Although we use the term “lymphedema therapist” in this section, there are a wide range of health care professionals who specialize in the diagnosis, treatment, and management of lymphedema after breast cancer. These include physical medicine doctors (physiatrists), nurses, physical therapists, occupational therapists, and massage therapists specializing in lymphedema therapy. Most cancer centers and hospital-based cancer programs will be able to refer you to a provider with expertise in breast cancer-related lymphedema. If your doctor doesn’t volunteer the information, ask for it. If you live in a remote area, it may be more challenging to find a lymphedema specialist close to home. Try to find someone within driving distance who can provide an initial consultation and some follow-up care.
The certification process for becoming a lymphedema therapist is not as well-defined as it is for other health care providers, such as nurses and doctors. However, the National Lymphedema Network (NLN) and the Lymphology Association of North America (LANA) have made some recommendations. Among these are the completion of 135 hours of training in complete decongestive therapy and experience working with patients in a clinical setting for at least one year. People who do this are eligible to sit for the voluntary LANA certification exam and, if successful, use the credentials “CLT-LANA.”
At the NLN and LANA websites, you’ll find an online directory of lymphedema therapists searchable by geographic location. You can also find international lymphedema organizations on the NLN Useful Links page and the LANA Resources page.
Still, it’s important to know that there is not yet a single agreed-upon set of standards that make someone a certified lymphedema therapist (CLT). The designation “CLT” after someone’s name is not necessarily an assurance of quality — just as there are trained professionals without this designation who are very good at treating lymphedema after breast cancer. Be prepared to research the training and experience of any lymphedema therapist you are considering. These questions can get you started:
- What is your medical specialty (physician, nurse, physical or occupational therapist, massage therapist, or other rehabilitation therapist)? How long have you been practicing?
- Have you received specific training in all of the elements of complete decongestive therapy , including manual lymphatic drainage, bandaging, and compression?
- Where and when did you complete your training in lymphedema management and treatment?
- Do you participate in continuing professional education on lymphedema?
- How much of your practice focuses on managing lymphedema after breast cancer treatment? How many people with breast cancer do you see in a typical week?
- Are you experienced in fitting people for compression sleeves and garments, or can you refer me to a fitter with your medical supply company?
- Which types of insurance do you accept?
- Would you feel comfortable letting me speak with a couple of your current patients?