Smartwatch App Targets Early Lymphedema Diagnosis

Smartwatches have transformed the way many people communicate and track their health. Considering this, researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) are testing whether these devices can also detect subtle early warning signs of lymphedema, a debilitating condition that sometimes affects cancer survivors.

Lymphedema is fluid build-up—most often occurring in the arms or legs—that causes gradual swelling. People who have had cancer surgery or radiation therapy for breast cancer and melanoma are at the highest risk, but the condition affects up to 90 million people worldwide.

A new clinical trial called Project Limb Rescue will create a reliable, painless, user-friendly and inexpensive monitoring platform for patients at risk for or diagnosed with lymphedema.

Led by OSUCCC – James surgical oncologist Carlo Contreras, M.D., and oncology nurse Lynne Brophy, the trial will use adhesive-based sensors that gather real-time data through custom smartwatch software to look for early signs of lymphedema.  Ohio State University engineering students helped develop the technology.

Early detection is key in lessening the impact of lymphedema. Developing ways for patients to monitor subtle changes at home – as with a wearable, real-time, data-measurement device – could be a game changer.

“We may be able to take steps to avoid lymphedema altogether or slow down the pace at which it accumulates over time, and that is so important for our cancer survivors’ quality of life,” said Brophy, an oncology clinical nurse specialist with the OSUCCC – James Stefanie Spielman Comprehensive Breast Center.

The team will recruit up to 35 men and women aged 19-90 who have been diagnosed with lymphedema in one arm for this smartwatch study. The device is equipped with Ohio State-developed, proprietary non-invasive sensors and custom Android-based smartwatch software to gather data on fluid retention. 

The adhesive-based sensors work through photoplethysmography (PPG) and bioimpedance (BI). PPG is an optical technique for detecting blood-volume changes in tissue, and BI evaluates the ways in which tissue responds to an externally applied electrical current. This combined information can help doctors detect rising fluid retention indicative of early lymphedema.

Doctors currently can detect lymphedema only by examining patients on a bioimpedance machine at a medical facility. Researchers hope that, in the future, patients could wear a monitoring watch that detects signs of lymphedema early and alerts a physical therapist or physician about it.

“We think a device like this used over the long term could settle patients’ fears and give them more control so they’ll know they’re doing the most they can to monitor their affected arms and legs, reduce their risk of lymphedema and live rich, full lives,” Contreras stated.

Understanding Lymphedema

Lymph nodes are small vessels that allow fluid to move through body tissues. During cancer surgery, surgeons remove nearby lymph nodes to determine if the cancer has spread. The more lymph nodes removed, the more likely fluid can build up in that area and eventually cause painful tissue swelling.

The condition is treated with exercise, compression garments, lymphatic drainage massage, and pneumatic pumps that manually stimulate movement of fluid throughout the tissue to reduce swelling. While effective, therapy can be lengthy and can disrupt quality of life.

The OSUCCC – James is designated as a Comprehensive Center of Excellence in the Diagnosis and Treatment of Lymphatic Disease by the Lymphatic Education & Research Network. This  international designation is awarded to hospitals that meet stringent quality standards of medical care for lymphedema and lymphatic disease in patient communities, including oncology.

The OSUCCC – James team includes seven plastic surgeons who specialize in microsurgical techniques required for lymphatic surgery. The team collaborates with experts in cardiovascular medicine and ambulatory rehabilitation, including more than a dozen physical therapists certified by the Lymphology Association of North America.