Jr. Casley-smith et al., Treatment for lymphedema of the arm - The Casley-Smith method - A noninvasive method produces continued reduction, CANCER, 83(12), 1998, pp. 2843-2860
BACKGROUND. This paper gives an outline of the Casley-Smith method for the
treatment of lymphedema of the arm. It includes a brief summary of the deve
lopment of manual techniques and the terminology applied to them.
METHODS. The four principles of this method are skin care, manual lymphatic
drainage, compression in the form of bandaging and/or garments, and exerci
se. The massage techniques, especially where they differ from other schools
, are described in some detail, as are the principles that apply in compres
sion and maintenance of reduction in lymphedema.
RESULTS, The results of this method have been analyzed both in Australia an
d in the United States and are discussed briefly. Mention is made of the be
nefits of the benzopyrones, which have been used for many years, when added
to the above treatment. Both benzopyrones and exercise will produce a cont
inued reduction after the treatment course. They are particularly useful in
a less compliant patient. It is stressed that the effect of patient compli
ance, particularly after treatment, makes a great difference to the ongoing
success of the regime.
CONCLUSIONS, A comparison is drawn between the efficacy of various current
treatments and their cost. This shows that this combined and conservative m
ethod of treatment should be considered before recourse to pumps or surgery
. The latter seldom achieve the results of decongestive lymphatic drainage,
and, in the long term, they are more expensive. Certain preventive measure
s may be indicated following, e.g., mastectomies. Prevention of the onset o
f lymphedema is of extreme importance. However, a return to as normal a lif
estyle as possible by the patient is also essential. The earlier treatment
begins after the onset of lymphedema, the better the prognosis for the pati
ent. Lymphedema can and should be treated. Cancer 1998;83:2843-60. (C) 1998
American Cancer Society.