Women who suffer from lymphedema, or chronic arm swelling, after breast cancer surgery may experience relief by lifting weights, according to a recent study. Lymphedema can occur after lymph nodes are removed during breast cancer surgery. Doctors have traditionally advised women with lymphedema to avoid lifting weights so as not to worsen the condition. However, this recent study contradicts that advice, showing that weightlifting might actually have a beneficial effect on breast cancer patients—in addition to its other benefits on bone density and health.
Lymphedema is the chronic swelling or feeling of tightness in the arm or hand due to an accumulation of lymphatic fluid in the soft tissue of the arm. The condition occurs when lymph vessels, which normally carry excess fluid out of the limbs and back into central circulation, have had their flow interrupted. Axillary (underarm) lymph node removal is commonly performed on breast cancer patients to stage or treat their cancer. However, between 15% and 20% of breast cancer patients who undergo axillary lymph node removal develop lymphedema. According to the American Cancer Society, of the two million breast cancer survivors in the U.S., approximately 400,000 must cope with lymphedema on a daily basis.
Traditionally, women with lymphedema have been told to avoid weight lifting so as not to aggravate the arm swelling. However, some researchers have called this advice into question. To conduct the current study, lead researcher Kathryn Schmitz, PhD, MPH, of the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania and colleagues enrolled 141 past breast cancer patients with lymphedema. Half of the women participated in a weight-lifting exercise program twice a week for 90 minutes over 13 weeks. The women wore a custom-fitted compression sleeve on the affected arm during exercise and began with light weights, around 1 to 2 pounds, gradually increasing the weight over time.
The results of the study showed that the majority of the women in the weight-lifting group reduced symptoms of lymphedema. Moreover, there were no serious adverse effects among the women who lifted weights.
Dr. Schmitz hopes that her study will change how doctors advise patients with lymphedema. "Hopefully this will be the last nail in the coffin for that kind of misguided advice," she said, in a statement on her center’s web site.
The American Cancer Society, National Cancer Institute, and American Lymphedema Institute have issued recommendations for women after breast cancer surgery to help avoid lymphedema. These recommendations include the following:
- Use the arm in normal activities (such as bathing, dressing, etc.).
- After surgery, keep the arm raised above the level of the heart for 45 minutes, two to three times a day while lying down. Position the arm on a pillow so the hand is higher than the wrist and the elbow is slightly higher than the shoulder.
- Use a soft ball or stress ball and perform squeezing exercises with the hand, even if patients are not yet ready to perform raised arm positions immediately after surgery.
- Clean the skin of the arm and hand every day and keep it moist with lotion. Lotions should not contain any alcohol, dyes, lanolin, mineral oil, petroleum products, talc or perfumes.
- Make sure all clothing in contact with the affected area is clean, and change bandages and dressing frequently.
- Avoid any needle sticks, blood tests, blood pressure testing, allergy tests or medical procedures of any kind on the affected arm whenever possible
- Be careful to avoid too much pressure on the arm. Avoid tight jewelry, clothing or elastic bandages on the affected arm.
- Do not use chemical hair removers under the arm. Use of an electric razor is recommended to avoid nicks and cuts when removing underarm hair.
- Avoid extreme changes in temperature. Do not use hot tubs or saunas.
- Take precautions to avoid any injuries to the affected arm, such as scrapes, scratches, burns, insect bites.
- Consider wearing soft pads under the arm after axillary node dissection.
- Wear a breast compression garment when traveling.
- Wear protective gloves when doing household chores, especially when chemical cleansers are involved.
- Exercise regularly but rest the affected arm immediately if it becomes tired or sore.
- Maintain a balanced diet and an ideal weight.
Any exercise program, including weight lifting, begun after breast cancer surgery should be discussed thoroughly with the patient’s medical treatment team. Despite the results of the current study, weight lifting may not appropriate for all patients.
- The study, “Weight Lifting in Women with Breast-Cancer–Related Lymphedema,†was published in the August 13, 2009, issue of The New England Journal of Medicine, http://content.nejm.org/
- A statement about the current study was published on the web site of the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, http://www.cceb.upenn.edu/
- To learn more about lymphedema, please visit http://www.imaginis.com/breasthealth/lymphedema.asp
