Photo-physical and -Chemical Effects of Low-level LASER on Lymphedema Treatment

Since the early 1990s, therapeutic potentiality of low-level LASER has been reported in dozens of trials in-vitro and in-vivo. Following promising results in animal-model-based experiments, low-level LASER has persistently gained high level of evidence of its clinical efficiency such as in randomized controlled trials, and, now a day, it is statistically affirmed in several numbers of meta-analysis articles that low-level LASER can reduce local swelling and its after-effect maintains in some periods in lymphedema patients underwent breast cancer surgery. As for authoritatively commercial approval by national institutions, LTU-904 is the only FDA-approved medical device in remedial management of lymphedema following breast cancer surgery so that it can be used as adjuvant ones to gold-standard treatment, complex decongestive physiotherapy. Therapeutic effects of low-level LASER are basically originated from moleculo-biological phenomenon, such as increased production of ATP and nitrous oxide and altered cytokine reaction in cellular level, especially in mitochondria, following cellular absorption of light within specific range of wavelength. Photo-physical and -chemical action of LASER let cells proliferate and be, in specific condition, repaired by themselves with the help of epigenetic affection: e.g., increased transcription of mRNA, up-regulated translation of DNA, and expanded synthesis of cyclic nucleotides and proteins. As a results, it is expected that lymphocytes proliferate, contractility of lymphatic vessels improves, and lymphangiogenesis may occur. However, every parameter, such as energy, power, frequency, duration, delivery mode, e.t.c., in clinical application has to be exactly in accordance with the FDA-approved protocol, and usage under unproved parameters has to be preemptively investigated in extensive degree in terms of safety issue due to its potentiality inducing mutagenicity and carcinogenicity in cellular level.