Gaining an accurate assessment of the stages of lymphedema subsequent to cancer: The role of objective and subjective information when to make measurements and their optimal use

Through the collection of subjective and objective information from patients prior to their surgery and/or radiotherapy, there are many opportunities to gain information about how the tissues between the side to be operated on and the contralateral one are structurally and functionally different. Knowing this base may help us make treatment more effective since the clinician knows well and accurately the base from which same data collected in the post operative post radiotherapy phase (when the lymphoedema may not be clinically manifest) will tell us how the patient is progressing and can indicate to the trained clinician how much there is a risk of that patient developing lymphoedema. This knowledge may serve to reduce the risk of that patient developing lymphoedema due to early treatment and management programs. Likewise the same data collected in the clinically manifest phase of lymphoedema can help the clinician and the patient decide on the effectiveness of any treatment or management strategy and through appropriate targeting of them can lead to a more effective resolution of the problem with a significant time and cost saving to the health system and to the patient. Through the collection of the very important and hitherto most often ignored subjective (qualitative) patient supplied information and reaction to it and through the provision of information to patients about what they can do to help themselves leading to improved awareness through patient empowerment we can achieve better results and can continue to achieve them with a declining staff and resource base. Most importantly, there is much information which we can learn from our patients, we should more frequently listen to them and act on and react to their suggestions. However, we can only treat their problems better when we record comments in a consistent manner and combine information with the traditionally collected range of objective information on which we have based the mainstay of our treatment to date. Overall then the objective and subjective data can help us significantly in getting the best result for our treatment and specifically allows targeted treatment and management strategies to be implemented. Particularly in times of limited budgets it can help us direct and select the appropriate treatment ensuring the best, most wanted and longest lasting result for the smallest cost.