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:

  1. Updates on malignant lymphedema therapy in palliative care: workshop. Canadian Lymphedema Framework Conference, Toronto Nov 2 2019.
  2. Surgery for lymphedema : the CLF statement. Canadian Lymphedema Framework Conference, Toronto Nov 2 2019.
  3. Nouveautés en recherche pour le lymphoedème, Vodder Review Course for lymphedema therapists, Montreal Aug 19 2019.
  4. Les oedèmes chroniques et le lymphoedème : implications pour les dermatologues. Société de dermatologie de Montréal, Jan 31 2019.
  5. Les oedèmes chroniques et le lymphoedème : implications pour les dermatologues. Congrès de la Société de dermatologie du Québec, Québec, Jan 18 2019.
  6. Les priorités de développement pour le lymphoedème, Congrès Association Québécoise du Lymphoedème, Montreal, 22 October 2010.
  7. Le lymphoedème et les oedèmes chroniques : le travail en équipe. Conférence Survie Après le Cancer, Trois Rivières QC Oct 12 2018.
  8. La prévention, le dépistage précoce et les traitements du lymphoedème. Conférence Survie Après le Cancer, Trois Rivières QC Oct 12 2018.
  9. Chronic edema and lymphedema of the lower limbs: current treatment guidelines and new developments. Webinar BSN, Laval, QC October 17 2018.
  10. Les oedèmes chroniques et le lymphoedème des membres inférieurs : standards de pratique et nouveautés, Webinar BSN, Laval QC October 24 2018.
  11. Psychosocial determinants of lymphedema care. Vodder International Review, Montreal August 20, 2018.
  12. New assessment techniques for lymphedema, Vodder International Review, Montreal August 20, 2018.
  13. Update on surgical treatments for lymphedema Vodder International Review, Montreal August 20, 2018.
  14. Thérapies pour les oedèmes chroniques. Vodder course for nurses, Montreal 29 May 2017.
  15. Novel assessment technologies for lymphedema. Vodder International Review. For lymphedema therapists. Stowe, Vermont, 4 June 2017.
  16. Update on surgical techniques for lymphedema. Vodder International Review. Stowe Vermont 4 June 2017.
  17. La chirurgie pour le lymphoedème: Quoi dire à nos patients? Webinar. MUHC Lymphedema Program, May 20, 2018.

Recent accepted proffered papers:

  1. Towers A. Inequalities in access to lymphedema assessment and follow-up in Quebec. Canadian Lymphedema Framework Conference, Toronto Nov 2, 2019.
  2. A Marshall, M Wright, A. Towers, R Kilgour, N St.Onge. Is decreased functional capacity linked to balance in lower limb lymphedema? Canadian Lymphedema Framework Conference, Toronto Nov 1, 2019.
  3. Whyte J, Kilgour R, Rivas H, Towers A. Are differences in hand grip strength related to skeletal muscle thickness between healthy woman and those with breast-cancer-related lymphedema? Canadian Lymphedema Framework Conference, Toronto Nov 1, 2019.
  4. Shallwani S, Towers A, Gilbert L et al. Feasibility and preliminary findings of a pilot RCT and early compression therapy and individualized exercise in women treated for gynecological cancer. Canadian Lymphedema Framework Conference, Toronto Nov 1, 2019.
  5. Cama G, Letellier ME, Ibrahim M, Chaput G, Towers A. Lymphedema triggers. Canadian Lymphedema Framework Conference, Toronto Nov 1-2, 2019.
  6. Ibrahim M, Letellier ME, Towers A, Yung A. Jutras M. Lymphaticovenous anastomosis and lymph node transplantation surgery: a case series report. Canadian Lymphedema Framework Conference, Toronto Nov 2, 2019.
  7. M. Wright, A. Marshall, A. Towers, R. D. Kilgour, N. St-Onge Do women with lower-limb lymphedema use more ankle muscle co-contraction to maintain balance? 9th International Lymphoedema Framework Conference, Chicago, USA, June 13-15, 2019.
  8. Towers A. Are Quebec oncologists less likely to refer working class cancer patients to “free” hospital-provided lymphedema assessment services? 9th International Lymphoedema Framework Conference, Chicago, USA, June 13-15, 2019.
  9. Towers A, Shallwani S, Newman A, Salvador S, Zeng Z, Gilbert L, Gotlieb W, Doneal Thomas D. Early compression therapy and individualized exercise to reduce the incidence of lower limb lymphedema in women treated for gynecological cancer:
    Preliminary findings of a pilot RCT. 9th International Lymphoedema Framework Conference, Chicago, USA, June 13-15, 2019.
  10. Feasibility of recruitment to a pilot trial examining the effects of early compression and exercise in women treated for gynecological cancer. Shirin M. Shallwani1,2, Anna Towers, Shannon Salvador, Anne Newman, Ziggy Zeng, Lucy Gilbert & Walter Gotlieb. International Lymphoedema Framework Conference, Rotterdam, 6-9 June 2018.
  11. Ultrasound elastography of breast cancer-related lymphedema. Hashemi HS, Fallone S, Boily M, Towers A, Kilgour RD, Rivaz H. Proceedings of the Institute of Electrical and electronics Engineers Conference, Washington DC, Apr 2-7 2018.
  12. Shallwani, S., Towers, A., Salvador, S., Newman, A. (2017-11). Effect of early compression therapy on incidence of lymphedema in patients treated for gynecological cancer: a randomised trial. Poster presented at the 3rd Annual Rossy Cancer Network Retreat Montreal, QC.
  13. Hashemi H, Fallone S, Towers A, Kilgour RD, Rivaz H. Ultrasound Elastography of Stage 2 Breast Cancer-Related Lymphedema. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  14. Kilgour R, Towers A, Rivaz H, Kim H, Demers T, Weiss C. Effects of Aerobic Training and Dietary Intervention on Arm Volume and Composition in Breast Cancer-Related Lymphedema. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  15. Whyte J. Thorbuirn A., Fallone S, Towers A, Rivaz H, Kilgour R. Identifying Training-Induced Changes in Tissue Properties and Muscle Architecture in Breast Cancer-Related Lymphedema Using Quantitative Ultrasound. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  16. Fallone S, Hashemi HG, Thorburn A, Whyte J, Towers A, Rivaz H, Kilgour RD. The Use of Quantitative Ultrasonography to Assess Tissue Properties of Stage 2 Breast Cancer-Related Lymphedema. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  17. Thorburn A, Whyte J, Fallone S, Towers A, Rivaz H, Kilgour R. Characterization of Skeletal Muscle Architecture and Quality in Breast Cancer-Related Lymphedema. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  18. Demanins L, Letellier ME, Towers A. Preventing chronic lower leg wounds: what can health care teams and patients do together? Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  19. Demanins L, Towers A. Management of lymphedema due to filariasis: a case study from Quebec. First poster prize. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  20. Demanins L, Cama G, Letellier ME, Towers A, Hodgson P. Is left-sided lower limb lymphedema more prevalent than right-sided lymphedema? Findings from a lymphedema clinical database review. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  21. Letellier ME, Towers A. Hospital-based lymphedema services: successes and challenges. Workshop. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  22. Shallwani SM, Hodgson P, Towers A. Understanding obesity and exploring the relationships between weight, lymphedema and cellulitis in a clinic population with lymphedema of different etiologies. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  23. Yung A, Cama G, Shay C, Hodgson P, Towers A. Clinical use of DXA measurement in lymphedema assessment and treatment. Canadian Lymphedema Framework Conference Montreal October 27-28, 2017.
  24. Shallwani SM, Towers A, Salvador S, Newman A. A multidimentional intervention of early compression therapy and exercise in women treated for gynecological cancer at risk of developing lymphedema. First prize, poster presentation. International Lymphoedema Framework Annual Conference, Siracusa Italy, June 21-24 2017
  25. Towers A, Demanins L, Leroux W, Letellier ME, Hodgson P. Chronic lower limb edema in long-term care populations: prevention and treatment challenges.
    International Lymphoedema Framework Conference, Syracuse, Italy, Jun 21-24 2017.

Selected publications:

  1. Shallwani S, Hodgson P, Towers A. "Examining obesity in lymphedema: a retrospective study of 178 new patients with suspected lymphedema at a Canadian hospital-based clinic" Physiotherapy Canada, Volume 72 Issue 1, Winter 2020, pp. 18-25, DOI: 10.3138/ptc-2018-0076.
  2. Rockson SG, Keeley V, Kilbreath S, Szuba A, Towers A (2019). Cancer-associated secondary lymphoedema Nat. Rev. Dis. Primers doi.org/10.1038/ s41572-019-0072-5.
  3. Hashemi HS, Fallone S, Boily M, Towers A, Kilgour RD, Rivaz H. Assessment of Mechanical Properties of Tissue in Breast Cancer-Related Lymphedema Using Ultrasound Elastography. IEEE transactions on ultrasonics, ferroelectrics, and frequency control. 2019;66(3):541-550. DOI: 10.1109/TUFFC.2018.2876056.
  4. Bélanger E, Towers A, Wright DK, et al. Of dilemmas and tensions: a qualitative study of palliative care physicians’ positions regarding voluntary active euthanasia in Quebec, Canada J Med Ethics Oct 2018 doi:10.1136/ medethics-2017-104339.
  5. Hashemi H, Fallone S, Bioly M, Towers A, Kilgour R, and Rivaz H,“Ultrasound elastography of breast cancer-related lymphedema,” in IEEE
    International Symposium on Biomedical Imaging (ISBI). IEEE, Jan 2018.
  6. Shallwani S, Towers A. Self-management strategies for malignant lymphedema: a case report with one-year and four-year follow-up data. Physiotherapy Canada, (2017 Dec); doi:10.3138/ptc.2016-94.
  7. Keast, D. Towers A. The rising prevalence of lymphedema in Canada: A continuing dialogue. Canadian Lymphedema Magazine, Pathways, Spring 2017. p.6-8.
  8. Kilgour R, Rivas S, Towers A. Advancing technological innovation with elastography and ultrasound in breast cancer-related lymphedema. Pathways, Fall 2017, p. 20-22.
  9. Shallwani S, Hodgson P, Towers A. Comparisons between cancer-related and non-cancer related lymphedema: an overview of new patients referred to a specialized hospital-based centre in Canada. Lymphatic Research and Biology 2017 Jan 30 (doi: 10.1089/lrb 2016-0023.
  10. Boquiren, V.M., Hack, T.F., Thomas, R.L., Towers A, Kwan W, Tilley A, Quinlan L, Miedema B. A longitudinal analysis of chronic arm morbidity following breast cancer, Breast Cancer Research and Treatment (2016) 157: 413. doi:10.1007/s10549-016-3834-8.

Selected books and book chapters:

  1. Towers A, Letellier ME. Lymphedema, Chapter in Palliative Care – A Case-Based Manual, 4th edition, MacDonald S, Boyle A, Herx L, eds, Oxford University Press (in press 2020).
  2. 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.
  3. 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, DOI:10.1093/acprof:oso/9780199694143.003.0123.
  4. 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.
  5. Towers A. Lymphoedema, Chapter 87, in Walsh D. ed. Palliative Medicine Elsevier Philadelphia, 2008 p. 474-478.
  6. Towers A. Lymphedema, Chapter in MacDonald N, ed. Palliative Care – A Case-Based Manual, 2nd edition, Oxford University Press, 2005.
  7. Barnard D, Towers A, Boston P, Lambrinidou Y. Crossing Over: Case Narratives in Palliative Care. Oxford University Press, 2000. (I contributed 9 chapters to this book)
Back to top