Information on scar therapy for breast cancer patients.
Please note this article was not written by me, but is an edited text provided by my scar therapy training organisation Restore Therapy.
‘Scar Therapy’ is the manual treatment or massage of a scar with the aim of reducing pain, improving flexibility and softening fibrous tissue and adhesions. Scar Therapy is useful when the consultant, breast care team or patient believe that scar tissue from the surgery or radiotherapy is causing a problem. Scar tissue and adhesions can describe the internal complications that can occur after surgery, even if externally there are no visual abnormalities on the superficial scar line.
Why have scar therapy after breast cancer?
Scar Therapy is often helpful when treating patients with excessive or problematic scar formation after mastectomy, lumpectomy and breast reconstruction surgeries. Scar tissue that forms following a surgery or a traumatic accident is different from the pre-injury tissue in its cellular structure and function. If a patient has had an infection or necrosis which has compromised smooth healing or the patient receives higher doses of radiotherapy, the likelihood of excessive scar formation, and subsequent discomfort or dissatisfaction with the scar increases. Hereditary factors can also impact scar formation. Therapists trained in Scar Therapy, including massage therapists, osteopaths, physiotherapists or lymphoedema therapists can treat the areas impacted in surgery to help promote improvement.
Scar Therapy has similar principles to massage therapy. The techniques have been developed to stimulate the body, to stretch and mobilise the scar and surrounding area to help the patient feel more comfortable. Tight, fibrous tissues can release following scar treatment and corresponding pain from pinched, trapped or compressed nerves can reduce as a result. Emotionally, scar therapy can help with acceptance.
What to expect in scar therapy treatment.
A variety of Scar Therapy courses are taught around the UK, each approach may differ slightly in its technique. Usually a patient will require a series of therapy treatments to help improve their scar, often in conjunction with exercise or self-management techniques for the patient to follow between appointments. More and more therapists are adopting a gentle, pain-free approach to scar treatment because more aggressive scar manipulation can be very uncomfortable for the patient and may cause inflammation or irritation.
ScarWork, also known as Sharon Wheeler’s ScarWork, is a gentle approach to treatment of new and old scars. ScarWork is represented in the UK by the ScarWork Committee, a voluntary organisation, who are funding clinical research, with a project led by Dr Beverley de Valois at Mount Vernon Cancer Centre.
ScarWork treatment can begin around 8-15+ weeks after breast cancer surgery. The ideal time to commence will depend on the magnitude of the surgery. Reconstructive surgeries such as DIEP Flap usually need longer to complete initial healing, around 15+ weeks. Mastectomy without reconstruction or lumpectomy surgery may start treatment as early as 8+ weeks. Individual considerations are taken into account as to the best start time when you book an appointment. Immature scar tissue will often respond quickly and accessing treatment when the scar is still considered immature (i.e. less than 2 years old) may be beneficial. However, ScarWork treatment can be given to scars of any age and improvements are still possible in mature scars, many years after surgery.
ScarWork treatment is focused on the underlying scar tissue, and often a visual change will not be observed. Treating symptoms such as discomfort, limited range of movement or areas with thick fibrous scar tissue may be goals agreed between the therapist and patient. Improvement to scar adhesions can create a change in appearance, so observable changes may be possible.
ScarWork was introduced to the UK in 2014 and there is increasing interest in its application to benefit cancer patients. Therapists from cancer support centres have completed training with Restore Therapy including The Christie, Breast Cancer Haven, Marie Curie, Rennie Grove, Bart’s Hospital, The Mulberry Centre, Macmillan, Hospice of St Francis, Royal Marsden, The Old Mill Foundation, Mount Vernon, and Peace Hospice.
Scar Therapy may be available at cancer support centres or from physiotherapists. Contact your local centre to ask about Scar Therapy or discuss with your consultant or physiotherapist. Free treatment is available at training course clinics, patients can book a free appointment with therapists completing training, under supervision by the tutor. More details on free treatments at scarwork.uk.
Find a practitioner.
I am qualified in providing scar treatment, including after breast cancer treatment. Please feel free to contact if yo u have any questions. Depending on where you are on your healing, I am likely to provide you with a letter for your consultant or your breast care team to ask for permission to commence treatment, ensuring that there are no medical concerns that would suggest that scar therapy is contraindicated.
To find a UK therapist trained in ScarWork in your location together with more information on ScarWork, please visit scarwork.uk.
Patients referred to physiotherapy or lymphoedema via health insurance may be able to receive scar therapy as part of their treatment plan. Not all therapists are trained in Scar Therapy, so access may be limited.
Further information on scar care.
For further information on scar self-care and resources, please visit my page Scar Tissue Understanding and Care.