in body image, sleep, sexuality, functional capacity, and social interaction. There is limited literature describing psychopharmacological considerations in CRL, though exercise, which may be used for the treatment of depression and anxiety, may also improve CRL. Psychiatrists, oncologists, physiatrists, palliative medicine physicians, and physical and occupational therapists should have an awareness and understanding of CRL. To effectively manage distress in these patients, it is crucial to be mindful of psychotropic side-effect profiles, emphasize non-pharmacologic modalities including psychotherapy and exercise, and ensure patients receive evidence-based treatments for CRL.
癌症相关淋巴水肿（CRL）使本已脆弱的患者群体面临发展和恶化心理困扰的风险。本文综述的目的是强调导致乳腺癌、头颈部癌、泌尿生殖系统癌和黑色素瘤继发淋巴水肿患者痛苦的因素，并讨论相关的治疗注意事项。
多种因素导致 CRL 患者痛苦，包括身体形象、睡眠、性功能、功能能力和社会交往的改变。虽然运动可能用于治疗抑郁和焦虑，但关于 CRL 中的精神药理学考虑因素的文献有限，运动也可能改善 CRL。精神科医生、肿瘤学家、理疗师、姑息治疗医生以及物理治疗师和职业治疗师应该了解并理解 CRL。为了有效地管理这些患者的痛苦，必须注意精神药物的副作用特征，强调包括心理治疗和运动在内的非药物治疗方法，并确保患者接受 CRL 的循证治疗。
