Suffering of patients developing lymphedema following gynecological cancer surgery

J Rural Med. 2023 Oct;18(4):205-214. doi: 10.2185/jrm.2023-003. Epub 2023 Oct 1.

Abstract

Objective: Lymphedema developing in the lower extremities following gynecological cancer surgery (LE-GCS) produces various kinds of sufferings, including impacts on quality of life (QOL) and body image. This research will serve as a basic resource for the care of patients with this type of lymphedema (LE).

Patients and methods: A qualitative discursive research method: Thirteen patients suffering from LE-GCS were interviewed in a semi-organized manner. Analysis involved extracting and codifying from transcripts and expressions related to the suffering of LE. Next, these codes were arranged into categories and subcategories under the supervision of qualitative researchers. Furthermore, this study was conducted with the approval of the Research Ethics Review Specialist Committee, which targets individuals affiliated with the public university corporation of Shiga Prefectural University.

Results: Based on the interviews with 13 patients aged 47-79 (median age 62), two core categories were created: 1). Suffering of LE Developing in Lower Extremities (570 codes, seven categories, 23 subcategories); and 2). Supports that Allow Patients to Face Suffering of LE (254 codes, four categories, 14 subcategories).

Conclusion: Patients with LE-GCS live with the fear that LE exacerbation will produce adverse life changes, and this may exceed the fear of cancer itself. The aggravation of their condition results in immense pain as well as reduced mobility, change in appearance, and loss of self-worth. The symptoms fluctuate, and may lead to chronic misery, which does not manifest, but occasionally flares-up because of both, worsening physical disability as well as ordinary events. Additionally, every patient subjectively described the strength they found within themselves to face the suffering. They cited the support of family and friends, existence of compassionate therapists and doctors, acquisition of knowledge, and self-care.

Keywords: gynecological cancer surgery; lymphedema; suffering.