Lymphology Association of North America (LANA) Practice Exam

Under what conditions is manual lymphatic drainage (MLD) permissible within the radiation field?

1. Until signs of severe redness and wet desquamation appear

2. Throughout the radiation treatment plan regardless of skin changes

3. Until signs of inflammation appear, usually 2-3 weeks into the radiation treatment plan

4. MLD is always contraindicated in the radiation field

The correct answer is: Until signs of inflammation appear, usually 2-3 weeks into the radiation treatment plan

Manual lymphatic drainage (MLD) is a specialized technique used to promote lymphatic flow and reduce lymphedema. When it comes to its use within the radiation field, there are specific considerations due to the potential effects of radiation therapy on the skin and underlying tissues. The correct understanding is that MLD can be performed until signs of inflammation appear, which typically occurs around 2 to 3 weeks into the radiation treatment plan. This timeframe is significant because the skin and tissues within the radiation field can initially tolerate MLD without adverse effects. The early to mid-stages of radiation therapy might not exhibit visible signs of skin damage; however, as treatment progresses, inflammation can develop as a response to radiation. The onset of such changes marks a threshold where MLD may no longer be beneficial and could potentially exacerbate skin problems or cause further tissue damage. Therefore, MLD is permissible only until noticeable signs of inflammation manifest, allowing for optimal management of fluid and tissue health while minimizing risks associated with treatment. Proper monitoring of the skin and patient responses is essential in guiding the continuity of MLD within the radiation field.