Treating Chronic Post-Mastectomy Lymphoedema With Low Level Laser Therapy: A Cost Effective Strategy To Reduce Severity and Improve the Quality of Survival

While there are some controversies and uncertainties about the effectiveness of LLLT in acute tissue disease and damage situations and some uncertainty about penetration, scatter and reflection effects of laser light, most do not apply to the progressive condition of chronic lymphoedema. In this study patients with moderate to severe chronic lymphoedema associated with axillary clearance and radiotherapy received 16 LLLT treatment sessions each of 2∼4 J/cm² over a period of 10 weeks. Each patient was their own control with the contralateral arm being used as a base reference point. the progression of LLLT was monitored fortnightly by circumference measurement, plethysmography, tonometry and bio-impedance as well as by subjective questioning of the patients. At the end of the 10 week period, oedema volumes decreased by an average of 19%, the lymphoedematous tissues progressively softened, the ECF volume significantly decreased and patients reported significant progressive improvements in aches and pains, tightness, heaviness, cramps, pins and needles, mobility and perception of circumference. the results show that when we are dealing with evaluation of treatment efficacy, we must not only present and interpret quantitative results but also the qualitative ones relating to the patient's quality of life. With declining health budgets, the cost of treatment is also a crucial issue. the cost of LLLT treatment in a public hospital was estimated at AU $16 per percentage point reduction compared with approximately AU $60 per percentage point reduction with the multifaceted complex physical therapy programs. LLLT is thus a cost effective strategy for the treatment of chronic lymphoedema.