Cross Cancer Institute,
Northern Alberta Cancer Program,
Lymphedema Management Program,
11560 University Ave.,
Edmonton, Alberta CANADA T6G 1Z2
Telephone: (780) 432-8716
Cross Cancer Institute's Lymphedema Management Program puts an emphasis on compression treatment with MLD provided to select/appropriate patients. The clinic can assess and provide guidance to clients on purchasing the appropriate compression garments and sleeves. Reid sleeves are provided on trial basis for assessment. Clients are also assessed for Legacy, MedAssist and Circaid sleeves.
The Institute's current treatment program is comprised of the following components:
Tom Baker Cancer Center Rehab Dept.
Lymphedema Management Program
2210-2nd St SW, Holy Cross Site,
Calgary, AB T2S 3C3
In the fall of 2006 publicly funded lymphedema treatment for cancer patients was extended to southern Alberta. Patients who meet eligibility criteria are being referred to the Tom Baker Cancer Centre at the old Holy Cross Hospital Centre.
A physiotherapist and occupational therapist have been hired to take over treating cancer lymphedema patients using the protocol that the Cross Cancer Institute uses in Edmonton Alberta. The Tom Baker Centre will be permitting GP's to provide a referral note to enable patients with secondary lymphedema to get treatment at their centre, in addition to their surgeon or oncologist, as was previously the case.
Canadian Prostate Cancer Network
The BC Cancer Agency Lymphedema Control Program no longer exists. Their publication, "Management of Breast Cancer Related Lymphedema" however can still be downloaded, at www.bccancer.bc.ca/PPI/TypesofCancer/Breast/Rehabilitation/default.htm
The British Columbia Ministry of Health funds medically required hospital treatment if the individual has been referred by a physician. Hospital-based physiotherapy is available at some facilities and requires referral from a physician.
The services of physiotherapists in private practice are not a benefit of the Medical Services Plan (MSP). Some private medical plans may reimburse their members for a portion of the cost of these services.
Physiotherapy, along with chiropractic, naturopathy, massage therapy and non-surgical podiatry, is a "supplementary benefit" that is limited to beneficiaries in receipt of MSP premium assistance. British Columbians receiving premium assistance are eligible to have MSP pay $23 per private visit towards a combined annual limit of 10 visits each calendar year. Effective April 1, 2008, acupuncturist services were included among the choice of services available. In addition, recipients of income assistance may qualify for an additional 12 visits through the Ministry of Social Development.
For patients who have received a full mastectomy and who have paid the relevant deductibles, Pharmacare will cover most of the cost of:
Although B.C. does not have an Assistive Devices Program, some financial assistance may be provided on a sliding scale basis to purchase extremity pumps through the Ministry of Human Resources. The multiple compression pump treatments necessary for lymphedema control are provided at no cost in a cancer clinic or hospital setting. The Medical Services Plan of B.C. does not cover the cost of manual lymph drainage (MLD) or complex decongestive therapy (CDP).
For more information on lymphedema treatment programs in B.C.
contact the B.C. Lymphedema Association at: www.bclymph.org/
Information regarding services in Manitoba for persons with lymphovenous disorders is available from local health professionals, including physicians and physiotherapists, or from the offices of any one of the 11 Regional Health Authorities (RHA) at: http://www.gov.mb.ca/health/rha/rhamap.html.
There are certified lymphedema therapists working throughout Manitoba. While this therapy does not have a governing body (in Manitoba), you may find listings of certified therapists on the websites of those bodies which provide this training. While Manitoba Health does not promote or recommend one organization over another, however they recommend that Manitobans receiving this therapy choose one which has been trained and certified by a reputable organization.
The Winnipeg Regional Health Authority Breast Health Centre (BHC) treats patients who have lymphedema after breast surgery/treatment. The staff hired at the BHC are certified in Manual Lymph Drainage (MLD) therapy and the service is available to all breast cancer patients regardless of whether they have received their referral through BHC or elsewhere.
All costs related to MLD therapy at BHC are publicly funded, but clients are responsible for the costs of the compression garments. There is some funding available for those who are unable to manage these costs. Breast health patients who receive private MLD treatment are not eligible for MH funding, however these costs may be covered by some insurance plans.
The services of a private practice therapist are not insured by Manitoba Health (MH) but may be covered through private insurance plans.
Treatment of lymphedema from any cause is also available via referral at the Health Sciences Centre Physiotherapy Department. These services are covered by MH, except for the cost of compression garments.
On the recommendation of a medical professional, extremity pumps may be provided to the individual through the RHA, on a loan basis without charge. The BHC does not use, nor does it offer, extremity pumps if recommended by a medical professional.
Persons with lymphovenous disorders may also meet the eligibility criteria for the provision of services through the Home Care Program (HCP). Home Care services include a range of health professional and para-professional services which are available throughout Manitoba. Referrals for assessment to the HCP may be made to the RHA where the individual resides. On the recommendation of a medical professional, extremity pumps may be provided to an individual through an RHA, on a loan basis without charge. This varies between RHAs.
For more information contact your RHA.
Note: An Atlantic Clinical Lymphedema Network has been established made up of CDT trained physiotherapists, nurses and massage therapists who work in the four Atlantic provinces.
In January 2003 the Atlantic Chapter of the Canadian Breast Cancer foundation assisted in funding the training of another physiotherapist in Complete Decongestive Therapy for the treatment of lymphedema.
Laine MacKinley BScPT, CLT, now works with Andrea Tilley, BScPT, in conjunction with the existing program out of Saint Joseph's Hospital at 130 Bayard Dr., Saint John, N.B. Tel: (506) 632-5510. The program also treats those with lymphedema at the Saint John Regional Hospital, University Avenue, Saint John NB. Tel. 506-648-6912.
Other therapy clinic:
Michelle Murray, Diana Leich and Assoc., 717 Millidge AVe., or 2 Mount Pleasant Court, Saint John, N.B. Tel: (506) 693-7325
Medical Services Insurance Plan
Telephone (902) 468-9700
The Lymphedema care program, at Capital District Health Authority, is located in the Rehab Services Department in the Dickson Building of Victoria General Hospital. The client services are provided by an Occupational Therapist and a Physiotherapist who both have certification training in Complex Lymphedema Therapy. This is a multi-faceted program that offers:
Once a month, an educational and screening session is offered to individuals who have had a diagnosis of breast cancer and are at risk of developing lymphedema post surgery and radiotherapy treatments. Clients are also seen on an individual basis who have a primary diagnosis of cancer and have lymphedema for assessment and treatment.
Assessment and consultative services are offered to clients/family/physicians regarding lymphedema not related to a diagnosis of cancer. View their brochure on their lymphedema program here
For more information contact Audrey Deveaux, physiotherapist, Rehab and Supportive CareServices 4th floor Dickson Building ,5820 University Ave., Halifax, Nova Scotia B3K 1V8 or e-mail at: Audrey.Deveaux@cdha.nshealth.ca
In 2006 the Eastern Health Board recognized the need for and provided funding for a Lymphedema Nurse Co-ordinator position permanently. You can contact the RN at the Cancer Care Program, Eastern Health, 300 Prince Philip Drive, St. John's, Nfld. AlB 3V6 at: (709) 777-8713.
Martina Reddick (Nurse Co-ordinator with Eastern Health) was involved in a clinic trial with 3M™ Coban™ 2 Layer Compression System 2 Layer Compression System with good results treating upper and lower extremities. The results of this trial were reported at the 3rd International Lymphoedema Network conference in June of 2011.
In 2011 RN Bev Lanning was hired to co-ordinate services for individuals with lower limb lymphedema in central Newfoundland. You can contact Bev for more information at: firstname.lastname@example.org
For other patient inquiries in the Eastern Region contact 709-466-6342 (Clarenville); in the Central Region contact 709-651-6253(Gander); in the Western Region contact 709-643-8702 (Corner Brook) and in the Labrador-Grenfell Region contact 709-454-0372 (St. Anthony) or 709-897-2352 (Happy Valley-Goose Bay).
For inquiries regarding massage therapy, contact the NL Massage Therapy Association at 709-726-2217.
16 Garfield Street
P.O. Box 2000
Charlottetown, PE C1A 7N8
Tel: (902) 368-6736
Fax: (902) 620-3072
Contact: Johanne Irwin, Manager, Physician Services, Medical Affairs, Health PEI
There are no specialized lymphovenous centres in PEI. There are no specific programs under Medicare Services in PEI to provide financial subsidies or rental of extremity pumps, however, those in financial need are referred to and assessed by the Department of Community Services and Seniors.
The following services are offered to hospital in-patients: nursing services, drugs, routine surgical supplies, physiotherapy. The following services are offered to hospital out-patients: necessary nursing services, drugs prescribed by an attending physician and administered in the hospital out-patient department, routine surgical supplies, physiotherapy.
The following services are not covered outside of a hospital: special nurses requested by the patient and family, crutches and other appliances, drugs for use outside of the hospital, services provided by physiotherapists, naturopaths or podiatrists.
Andrew Rice, Manager, Insurance Programs
NWT Health and Social Services
Bag Service 9
Inuvik, NT X0E 0T0
Telephone 1-800-661-0830 ext. 7402
Supplementary programs are available for clients who are not covered under Non-insured Health Benefits, such as the Metis Health Benefits program, to those who are over 60 years of age under the Extended Health Benefits Program, and people with a specific medical condition such as cancer. All of the listed programs are eligible for prescription drug coverage, medical supplies and equipment to he maximum of the program guidelines. Other specified medical conditions may be covered under Extended Health Benefits and are reviewed on a case-by-case basis by exception.
Medical supplies and equipment such as pressure garments or other supplies related to a lymphovenous condition may be covered for clients who require financial assistance and meet the guidelines. Prior approval is required for this coverage.
Extremity pumps are not available in the Northwest Territories. Clients they see with lymphedema are treated with modalities that assist with circulation and are referred to occupational therapy for compression garments or compression wraps.
The Province of Ontario provides 75% of the costs for compression garments for individuals with chronic lymphedema of all types. The Assistive Devices Program (ADP) is now covering 75% of the cost of the Reid Sleeve Classic for persons with lymphedema in their upper and lower limbs. Registered massage therapists with lymphedema certification can now be authorizers for compression garments in Ontario.
A number of lymphovenous treatment teams and clinics are located in hospitals across the province. Below is a list of some of the teams in Ontario. For more complete information on what is available in your area, contact the Ministry of Health and Long-term Care.
These private clinics are filling the gap until lymphedema treatment centres are established in hospitals in their areas:
A rehabilitation facility at the Ottawa Hospital Civic Campus. This clinic is located at Maurice Grimes Lodge, Level S (Sublevel), 200 Melrose Ave., Ottawa, ON K1Y 4K7. For more information contact: Louise Haley at: (613) 761-4062 or view their web site at: www.haleyrehab.ca
Currently, the Quebec health care system does not have a specific program for the treatment of lymphedema. People with cancer are supported by the general program governed by the Quebec insurance program and treated in hospitals with the expertise and resources to do so, which also provide services such as surgery and radiotherapy. However, the Quebec health insurance plan does not cover all treatments for lymphedema.
Some treatments for lymphedema and services are provided under the Quebec cancer care program. This program is aimed at people with cancer who receive continuity of care and services regardless of tumor sites. In some cases the Quebec Office for Persons with Disabilities and the Quebec Ministry of Social Services can offer, at its discretion, financial assistance to meet the needs of people.
The regional health and social services boards are responsible for the organization of medical services in their territory. They are the best qualified to answer questions about the treatment of lymphedema in their region. Their coordinates are available on the web site of the Ministère de la Santé et des Services sociaux (http://www.msss.gouv.qc.ca).
For more information about lymphedema treatment and services in Quebec, please contact the Lymphedema Association of Quebec at www.infolympho.ca/
Therapies Departments in health regions in Saskatchewan may provide primary and secondary lymphedema education, prevention and management strategies including compression garments along with range of motion, strengthening, soft tissue mobilization, manual physical therapy and graduated return to work assistance and monitoring.
Physician referral may be required to see physical or occupational therapists in the following therapy departments offering services:
Kelsey Trail Health Region Therapy Services:
Melfort Therapies Phone: (306) 752-1750
Tisdale Therapies Phone: (306) 873-8282
Nipawin Therapist Phone: (306) 862-9822
Prince Albert Parkland Health Region Therapy Services:
Prince Albert Therapies Phone: (306) 765-6126
Shellbrook Phone: (306) 747-4273
Spiritwood Phone: (306) 883-2133
Saskatoon Health Region Therapy Services:
Saskatoon Therapies Phone: (306) 655-2431
Watrous Therapies Phone: (306) 946-1200
Rosthern Therapies Phone: (306) 232-4811
Wakaw Therapies Phone: (306) 233-4611
Regina Qu'Appelle Health Region
Regina Therapies Phone: (306) 766-8600
Community Therapies Phone: (306) 697-4049 or (306) 435-6267
Five Hills Health Region
Moose Jaw Therapies Phone: (306) 694-0201
Assiniboia Phone: (306) 642-9421
Gravelbourg call Assiniboia or Moose Jaw Central Butte/Craik call Moose Jaw
Sunrise Health Region
Services are provided in 15 sites across the region. Contact: Cornerstone Therapies Phone: (306) 786-0184
Prairie North Health Region
Lloydminster Phone: (306) 820-6055
Battlefords Phone: (306) 446-6400
Meadow Lake Phone: (306) 236-1550
Turtleford Phone: (306) 845-2195
Complex Decongestive Therapy (CDT) is currently provided in Regina Qu'Appelle Health Region (RQHR) to patients presenting secondary lymphedema following breast cancer surgery. Manual Lymphatic Drainage (MLD) may be provided privately by trained professionals throughout the province however, is not a covered benefit of the Saskatchewan Health Card.
Effective Oct. 1, 2013, following extensive consultations, the list of eligible benefits for the Compression Garment Program has been expanded through:
The Saskatchewan Aids to Independent Living (SAIL) Compression Garment Program covers the cost of two compression garments every six months for clients who have serious conditions (including lymphedema) that require moderate to high pressure (20 mmHg or higher) that cannot be managed by other means such as elevation or medication and would become more severe without compression. Garments must be requisitioned by an occupational or physical therapist, or an enterostomal therapy, diabetes or wound care nurse. Garments are purchased and shipped to clients and replaced every six months or more frequently if required.
The SAIL Special Needs Equipment Program provides the free loan of lymphedema control units (three chamber pressure pumps) and the related pressure sleeves when requisitioned by a physiatrist, occupational therapist or physical therapist.
A grant option is available to clients with a diagnosis of primary lymphedema for the purchase of a multi-chambered (six or more) lymphedema pump. SAIL will reimburse the client for 2/3 of the actual cost of the pump, sleeves and accessories to a maximum of $4000 once every five years.
For more information, contact SAIL at:
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Last revised Oct. 1, 2013.