Anna Towers

Anna Towers, MD
Montreal University Health Centre
anna.towers [at] muhc.mcgill.ca (Email)

Anna Towers is Associate Professor in the Department of Oncology and was Director of Palliative Care McGill and the MUHC Division of Palliative Care from 1999-2009.  She was Chair of the biennial International Congress on Palliative Care from 2005 to 2014. Her main academic interest since 1994 has been in the development of lymphedema services for cancer patients, an area in which she is recognized as a national and international leader. The clinic within the MUHC Lymphedema Program, operational since 1995, is now known as the Lymphedema Support Centre of the Breast Cancer Foundation of Quebec in recognition of the significant past support from the FCSQ. A referral and assessment resource for Quebec and Eastern Ontario for complex lymphedema cases, it is now supported by the Royal Victoria Hospital Foundation and is based at the Vendome annex of Glen site. Dr. Towers’ team works in close collaboration with the Lymphedema Association of Quebec and the Quebec Ministry of Health, advising on clinical and academic matters. In 2008 Dr. Towers was appointed by the International Lymphoedema Framework (ILF) to found and co-chair the Canadian Lymphedema Framework (CLF), along with Dr David Keast of London, Ontario. Its vision is that comprehensive effective treatment for lymphedema and related disorders will be accessible to all persons across Canada. The CLF works closely with international partners as part of a global initiative to develop and promote best practices. It hosts national and international conferences as part of its work.

Research projects in which Dr Towers is involved include: a study using Dual-energy X-ray Absorptiometry and Bioelectric Impedance Spectroscopy to assess body composition in arms of women with breast cancer-related lymphedema; a study on the evaluation of lymphedema self-management techniques; and a Rossy-funded study on the prevention of lymphedema following gynecological cancer; a project with the PERFORM laboratory at Concordia University to investigate the use of high-definition ultrasound to help stage lymphedema in breast cancer patients. In the palliative care field, her present research interest is in qualitative studies relating to Euthanasia/Medical Aid in Dying law in Quebec and in Canada.

Recent invited presentations:

Not So Swell: Lymphedema Prevention and Treatment. Hope and Cope, Jewish General Hospital, Montreal, May 17, 2016

New research on lymphedema prevention, Vodder CME Review Course, Stowe Vermont, May 7, 2016.

How to appraise the scientific literature on lymphedema. Vodder CME Review Course, Stowe Vermont, May 7, 2016.

Le traitement du lymphœdème: une affaire d'équipe. CSSS Laurentides, Ste Jerôme QC, April 20 2016
Update on surgical treatments for lymphedema. Vodder CME Review Course, Victoria BC, April 17, 2016.
Lymphedema development in Canada: a question of justice. Austrian Association of Lymphology Conference, Walchsee, Austria, Jan 8-9 2016
La science de la compression et son rôle dans la gestion du lymphoedème. Association Québecoise du Lymphoedème, Montréal, Nov 17 2015
Evaluation and management of chronic edema and lymphedema. Canadian Lymphedema Framework Conference, Calgary AB, 30 Oct 2015
Breast cancer, chronic illness and our failing society: a call for justice. ZONTA Montreal, Concordia University, Oct 17 2015.
Nouveautés de recherche en lymphoedème. Cours de révision Vodder, Montréal 24 août 2015.
Research on potential drug treatments for lymphedema, Vodder CME Review Course, Toronto June 15, 2015.
Communication between physicians and lymphedema therapists: results of a qualitative study. Vodder CME Review. Stowe, Vermont, May 31, 2015
Self-management of lymphedema and the chronic care model. Vodder CME Review Course, Stowe, Vermont, May 31, 2015
Advances in the immunology of lymphedema. Vodder CME Review Course, Victoria, British Columbia 4 May 2015
Surgical treatments for lymphedema: a review of the evidence. Vodder CME Review Course, Victoria, British Columbia, 4 May 2015
Recent advances in lymphedema research.  Lymphedema Association of Quebec, Montreal April 15, 2015.
Le lymphoedème en cancerologie: son diagnostique et ses traitements. Radiation Oncology Rounds, Maisonneuve-Rosemont Hospital, Montreal April 1, 2015.
La Gestion du Lymphoedéme, Association Canadienne des Infirmières en Oncologie, Webinaire, March 12, 2015
Lymphedema Management, Canadian Association of Oncology Nursing (CANO) Webinar, Feb 19, 2019
Le lymphoedème et les oedèmes chroniques. Newly created  eight-hour course with examination, for garment fitters. Association des Orthésistes et Prosthésistes du Québec, Montréal Nov 6 2014.
Les oedèmes chroniques : pathophysiologie et traitements.  Congrès de la Féderation des Massothérapeutes du Québec, Montréal, le 5-6 octobre 2014
Chair, 20th International Congress on Palliative Care, Montreal, September 9-12, 2014
Comment apprécier la littérature scientifique sur le lymphoedème. Révision Vodder, Montréal, le 25 août 2014
Les résultats d’un programme d’autogestion du lymphoedème, Révision des traitements chirurgicaux du lymphoedème. Révision Vodder, Montréal, le 25 août 2014
Appraising the lymphedema scientific literature, Vodder CME Review, Toronto, June 22 2014
Results of a self-bandaging programme for lymphedema, Vodder CME Review, Toronto June 22, 2014
Review of surgical treatments for lymphedema, Vodder CME Review, Toronto, June 22 2014
Self-management of lymphedema and the chronic care model. International Lymphedema Framework Conference, Glasgow, June 3 2014
Breast reconstruction and the risk of lymphedema. Vodder CME Review Course, Stowe, Vermont, June 1, 2014
Keynote address: Lymphedema and the Chronic Disease Model. Lymphedema Association of Saskatchewan Annual Meeting, Prince Albert Sask, K 8-9 May 2014
Keynote address: The Canadian Lymphedema Framework. Lymphedema Association of Saskatchewan Annual Meeting, Prince Albert Sask 8-9 May 2014
Review of guidelines for surgical treatments for lymphedema. Vodder CME Review Course, Victoria BC May 3, 2014
Case series report on self-bandaging for lymphedema. Vodder CME Review Course, Victoria BC May 3, 2014

Recent accepted proffered papers:

Towers A, Tradounsky G, Belanger E, Chen Y ,Wright D, Wallace T, MacDonald ME. Perspectives of palliative care physicians on the decriminalization of euthanasia within their own institutions: an exploratory qualitative study. Canadian Hospice Palliative Care Association National Conference, Ottawa ON, October 29-Nov 1, 2015

Beyond edema: the symptoms, impact, and clinical implications of arm morbidity after breast cancer. Elizabeth Quinlan, Anna Towers, Roanne Thomas, Thomas Hack, Winkle Kwan, Baukje Miedema, Andrea Tilley. Canadian Lymphedema Framework Conference. Calgary AB. 24 -25 October 2015.

Newman A, Towers A, Rosenthall L, Hodgson P, Tidhar D, Kilgour R. A comparison of three intervention methods for women with breast cancer related lymphedema. Poster presentation. Canadian Lymphedema Framework Conference. Calgary AB. 24 -25 October 2015.

Shirin Shallwani, Pamela Hodgson and Anna Towers. Characterizing the lymphedema patient population: an overview of new referrals to a hospital-based specialized lymphedema clinic. Canadian Lymphedema Framework Conference. Calgary AB. 24 -25 October 2015.

Anne Newman, Shirin Shallwani, Anna Towers, Shannon Salvador. Effect of early compression therapy on incidence of lymphedema in patients treated for gynecological cancer:  a randomised trial. Canadian Lymphedema Framework Conference. Calgary AB. 24 -25 October 2015.

Roanne Thomas, Anna Towers, Katie Armstrong. Canadian Lymphedema Research Priorities: Results of National Surveys. Poster presentation. Canadian Lymphedema Framework Conference. Calgary AB. 24 -25 October 2015.                                                                                       

Landers A, Towers A, Thomson M, Tradounsky G. Subcutaneous needle drainage of lymphedema in palliative care. Canadian lymphedema Framework National Conference, Calgary AB 24 October 2015.

Dubois S, Folch N, Towers A et al. Développement et évaluation d’un outil éducatif Web traitant du lymphoedème secondaire pour des femmes diagnostiquées d’un cancer des organes génitaux :  Lympheduc-TAVIE ongrès de l'Ordre des infirmières et infirmiers du Québec, 3 et 4 novembre 2014, Montréal.

Towers A, Tradounsky G., Landers A. Le drainage par aiguilles du lymphoedème chez les patients en soins palliatifs.  Congress of the Lymphedema Association of Quebec, Quebec City, Sept 21, 2014.

Towers A, Tidhar D, Hodgson P.  L’autogestion du lymphoedème et le modèle des soins chroniques. Congress of the Lymphedema Association of Quebec, Sept 21, 2014.

Towers A, Hodgson P. Le Cas de Madame G : syndrôme de Klippel –Trenaunay, Congress of the Lymphedema Association of Quebec, Sept 21, 2014. 

Towers A, Shallwani S, Shay C, Hodgson P, Adelman M, Khan S, Pritzker R. Le rôle des médecins dans les soins pour le lymphoedème. Congress of the Lymphedema Association of Quebec, Sept 21, 2014.

Ferrier C, Towers A, response of a Quebec physicians’ group to the euthanasia debate in Quebec.  20th International Congress on Palliative Care, Montreal, Sept 9-12,2014.

Marchesssault J, MacDonald K, Towers A, Wallace T, Tradounsky G, Khadoury A. Résultats d’un programme de soins palliatifs intégrés : désirs et facteurs déterminants le décès à domicile, 20th International Congress on Palliative Care, Montreal, Sept 9-12, 2014.

Wright D, MacDonald ME, Wallace T, Ferrier C, Towers A. A socio-historical exploration of euthanasia : situating Quebec’s Bill 52. 20th International Congress on Palliative Care, Montreal, Sept 9-12, 2014.

Tidhar D, Hodgson P, Towers A. Longer-term follow up of self-bandaging for lymphedema: a case series. International Lymphoedema Framework Conference, Glasgow, June 7, 2014.

Hodgson P, Khan S, Towers A, Pritzker R, Shalwani S, Shay C, Adelman M. Collaboration between an interdisciplinary hospital lymphedema clinic and health professionals in community clinics –a process. Poster presentation.  International Lymphedema Framework Conference, Glasgow UK, 5-7 June 2014.

Khan S, Adelman M, Hodgson P, Shallwani S, Shay C, Towers A, Pritzker R. Evaluation of an exercise and educational program in a hospital lymphedema clinic. International Lymphedema Framework Conference, Glasgow UK, 5-7 June 2014.

Hodgson P, Letellier ME, Shay C, Towers A. Measurement techniques used in clinical assessment of limb volume changes—a survey of lymphedema therapist s in Quebec, Canada. Poster presentation.  International Lymphedema Framework Conference, Glasgow UK, 5-7 June 2014.

Exploring the relationships between arm morbidity, perceived disability and mood disturbance in breast cancer survivors. Boquiren VM, Hack T, Thomas R, Towers A, Quinlan E, Canadian Association of Psycho-Oncology Conference, Winnipeg, MN April 30-May 2, 2014.

Selected publications:

Belanger E, Tetrault D, Tradounsky G, Towers A, Marchessault J, Accuracy and Usefulness of the Palliative Prognostic Index when Administered by a Nurse in a Community Setting, International Journal of Palliative Nursing, 2015 Dec 2;21(12):602-605.

Towers A, Tradounsky G, Belanger E, Chen Y ,Wright D, Wallace T, MacDonald ME. Perspectives of palliative care physicians on the decriminalization of euthanasia within their own institutions: an exploratory qualitative study. Journal of Palliative Care 31(3): 198, 2015.

Tidhar D, Hodgson P, Shay C, Towers A. A lymphedema self-management programme: a report on 30 cases. Physiotherapy Canada, advance online article doi:10.3138/ptc.2013-46, 2014.

Letellier ME, Towers A, Shimony A, Tidhar D. Breast cancer-related lymphedema: a randomized controlled pilot and feasibility study. American Journal of Physical Medicine and Rehabilitation 93:751-763, 2014.

Towers A, Keast D. Surgical treatments for lymphedema. Pathways, Canada’s Lymphedema Magazine, Summer 2014 p. 20-21.

Quinlan E, Thomas R, Hack T, Kwan W, Tatemichi S, Towers A, Tilley A, Miedema B.  Lymphedema Trajectories Among Breast Cancer Survivors.  Journal of Lymphoedema, 9 (1). 12-19, 2014.

Towers A. Managing lymphedema in palliative care. LymphLink , National Lymphedema Network, 2013, 25(4):2-5,27.

Newman A, Rosenthall L, Towers A, Hodgson P, Shay C, Tidhar D, Vigano A, Kilgour R. Determining the precision of dual energy x-ray absorptiometry and multi-frequency bioelectric impedance spectroscopy in the assessment of breast cancer-related lymphedema. Lymphatic Research and Biology, 2013, 11(2):104-109

Towers A. Lymphedema advocacy, Pathways, Canada’s Lymphedema Magazine, Spring 2012, p. 10-11.

Towers A. Adapting compression bandaging for the palliative patient, in Compression Therapy: a position document on compression bandaging. International Lymphoedema Framework, UK, June 2012, p 57-61.

Hodgson P, Towers A, Keast D, Pritzker R, Allen J. Lymphedema in Canada: a qualitative study to help develop a clinical, research and educational strategy, Current Oncology, 2011, 18(6), e260-264.

Hodgson P, Towers A MD, Kennedy A,  Pritzker R, D. Keast D,  Allen J RN. Lymphoedema Care and Management in Canada. Journal of Lymphoedema, 2011, 6(1):12-15.

Towers A. Adapting compression bandaging for the palliative patient, in Compression Therapy: a position document on compression bandaging. International Lymphoedema Framework, UK, June 2012, p 57-61.

Towers A, Hodgson P, Shay C, Keeley V. Care of the palliative patient with cancer-related lymphedema. Journal of Lymphedema, 5(1), 72-80, 2010.

Thomas-MacLean R, Towers A, Quinlan E, Hack T, Kwan W, Miedema B, Tilley A, Graham P. “This is a kind of betrayal”:  A Qualitative Study of Disability after Breast Cancer. Current Oncology. 16(3) 26-32, 2010.

Towers A, Hodgson P, Shay C, Keeley V. Care of the palliative patient with cancer-related lymphedema. Journal of Lymphedema, 5(1), 72-80, 2010.

Norton S., Towers A. Adapting CDT in palliative patients. International Lymphedema Framework, Palliative Care Template for Practice, March 2010.

Towers A. Lymphoedema, pain and disability: are we ignoring large parts of the picture? Journal of Lymphedema, 3(1):8, 2008.

Towers A, Carnevale  F, Baker ME. The Psychosocial Effects of Cancer-Related Lymphedema, Journal of Palliative Care 24(3): 134-143, 2008.

Towers A, Letellier ME, Cohen R. Remedial exercises for breast cancer related lymphedema: a randomized controlled pilot study. Journal of Palliative Care 24:3 p. 215, Sept 2008.

Klove J, Towers A, Langevin N, Letellier ME. Living with Lymphedema: Prevention, Treatment and Working Together to Advocate for Our Patients.”, Journal of Palliative Care 22(3):241, 2006.

Towers A, MacDonald N, Wallace E. A qualitative study of ethical issues in palliative care as viewed by patients, families and non-physician staff. Canadian Family Physician, 49:1626-1631, 2003.

Boston P, Towers A,  Barnard D. Embracing vulnerability: risk and empathy in palliative care. Journal of Palliative Care, 17(4): 248-253, 2001.

 

Books and book chapters:

Towers A, Hodgson P. Lymphedema Towers A. Lymphedema, Chapter in MacDonald N, ed. Palliative Care – A Case-Based Manual, 3rd edition, Oxford University Press, 2012

Towers A. “Diagnosing dying”, Chapter in Rocker G, Puntillo K, Azoulay E and Judith Nelson J book End of Life Care in the ICU, Oxford, Oxford University Press, 2010, p.1-3,  ISBN 978-0-10-923924

Towers A. Lymphoedema, Chapter 87, in Walsh D. ed. Palliative Medicine Elsevier Philadelphia, 2008 p. 474-478

Barnard D, Towers A, Boston P, Lambrinidou Y. Crossing Over: Case Narratives in Palliative Care. Oxford University Press, 2000.