Alyssa Mixon, DO, MBA
Cancer Rehabilitation Assistant Professor
In this edition of Grand Rounds in Hematology and Oncology, Patrick M. Dillon, MD, University of Virginia Hematology & Oncology, Charlottesville, Virginia, introduces Alyssa Mixon, DO, MBA, Cancer Rehabilitation Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Virginia School of Medicine, Charlottesville, Virginia. In this 60-minute presentation, Dr. Mixon explores contemporary approaches to lymphedema prevention and management in cancer survivors, emphasizing the role of early detection and interdisciplinary care. The talk ends with a short Q&A discussion.
Dr. Mixon begins by defining lymphedema as a chronic, progressive condition often resulting from cancer treatment. A key focus is on identifying patients at high risk, including those undergoing lymph node dissection or radiation. She underscores the importance of risk stratification and proactive intervention to prevent progression to irreversible stages.
Bioimpedance spectroscopy (BIS) emerges as a critical tool for early diagnosis. BIS allows for detecting subclinical lymphedema before overt swelling occurs, enabling timely intervention. Evidence shows that monitoring patients with BIS and initiating early treatment reduces the incidence of chronic lymphedema and improves outcomes. The discussion highlights how BIS-guided protocols are integrated into cancer rehabilitation programs to support long-term survivorship.
Dr. Mixon also examines current strategies for managing established lymphedema, including manual lymphatic drainage, compression therapy, exercise, and skincare. Surgical options such as lymphovenous bypass and vascularized lymph node transfer are addressed for select patients with refractory disease.
Dr. Mixon advocates a multidisciplinary model of care, integrating oncologists, surgeons, physical therapists, and nursing staff to optimize lymphedema outcomes. She calls for increased awareness among clinicians to recognize early signs, utilize risk-based screening, and refer patients promptly to lymphedema services. Through a combination of surveillance, preventive therapy, and coordinated care, it is possible to reduce the burden of lymphedema and enhance the quality of life for cancer survivors.