Wake up Canada! We have a dedicated roster of "stars" right here in this country who are making their mark around the world through their evidence-based lymphatic research.

In British Columbia:

Professor Susan Harris at the University of British Columbia's School of Rehabilitation Sciences, Faculty of Medicine, has been instrumental in challenging the myth that individuals who have lymphedema should not undertake any exercise. Breast cancer survivors can be active, she suggests, in her study Challenging the Myth of Exercise-Induced Lymphedema Following Breast Cancer: A series of case reports, in June 2000 www.lymphovenous-canada.ca/exercise.htm

Professor Harris oversaw research with her student Antoinette Megens, which showed compression garments alone can be effective in reducing limb size, particularly after six months of use. (See: www.lymphovenous-canada.ca/ptpaper.htm for more information on this study). The two also illustrated the role of using Measures of Upper Extremity Volumes in Women Following Axillary Dissection for Breast Cancer in the Archives of Physical Medicine and Rehabilitation (See: www.lymphovenous-canada.ca/measuremtstan.htm)

The Canadian Breast Cancer Research Alliance has recently provided funding for Dr. Susan Harris and Kim Keays to conduct a study to examine the effects of Pilates on women living with breast cancer.

Although conventional exercise has already been investigated, Pilates has yet to be examined. To date, research on Pilates has been limited to dancers and the focus has been posture and alignment. This pilot study hopes to provide information about the safety and efficacy of this increasingly popular activity. Interest is also in managing the adverse physical and psychosocial outcomes commonly associated with breast cancer treatment.

For more information regarding the study; please contact: Dr. Susan Harris @ 604-822-7944 or Kim Keays at kkeays@shaw.ca.

Dr. Maria Hugi, an emergency room physician, participated along with Professor Susan Harris in the development of the Canadian Medical Association Clinical Practice Guideline 11 on breast cancer-related lymphedema. Both were members of the Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer, part of Health Canada's Canadian Breast Cancer Initiative. The Guidelines called for more research to determine the effectiveness of treatments for breast cancer-related lymphedema and has pressed for more funding dedicated to research in this area. Dr. Hugi now sits on the Canadian Breast Cancer Research Alliance research advisory committee.

Joseph Ragaz et al of the Department of Medical Oncology, British Columbia Cancer Agency, Vancouver. Reported on their research in a ground-breaking 1997 study: Adjuvant Radiotherapy and Chemotherapy in Node-Positive Premenopausal Women with Breast Cancer in the New England Journal of Medicine (See: http://content.nejm.org/cgi/content/abstract/337/14/956) The study reported on the increased rates of survival in women who receive radiation and chemotherapy - and also tracked the incidence of lymphedema in these women. Dr Joseph Ragaz, FRCP, is presently the Director of the Oncology Program, McGill University Health Center, one of the largest teaching medical institutions in Quebec, and a McGill Professor, departments of Medicine and Oncology.

In Alberta:

Margie McNeely is a research grant recipient of the Alberta/NWT Chapter of the Canadian Breast Cancer Foundation for a project - just completed - which investigated the effectiveness of manual lymph drainage (specialized massage) on breast cancer-related lymphedema. For information on this study click here. Margie works part-time at the Cross Cancer Institute as aRehabilitation Physical Therapist. The Cross Cancer has been doing dedicated lymphedema work with individuals who have had breast cancer for 22 years.

Professor Pierre-Yves von der Weid is an Assistant Professor with the Mucosal Inflammation and the Smooth Muscle Research Groups in the Dept. of Physiology & Biophysics, Faculty of Medicine at the University of Calgary, Alberta. He is looking at how lymphatic vessels pump, which may eventually lead to identifying drugs and improve the circulation of lymph fluid in individuals with lymphedema and other inflammatory disorders. For more information on his work see:www.lymphovenous-canada.ca/pierreyves.htm

In Ontario:

Dr. Ian Dayes, a Radiation Oncologist with Hamilton Regional Cancer Centre, is heading up a two year randomized trial on the effectiveness of decongestive lymphatic therapy on approximately 100 breast cancer patients in Ontario. The patients will be drawn from cancer regional centres in London, Toronto and Hamilton. Lyn Kligman, Advance Practice Nurse at the London Cancer Regional Centre, has been key in contributing information to the project, along with Donna Lue Reise, a Vodder-trained therapist in the Hamilton area. The project will involve advance practice nurses Kligman in the London Cancer Regional Centre symptoms clinic, Anne Blair, at the Sunnybrook Cancer Regional Centre lymphedema clinic in Toronto and Jennifer Wiernikowski, with the Hamilton Regional Cancer Centre Advance Practice Nursing Clinic for Breast Cancer Survivors. The project is funded by the Canadian Breast Cancer Research Initiative (CBCRI). To learn more about this unique project see: www.lymphovenous-canada.ca/ianandjennifer.htm

Pamela Hilliard,a physiotherapist in the Dept. of Rehabilitation Services at the Hospital for Sick Children in Toronto, spearheaded A Retrospective Study of the Effects of the Lymphapress Pump on Lymphedema in a Pediatric Population, along with A. Hassall and C. Graveline. Results of the study, which reported no noticeable side effects in the 16 children who used a Lymphapress pump, was reported in Lymphology 34(2001) 156-165. (See www.lymphovenous canada.ca/extremitypumps.htm for more information).

Professor John Hay: or "Jack" as he is referred to by his many friends, calls the University of Toronto Immunology Department his home. He has been working in the field of lymphatic research for close to 30 years. The focus of his laboratory at the U. of T. is the lymphatic system and its role in immune responses - most recently the traffic of cells in lymph as it relates to cancer. (See a full explanation of his research at: www.lymphovenous-canada.ca/jackhay.htm).

On April 6, 2003 Jack received a Biomedical Science Ambassador Award from the Partners in Research Foundation. Nature Immunology, Sept. 2005, Chemokine receptor CCR7 required for T lymphocyte exit from pheripheral tissues reported on Jack's joint work with researchers from Stanford University. They showed that lymphocytes traffic from the skin is regulated and sensitive to pertussis toxin. The researchers have suggested that regulated expression of CCR7 by tissue T lymphcytes may control their exist, acting with recruitment mechanisms to regulate lymphocyte transit and accumulation during immume surveillance and inflammation.

Professor Miles Johnston - Professor Miles Johnston, and the Sunnybrook Health Science Centre has often been a lone voice championing scientific research into the lymphatic system in Canada along with Professor Jack Hay. Johnston has studied a broad range of issues related to the lymphatics over the years (See his overview of issues in this area at: www.lymphovenous-canada.ca/research.htm).

Professor Johnston is currently undertaking a three year research project (2004-2007)on how lymphatic vessels regenerate up to 4 months after injury to the vessels, by measuring their ability to pump lymph, their resistance and permeability. His team will assess the influence of two molecules called VEGF-C and Ang-2 in the repair and the stabilization of the newly formed ducts. These studies should shed light on the feasibility of using new molecular agents in the treatment of lymphedema. The study is funded by Canadian Breast Cancer Research Alliance (CBCRA).

His lab has undertaken exciting and novel research related to connections between the central nervous system and the lymphatic system - suggesting that hydrocephalus may involve reduced CSF transport to, or into extracranial lymphatic absorption sites before birth. This research is reflected and built upon in the recently published article: "Integration of the subarachnoid space and lymphatics: Is is time to embrace a new concept of cerebrospinal fluid absorption?" Cerebrospinal Fluid Research, Sept. 20, 2005. In it, three Toronto scientists rethink the relationship between cerebrospinal fluid and extracranial lymphatic vessels. They suggest lymphatic drainage of brain antigens could effect the development of Alzheimer's disease and multiple sclerosis. Johnston sits on the editorial board of the U.S. scientific journal entitled Lymphatic Research.

Professor John Semple is with the Department of Plastic Surgery at Sunnybrook Health Science Centre and the University of Toronto. Between 2001-2006 he received $15 million for the Establishment of An Advanced Regenerative tissue Engineering Research Centre from the Ontario Research and Development Challenge Fund. The lymphatic system is included in the research he is undertaking at his Advanced Reconstructive Tissue Engineering Centre. Stay tuned for further developments in this area.

In Quebec:

Dr. Anna Towers, Director of Palliative Care at the McGill University Health Centre and McGill University, is in the process of developing the protocol to look at the psychosocial effects of lymphedema. The study, which should be starting in the summer of 2003, is McGill and hospital funded. About 50 or 60 women will be interviewed for the study and several focus groups will be held. Towers has been a long-standing supporter of the Lymphedema Association of Quebec and worked with the Association in sponsoring the First Montreal International Lymphedema Congress May 28-30, 2003.

In New Brunswick:

Researchers, Baukje (Bo) Miedema, PhD, Sue Tatemichi, MD, and Roanne Thomas-MacLean, PhD (now in Saskatchewan). In 2005 the Canadian Family Physician published a study by these researchers entitled: Breast cancer–related lymphedema Women’s experiences with an underestimated condition. The objective of these researchers in this study was to explore New Brunswick women’s experiences of BCRL and its treatment through a focus group and 15 individual in-depth interviews. The researchers concluded that participants were unaware of the risk factors and treatment options for BCRL. Family physicians should discuss BCRL with their breast cancer patients routinely. They should be vigilant for the possible onset of BCRL and, if it is diagnosed, should manage it aggressively to minimize the severe effect it has on the lives of breast cancer patients. For more information on this study click here

In Nova Scotia:

Victoria Sullivan Director Cancer Care Program which has a Lymphedema Clinic at the Elizabeth II Health Sciences Centre initiated a research study research funded by the Nova Scotia Breast Cancer Foundation and the Capital Health Research Foundation which they hope will compliment the work that is being done elsewhere in the country. Their $35,000 pilot project, which they expected to start early in 2004, will be looking at the effectiveness of compression garments versus bandaging and randomizing who gets what. They will be looking at the difference between using bandaging initially versus using compression garments over a two week period. For more information on on the Nova Scotia Lymphedema treatment clinic and this study click here

In Saskatchewan:

Roanne Thomas-MacLean, PhD: Dr. Roanne Thomas-MacLean of the University of Saskatchewan is heading up a cross-Canada study on lymphedema, pain and limitations to range of motion in breast cancer survivors. Her research team has received funding from the Breast Cancer Research Alliance (CBCRA) to undertake the study from 2004 - 2007. 1,000 women will be followed over a three year period to learn how many women will develop arm problems, what type of symptoms they have, what triggers arm problems, the extent to which arm problems can be disabling and their impact on women's emotional health. The study involves four sites: Fredericton, Montreal, Winnipeg and Surrey. For more information on this study click here