Surveillance program empowers women before, after breast cancer surgery

January 30, 2020 | by Edward-Elmhurst Health

A year ago, life was very different for Elmhurst resident Pam Boscamp. Reeling from a breast cancer diagnosis, she found herself in an unfamiliar world full of consultations, tests, surgeries and treatments. The active wife, grandmother, exercise and yoga enthusiast gets emotional as she remembers that time in her life.

“I’m looking at my calendar and all those appointments,” she recalls. “It’s truly overwhelming to think about.”

Things moved quickly. The two tumors in Boscamp’s left breast required removal and the surgery was scheduled just 10 days after detection. But prior to surgery, Boscamp was able to participate in Elmhurst Hospital’s Breast Cancer Rehabilitation Surveillance program, a free, multi-visit physical therapy screening program that prepares breast cancer patients for the potential postoperative issues they may face and helps detect early signs of surgical side effects.

“This screening prior to and after breast cancer surgical procedures assists us in monitoring changes in range of motion and strength, and helps us educate patients about the lymphedema that may result following surgery,” says Breast Oncology Navigator, Kelly Southwell, RN, BS, OCN, CBCN. “Managing deficits after surgery is all about early identification and intervention.”

The screenings are especially important when it comes to lymphedema, an abnormal swelling that can develop in the arm, hand, breast or torso following breast cancer surgery and/or radiation therapy. Education and early detection are crucial as lymphedema can be debilitating, requiring considerable treatment, especially when left undetected. The condition can appear months or years following surgery or treatment, so it’s important patients know what to look for.

Unfortunately, many insurance companies don’t cover the cost of pre- and post-operative screenings, but Elmhurst Hospital physical therapist Janet Benedict PT, DPT, CLT-LANA, understood the research that supports them. She led a 2014-2016 Elmhurst Hospital research project that showed 35% of breast cancer surgical patients develop some kind of deficit after surgery and that early detection allowed for faster recovery.

Aware of the research project’s outcomes, the Elmhurst Memorial Hospital Foundation fully supports the program, and now most breast cancer surgical patients are offered the opportunity to participate free of charge. According to Benedict, more than 250 patients have taken part in the program since it began in April 2016. The original study was funded by a grant through a private family foundation, and due to its success and outcomes, funding has continued through contributions from the Addison Trail High School Girls Clubs.

At an initial visit, patients meet with Benedict or Diane Bullock, PTA, CLT to undergo a series of screenings that establish baseline numbers for range of motion, strength and arm circumference. Patients leave with information about lymphedema and a plan for post-surgical exercises, and return approximately four weeks after surgery to repeat the screenings. If they’ve returned to baseline numbers, they may not need another visit. If they still have some progress to make, they’ll come back for another assessment.

“Following surgery, some patients may develop pain, swelling or struggle to use their arm to perform daily activities. A lot of patients dismiss it because they think ‘I just had surgery, this is normal,’” says Benedict. “After learning what to look for, patients are empowered to take control and recognize problems that may develop later on.”

Most importantly, if concerns are identified, a patient’s surgeon or oncologist is notified so treatment can be ordered.

Boscamp did well after surgery, returning to baseline numbers quickly, but six months after completing radiation treatment, her oncologist detected early signs of lymphedema. Thanks to the education she received in the Breast Cancer Rehabilitation Surveillance program, she knew what to expect and that she was going to be okay. Today, she’s back to a normal life and incredibly thankful for the expert and comprehensive care she received from her entire team of healthcare professionals.

My care was seamless at Elmhurst Hospital,” she says. “My life is not just cancer or my left breast. My life is my whole body, my brain, my whole sense of well-being.”

For Benedict, seeing the program through to fruition has been incredibly rewarding as she works with women and men dealing with breast cancer diagnosis and treatment.

Many patients cry in my office and I cry right along with them,” she says. “It’s so satisfying to be able to help them at a time when they feel completely lost.”

It’s clear the benefits of the program go beyond the physical, by supporting patients at a time when they need it most.

“Emotionally, I had one foot in the present dealing with the surgery,” says Boscamp. “But the screening program provided me with hopefulness. It allowed me to understand that there is life after surgery and something I can do about it.”

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