Women who develop lymphedema after breast cancer surgery have traditionally been counseled by their doctors to avoid lifting heavy objects. However, a new research finding turns that wisdom on its head.
Researchers at the University of Pennsylvania found breast cancer survivors who participated in weight lifting training experienced reduced lymphedema symptoms, increase muscle strength and reduced the incidence of lymphedema exacerbations.
"If your lymph nodes are removed because of breast cancer treatment, you suffer impairment in your ability to respond to infection, trauma, injury, and inflammation. Exercise improves the body's response to those four things," said lead researcher Kathryn H. Schmitz, PhD, MPH, from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania.
This is welcome news for the 2.5 million breast cancer survivors, many of whom have been discouraged from weight-lifting exercise because of concerns it may bring on lymphedema or worsen the swelling they already have. As a consequence, many women worry everyday activities such as picking up their kids or carting around grocery bags might be harmful.
Lymphedema is swelling due to the buildup of lymph fluid in the limbs and it can occur at any time after treatment for breast cancer—even many years later. Symptoms include a feeling of tightness in the arm or hand on the same side that was treated for breast cancer, leathery skin texture, heaviness, pain, pitting and difficulty writing.
For the study, Schmitz and her colleagues recruited 141 women with stable lymphedema and a history of breast cancer. Half were assigned to a controlled, weight-lifting exercise program that met twice weekly for 90 minutes over 13 weeks. The women were required to wear a custom-fit compression sleeve on the affected arm during exercise and started with low-weight resistance (about 1 to 2 pounds). They were closely monitored for changes in the affected arm. The amount of weight they lifted was increased gradually if the lymphedema symptoms did not worsen.
Over the course of the study, the majority of the women in the weight-lifting group had increased their strength and reduced symptoms of lymphedema. The number of women who saw their swelling increase was about the same in both groups (11% in the weight-lifting group and 12% in the control group). There were no serious side effects reported in either group.
"Our study shows that participating in a safe, slowly progressive structured weight-lifting routine can help women with lymphedema take control of their symptoms and reap the many rewards that resistance training has on their overall health as they begin life as a cancer survivor," Schmitz said.
While the benefits seem to outweigh the risk, Colleen Doyle MS, RD, American Cancer Society, Director, Nutrition and Physical Activity cautions women to always talk to their doctor before starting any exercise program, and start out slowly.
Schmitz stresses the importance of starting slowly and using proper form. "Women with lymphedema should work with a well-trained certified fitness professional to begin weight training. Do not try to start this kind of program on your own. Your trainer should start you out with very light weights. If you do that for a week and you aren't seeing any problems, increase your resistance, but do it in very small increments," she says.
The study is published in the August 13, 2009 New England Journal of Medicine, Volume 361:664-673.
Azsunshinegirl, aka Lynette Summerill, is an award-winning journalist who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.