Health Report:
Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors
"A critical weekly review of important new research findings for health-conscious readers..."
By, Robert A. Wascher, MD, FACS
Updated: 08/16/2009
The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.
EXERCISE IMPROVES LYMPHEDEMA SYMPTOMS IN BREAST CANCER SURVIVORS
Arm lymphedema, or chronic swelling of the arm, occurs in 10 to 30 percent of women following treatment for breast cancer. When the lymphatic drainage network in the arm has been disrupted by the surgical removal of armpit lymph nodes by the surgeon, or by radiation therapy to the armpit area (or, sometimes, following both types of treatment), the delicate network of lymphatic vessels that return excess tissue fluid back to the heart can become obstructed. This lymphatic obstruction can result in chronic swelling of the hand and arm. Patients with significant lymphedema of the arm following breast cancer treatment may experience considerable swelling (edema), heaviness, stiffness and discomfort of the affected hand and arm.
Physicians caring for breast cancer patients have traditionally advised against heavy lifting following breast cancer surgery, for fear that doing so might increase arm lymphedema. However, a new prospective randomized clinical research study calls into question the traditional advice against vigorous exercise involving the upper extremities, including lifting weights as a strengthening exercise.
This new study, which appears in the New England Journal of Medicine, included 141 breast cancer survivors with chronic lymphedema. These women were divided into two groups, with a “treatment” group randomized to twice-weekly progressive weight training and a “control” group of women who were randomized to no weight training. All of the women participating in this study were followed for one year, at the end of which the degree of arm lymphedema was reassessed. Of note, all of the women who were randomized to the weight training group were required to wear custom-fitted compression garments when they were lifting weights.
Not surprisingly, the women who participated in regular weight training reported significant improvement in upper and lower body strength during the course of this research study. Moreover, at the end of one year, both the patients and a certified lymphedema specialist reported a significant decrease in the severity and frequency of lymphedema symptoms among the patients who were randomized to the weight-lifting group. At the same time, twice weekly weightlifting sessions had no significant effect on the extent of arm and hand swelling among these women with chronic lymphedema.
The results of this clinical study are good news for breast cancer survivors with chronic lymphedema. Physicians who care for such patients should all be made aware of the results of this research study, and they should begin encouraging their lymphedema patients to engage in regular weight training (provided, of course, that there are no health issues that preclude lifting weights). Not only does regular weight training appear to decrease the severity and frequency of lymphedema symptoms (based upon the findings of this study), but the added health advantages of such training also include increased strength and a decreased risk of osteoporosis as well.
Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity
Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and a Surgical Oncologist at the Kaiser Permanente healthcare system in Orange County, California
(Anticipated Publication Date: March 2010)
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Robert A. Wascher, MD, FACS
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