Lymphedema Program Receives Coveted Center of Excellence Designation

Center uses both an interdisciplinary and multidisciplinary team approach, including certified lymphatic massage therapists to help cancer patients.

Sylvester Comprehensive Cancer Center, part of the University of Miami Health System, is dedicated to the care of patients living with lymphedema and lymphatic disease, and its leadership recently celebrated the designation of the health system’s Comprehensive Lymphedema Program as a Center of Excellence by the Lymphatic Education and Research Network (LE&RN).

“We are the first and only comprehensive lymphatic Center of Excellence in South Florida,” said Kyle Xu, M.D., the center’s director and assistant professor of plastic, reconstructive and microsurgery. “This designation advances our mission to provide the highest quality and most advanced care to our patients, to educate our future medical professionals on the field of lymphology and to perform cutting-edge research that will improve quality of life for our patients.”

Complementary Therapies

Lymphedema happens when lymph nodes or vessels have been damaged, removed or do not work properly, which can lead to swelling, limb fatigue, pain and a higher risk of skin infections. The condition often impacts cancer patients who have had their lymph nodes removed or irradiated as part of their cancer treatment.

“The Comprehensive Lymphatic Center uses both an interdisciplinary and multidisciplinary team approach, including certified lymphatic massage therapists, certified lymphedema physical and occupational therapists, cancer rehabilitation medicine, microsurgery and vascular surgery specialists to create individualized treatment plans to meet the needs of our diverse patient population,” said Diana Molinares, M.D., assistant professor of physical medicine and rehabilitation and director of the Division of Cancer Rehabilitation Medicine.

For patients at high risk of developing lymphedema, the center offers early and comprehensive screening and diagnostic tools, including bioimpedance spectroscopy, perometry, ultrasound, CT imaging, MR lymphography, ICG lymphography and lymphoscintigraphy. A wide spectrum of treatments is offered, including lymphatic decongestion through both manual work and various types of compression bandaging, therapeutic exercises and compression garments and pumps.

“The lymphatic center offers cutting-edge microsurgical and super microsurgical techniques that can repair lymphatic vessels as tiny as one to three millimeters, and less than one millimeter, respectively, using sutures thinner than an eyelash,” said Juan Mella Catinchi, M.D., assistant professor of plastic, reconstructive and microsurgery.

Better Lymphedema Outcomes

These surgeries can reduce the risk, and in some cases prevent the development of lymphedema.

“Patients who have breast cancer with lymph node involvement usually have their lymph nodes removed and then get radiation,” said Dr. Xu. “Their chance of developing lymphedema is about 30%, sometimes higher. With microsurgery, we can reconstruct the lymphatic system and decrease their risk to 5% to 10%.”

“Additionally, the medical team takes a holistic approach, addressing other common co-morbidities related to lymphedema in order to restore cancer survivors’ functional independence and quality of life,” said Laura Huang, M.D., assistant professor of physical medicine and rehabilitation and cancer rehabilitation medicine subspecialist.

The lymphatic center is focused on educating and raising awareness for medical professionals, hospital staff and the South Florida community about lymphedema and the many available techniques to combat it. Compared to their cardiovascular education, physicians in training receive relatively little information about the lymphatic system.

“Starting South Florida’s first and only Comprehensive Lymphedema Center was an important objective,” said Devinder Singh, M.D., chief and program director, Division of Plastic Surgery. “I am extremely proud that the program grew so fast and is now designated a center of excellence. Kudos to the entire team for a tremendous effort.”

Gaining LE&RN certification required a diligent effort from the lymphatic center team. This endeavor would not have been possible without the commitment and support of Frank J. Penedo, Ph.D., associate director of Cancer Survivorship and Translational Behavioral Sciences and director of Cancer Survivorship and Supportive Care at Sylvester; and Jessica MacIntyre, D.N.P., M.B.A., executive director for clinical operations, and her administrative team.

Tags: Comprehensive Lymphedema Program, Dr. Devinder Singh, Dr. Diana Molinares, Dr. Juan Mella Catinchi, Dr. Kyle Xu, Dr. Laura Huang, Lymphatic Education and Research Network, lymphedema, Sylvester Comprehensive Cancer Center, Tags: center of excellence