Demystifying lymphedema: development of the lymphedema putting evidence into practice card

Cancer treatment is the leading cause of lymphedema in developed countries. Development and severity of lymphedema have a significant impact on comfort, psychological distress, and overall quality of life. Incidence statistics have ranged from 5%-60%, with onset of symptoms ranging from immediately after treatment to 30 years after treatment. Oncology nurses caring for patients throughout the cancer trajectory have a critical role to play in early assessment of risk, prompt identification of lymphedema, and implementation of evidence-based, individualized treatment plans in collaboration with therapists. As part of an Oncology Nursing Society (ONS) project team, the authors of this article undertook a review of current literature to identify effective interventions for the treatment of secondary lymphedema. Following the guidelines established by the ONS Evidence-Based Practice Resource Team, the authors evaluated current clinical practice guidelines, systematic reviews, and research studies conducted since 1998. The team reviewed and synthesized the literature and developed evidence tables and a Putting Evidence Into Practice(R) (PEP) card. The data were reviewed by experts in the field of lymphedema management. The lymphedema ONS PEP card, a user-friendly, succinct summary of interventions, was released at the 33rd Annual ONS Congress in May 2008.