Client had breast cancer

Bubbly Brit!

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My client of 3 months had breast cancer in May '05 and had a lumpectomy and axial disection. Since having the procedure, she has developed extreme tightness in her upper back, shoulders and neck.

I have used deep pressure on her, along with stretching, with limited, long-term improvement.

She has been seeing a pt who also has used traction at her neck.

How would you treat her? I also suggested she might want to explore acupuncture, and she is going to think about it.

Thanks for any suggestions.
 


What muscles have you been stretching and where have you been doing the DT work?
 


I'd recommend Lymphatic work from someone with advanced training/certification. Maybe someone in her PT office is certified? Having lymph nodes removed in the axilla can cause restricted lymphatic flow that affects the entire shoulder. Addressing this problem can provide profound relief on the "stiff" feeling & the tense muscles as well.
 


Sharon -

I'm mostly stretching arms/neck, releasing the pecs, the traps and scapula areas.

I've been using deep tissue in her upper back/neck region, along with stretching and rom neck and shoulders.

Thanks, Blisss, for your thoughts. I will ask her to check with her pt to see if anyone is available to do LD for her.

Donna
 


healer611, thank you for posting your question. While it is obvious that your intentions are good and you are truly concerned for the wellbeing of your client, please stop what you have been doing. I will share with you what I have learned about working with clients such as yours, and hopefully this will in turn be of benefit to your client.

The tightness that your client claims to be experiencing in her upper back sounds like a clear sign of lymphedema. If I were seeing this client, the first thing I would do is ask her to get checked out by her doctor, and if it is lymphedema, refer her to a Manual Lymphatic Drainage specialist.

EVERYONE PLEASE TAKE NOTE OF THIS - we as Massage Therapists CAN CAUSE LYMPHEDEMA in this population of clientele. Using DEEP PRESSURE (above level 2-3) in the quadrant where lymph nodes have been removed moves the lymph into a space where it cannot be processed, and thus it accumulates there and can result in lymphedema. Lymphedema is always a risk for people who have had lymph nodes removed, in fact, it is a risk for them for the rest of their lives. It can also come about from any number of activities such as heavy lifting with that arm or flying on a plane without bandaging.

Defining the quadrant affected -
Visualize a vertical line along the midline, a horizontal line at the waist, and another horizontal line below the clavicle and at the superior edge of the scapula. This creates 4 quadrants plus the head/neck. A single quadrant includes both front and back.

Lymph removal sites concerned -
Axillary, inquinal and neck.

A few rules of thumb to "do no harm" while working with clients who have been diagnosed/treated for cancer:

1. Avoid all circulatory work in the entire quadrant where the lymph nodes were removed. Very gentle acupressure holds are ok.
2. Avoid stretching in the affected quadrant, as well as any stretching in another quadrant which will pull on the tissue of the affected quadrant.
3. Avoid ROM in the affected quadrant.
4. If the client is in chemo, or is within one year of completing chemo treatment, only apply light circulatory massage at a pressure level of 2-3 on all areas of the body excluding affected quadrants. Again, gentle acupressure holds are ok.
5. Regular acupressure (level 6 or so) is ok on the BOTTOMS of the feet for all clients.

There are some very lovely, effective bodywork techniques that can be learned from a qualified, experienced Oncology Massage instructor and can be used when working through any seforum.xxxe of cancer. I am not an expert in this, however if anyone has any other questions about treating cancer patients, please feel free to PM me, and I would be happy share the information I have with you. You can also contact the following Oncology Massage specialists:

Isabel Adkins http://www.OncologyMassageMatters.com
Gayle MacDonald http://www.medicinehands.com/
Tracy Walton http://www.tracywalton.com/
Charlotte Michael Versagi http://www.beaumonthospitals.com/pls/portal30/site.web_pkg.page?xpageid=allied_onc_des
 


Cy,

Thank you so much for your information. I have already called my client and suggested that she see her oncologist to speak about this.

I was at the point where I knew something else was probably at issue, and I only regret not saying something to her sooner. I sincerely appreciate your information.

(Tracy Walton was a teacher of mine while in school, but I have not taken her Oncology training. Perhaps I should.)
 


I would just like to add a few thoughts. First, I have had breast cancer and had lymph node dissection 11 years ago. I have never had lymphedema but I did have a lot of tightness in my arm and under my axilla. I agree that no deep tissue work should be done on the area that has had lymph nodes removed. It was always recommended to me that even the taking of blood or a blood pressure cuff should be avoided on that side.

I really like John Barnes Myofascial Release and as soon as I learned about MFR, I released all my breast cancer scars, and also the tightness in my upper arm and axilla. I have felt much freer since. However, do not use traditional forms of MFR as much of it would be too deep. Very gentle cross-handed releases or light, sustained compression on the affected area should help ease the tightness. Follow the fascia!

If you stop to think what the fascia has been put through during the surgery, it is not surprising that there are problem areas in the fascia.

I help to moderate a Breast Cancer Support Group. One lady had a lot of pain and got out of breath every time she tried to walk although she had been a runner before surgery.

I did some very light releases all around the areas that felt tight and she thought it felt much better. I suggested she try a walk first but she told me later that was able to jog that evening, without pain for the first time since her surgery which had been some months prior.
 


Thank you so much for sharing, Marion. I have wondered what styles of work would benefit scar tissue most, so thanks for pointing me in the direction of John Barnes' MFR.
 
Breast cancer client

Without wanting to repeat the postings here too much,

I don't do a lot of lymphatic drainage work (being a male practitioner, I don't feel as comfortable with this modality). Having said that I had great success with a client who was recovering from breast cancer surgery. She had a large , uncomfortable fluid build up near her armpit and was referred to me for MLDM, and in one session we drained most of it away.

It was a very satisfying session, and she was lovely enough to send me a photo and thankyou card from her home state.

Just thought I'd share that in case you were interested or needing to be convinced about the lymphatic drainage benefits.

Best regards,
Luke.
 


Thank you, Luke, for your post.

You say you don't do much MLD since you are not comfortable doing it ... do you mean in this scenerio? Since she was referred to you, you must have had training in that modality. What other areas do you tend to use MLD (any specific populations?).

I would be interested in exploring what training is involved and where a specialist in MLD would work. From my initial exploration, I have found a number of MLD specialists are working in rehab centers.

Donna
 


healer611 said:
Thank you, Luke, for your post.

You say you don't do much MLD since you are not comfortable doing it ... do you mean in this scenerio? Since she was referred to you, you must have had training in that modality. What other areas do you tend to use MLD (any specific populations?).

I would be interested in exploring what training is involved and where a specialist in MLD would work. From my initial exploration, I have found a number of MLD specialists are working in rehab centers.

Donna

I know you addressed this question to Luke, but since I specialize in lymphatic work, I thought I'd respond as well. Generally in the U.S., there are two respected methods to become trained in lymph drainage:

Upledger's LDT Training Series (where I chose to get my training):
http://www.iahe.com/html/therapies/ldt.jsp

Vodder's MLD Training Series:
http://www.vodderschool.com

You can take the first level of either training, to see if you like it, before advancing on to certification. In order to work safely with lymphedema, over 100 hours of training is recommended. Both the Vodder School & Upledger have a lymphedema certification program.

Upledger also teaches a wide variety of other applications for lymphatic work. Generally, the works boosts the body's healing ability overall, and therefore can assist with the healing of just about any health condition you can imagine: allergies, digestive disorders, menstrual problems, skin conditions, all kinds of pain relief, inflammation, pre/post surgery, healing from injuries, etc. In my massage therapy practice, I specialize in lymphatic work. I offer 30-min to 90-min sessions, and work with people cumulatively on health issues. I also combine it with massage frequently, because LDT has a side-effect of relaxing the muscles, making the massage both easier & more effective.

I highly recommend LDT1 through Upledger. It's amazing. A wonderful side benefit of the training is that you learn to do lymphatic work on myself. It's a wonderful self-care tool.
 
MLD comfort

Hi Donna,

I just meant that as a male therapist, I'm happy to do remedial massage around the inner-thigh and front of the hips. When it comes to MLD, however, its just not the kind of touch I like to use around the anterior hip region on female clients. Thats not to say I don't think males should do it, its just a personal issue that I had with doing it.

As far as quals go, I just did a short course in MLD and don't claim to be an expert by any means - but I knew how to drain that region and just put what I knew into practice with fantastic results. I still do MLD regularly from the shoulders upward by the way.

Hope that helps! Best regards, Luke
 


Blisss and Luke -

I am convinced the work is effective and will likely take Upledger's MLD Level 1 in April when it comes to my area. In the meantime I am going to try and get my hands on some of the reading material for that workshop.

There are many modalities that interest me and it's hard to choose which direction to go in. After working as an MT for almost 10 years, I am looking to slow down a bit and do less physical work. I want to do a more specialized type of massage and market myself as doing that. So at this point I am exploring possibilities such as MLD.

Again - thanks for your info.
 
dvd

Good luck with that Donna, I was just sent a DVD on MLD - I'll PM you when I've watched it and let you know if I think it would be of any help. Obviously no substitute for training but somtimes the more ways things are explained the better they sink in.
 
boob

I will be massaging a friend in Portland, OR who has had a breast removed (cancer) and has an implant. The thoroughness of this thread is impressive and appreciated. Thanks for the question and the considered responses, you are wonderful .
 
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    Tomorrow's sneak peek: On Thursday May 29, 2025, our attendants will be Ada ๐Ÿค—, Cici ๐Ÿคฉ, Vicky ๐Ÿ˜, Sophie ๐Ÿ˜ and Monica ๐Ÿฅฐ. Call us at โ˜Ž๏ธ(905) 479-6668โ˜Ž๏ธ to book!
  30. wilson holistic centre:
    ๐Ÿ’•๐Ÿ’•Beautiful Korean girl working at 382 Wilson Ave ๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-840-0071โค๏ธโค๏ธ
  31. Nu spring spa888:
    ๐ŸŒน๐ŸŒน๐ŸŒนsexy hot Viennese ๐Ÿ’–Filipino ๐Ÿ’– Korean girls ๐Ÿ‘working at Nu spring spa๐Ÿ’‹๐Ÿ’‹โ˜Ž๏ธ416-669-8508๐ŸŒน๐ŸŒน๐ŸŒน
  32. Spa in Markham:
    GOLDEN FS โ€“ 8380 Kennedy Rd ๐Ÿ“ž 905-258-0777 / 416-688-6886 ๐Ÿ‡ป๐Ÿ‡ณ CICI, ๐Ÿ‡ฎ๐Ÿ‡ณ SONIA (2PM), ๐Ÿ‡ฒ๐Ÿ‡พ AMY ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookinggoldenlove
  33. FLOWER Spa - BLUEXADO | Thornhill | VAUGHAN:
    BLUEXADO FS โ€“ #06-1102 Centre St ๐Ÿ“ž 416-357-9797 / 416-678-8668 ๐Ÿ‡จ๐Ÿ‡ด MEGAN, ๐Ÿ‡ป๐Ÿ‡ณ MY LINH, ๐Ÿ‡ป๐Ÿ‡ณ JULIE ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingbluexadolove
  34. FLOWER Spa โ€“ PINK | Scarborough | TORONTO:
    PINK FS โ€“ 3300 McNicoll Ave ๐Ÿ“ž 416-299-5515 / 416-817-3839 ๐Ÿ‡ฎ๐Ÿ‡ท ELINA, ๐Ÿ‡ป๐Ÿ‡ณ KELLY, ๐Ÿ‡ธ๐Ÿ‡ฌ CANDY (12PM) ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingpinklove
  35. Golden Sunshine Spa:
    โœจClick on our Username and FOLLOW US for updates and special services ! โœ… Click Here Today๐ŸŒธAkame๐ŸŒธChristina๐ŸŒธXuka๐ŸŒธLynda๐ŸŒธMilly Call us โ˜Ž 905 - 265 - 2158โ˜Ž๏ธ Your ultimate service awaits! โœจ
  36. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Click Here Meet๐ŸŒธTina๐ŸŒธIsabella๐ŸŒธMonikaCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
  37. SL Spa:
    ๐Ÿ’†โ€โ™€๐Ÿ’–WooHoo Wed๐Ÿ’– Ultimate destination for Asian massages๐ŸŽ‰ Two fab spots: Richmond Hill & Oakvilleโœจ Your passport to paradise with 10 enchanting girls fr China, HK, Japan & Korea โ€” ๐Ÿ†•Luna, Cindy, Coco,Cici, Jenny, Amber, JPN Yui, Akino, Jasmine & Lucyโ€” ready to pamper you๐ŸŽ๐Ÿ Ring us ๐Ÿ“ž647-695-6354 or text us ๐Ÿ“ฑ647-578-8169โœจ 160 East Beaver Cr., Unit 12, RichmondHill ๐Ÿ’ฐWhere Eastern charm meets Western comfort - your bliss awaits๐Ÿ™Œ
  38. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน2 girls ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ5124 Dundas St W Etobicokeโ˜Ž๏ธ416-817-3366๐Ÿ‘ Table Shower Sea Salt Bath Body Scrub๐Ÿ˜˜ Japanese girl Nina โค๏ธ Natural Big Boobs 38 DD ๐Ÿ˜˜Pink Mini Nipples Hot body slide, super enjoyable๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ very provocative service๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜, professional super Luna deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธYou are welcome to make an appoint
  39. SpringGreen.:
    Today we have 5 girls on downtown Toronto 72 gerrard st west๏ผš๐Ÿ’‹๐Ÿ’‹ New girl gaga Serving The Queen ๐Ÿ’‹๐Ÿ’‹Bunny- Tanned Spanish beauty with large melons and a fun booty too Wendy- exotic goddess with a gymnasts body and corresponding flexibility Jennifer- Exotic beauty with... Call and text 647 891 0699 ask questions Thanks ๐Ÿ’‹๐Ÿ’‹
  40. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  41. Red Rose Spa:
    ๐ŸŒธ We have 5 hot brown girls today ๐ŸŒธ MONICA, PAOLA, MALIYA, MONIKA, AMANDA, ASHA, JAZMINE, PREETI, ANGELINA, KIRAN ๐ŸŒธ 2588 Birchmount ๐ŸŒธ 2 Invergordon ๐ŸŒธ 647-702-8800 ๐ŸŒธ Please visit for a great erotic massage
  42. wilson holistic centre:
    ๐Ÿ’•๐Ÿ’•Beautiful Korean girl working at 382 Wilson Ave ๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-840-0071โค๏ธโค๏ธ
  43. wonderspa:
    ๐ŸŒบWonder spa,(9421Jane st unit127)call416-5000-800โ˜Ž๏ธbest massage in vaughan,Wednesday RMT available,๐Ÿ’„sexy face young girl Joey natural c cup,very good looking nice body slide,really popular ๐ŸŽlong hair Q Lucy good strong to relax oil massage, Relieve pain and remove stress,more experience,๐ŸŒนvery nice new girl CiCi, amazing the end,give you warm time,must try๐ŸŒน๐Ÿฅค
  44. AliceSpa:
    WEDNESDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—” 416-298-0898, 4915 Steeles Ave. E, Scarborough 3 very nice girls here today. Open 10am to 9pm: CLOUDIA (11am-8pm): is Vietnamese, young, petite 5'2" & 96 Lbs, B Cup, best rim deep bbbj cim. $40 Room Fee + $80 (incl bbbj & fs). +$20 for rim/cim. Excellent open minded services. DORIS (12pm-9pm): from Taiwan, is young & petite with loing thick black hair, 105 Lbs
  45. Annie Spa:
    ๐Ÿ’‹๐Ÿ˜˜Sexy Petite Korean๐Ÿ‡ฐ๐Ÿ‡ทGirl Eva working with Sweet Beautiful Japanese New Cummer to Canada Feifei ๐Ÿ‡ฏ๐Ÿ‡ต and Sensual Pleasing Busty Coco๐Ÿ‡จ๐Ÿ‡ณtoday๐Ÿ’‹๐Ÿ˜˜Call or text ๐Ÿ“ฒ647-891-9688 or 416-291-8879๐Ÿ“ฒ
  46. EMSpa_schedule:
    Hey! Where have you been? Today (Wednesday), our amazing attendants are Carla โ€, Cici ๐Ÿ˜, Opal ๐Ÿคฉ, Sandy ๐Ÿค— and Yoyo ๐Ÿ˜. Call us at โ˜Ž๏ธ (905) 479-6668 โ˜Ž๏ธ to book your favourite and head on over to 7665 Kennedy Road, Unit 4, Markham!
  47. ForeverWarden:
    Wednesday at ๐Ÿซฆโค๏ธ๐Ÿ”ด๐ŸŸฅโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ: Bella, Cindy & Sasa. Bella is around 5โ€™3โ€ with a thin to medium build, C Cups, and a pleasing personality. She can offer dfk, bbbj and cfs as well as a good massage experience. Cindy is a slim beauty, 5โ€™4โ€, natural C Cups. Her massage is nice, her services will drive you wild & her finish is a dream
  48. HolidaySpa:
    Wednesday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: FIONA, KIKI & CINDY. FIONA is a slim hottie with long dark hair, great melons and ass, and nice services. Kiki is very attractive, young, about 5โ€™4โ€ and 110 Lbs., slim with a banging body. Kiki is very popular for her great attitude and services. CINDY is slim & incredibly sexy
  49. SugarLoveSpa:
    Wednesday at โค๏ธ๐Ÿ’™ ๐Ÿ’œโŽ๐—ฆ๐—จ๐—š๐—”๐—ฅ ๐—Ÿ๐—ข๐—ฉ๐—˜ ๐—ฆ๐—ฃ๐—”โŽ ๐Ÿ’–๐Ÿ’—๐Ÿ’˜: SARAH, SUSAN, TIFFANY & VIVI. 1270 Finch Ave W (at Keele St), Unit 18. North York, ON โ˜Ž ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฏ๐Ÿฒ๐Ÿฑ-๐Ÿฎ๐Ÿฒ๐Ÿด๐Ÿด โ˜Ž SARA is a beautiful Thai lady with C Cups, 160 Cms and 50 Kgs, with a full set of services to delight you. SUSAN is a small, slim & sexy Latina girl, 5'4" & 116 Lbs, with nice boobs and ass, very versatile services.
  50. ใ™ใฟใพใ›ใ‚“:
    Top notch line up with superstars like sunny , gabby , elena , kiki , Ella and cindy. At top notch wellness
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