|Does life after breast cancer include lymphedema?|
A Closer Look
The National Cancer Institute’s Office of Cancer Survivorship defines an individual as a cancer survivor from the time of cancer diagnosis through the balance of his or her life.
According to the American Cancer Society there are over 2.5 million breast cancer survivors in the United States. Breast cancer survivors make up the largest group of all cancer survivors, representing 3.6 percent of the US population.
Life after breast cancer requires many survivors to redefine “normal” from a physical, emotional and spiritual perspective. Among the physical changes that may result from breast cancer treatment is a condition known as lymphedema.
Lymphedema is tissue swelling in the arm due to fluid retention caused by removal of lymph nodes during breast cancer diagnosis, treatment and/or radiation therapy.
Lymph is a fluid made up of protein and white blood cells that circulates throughout our body. The lymphatic system uses the lymph fluid to collect bacteria, viruses, and waste products, including cancerous cells, from the various tissues in the body. This fluid passes through the lymph nodes which filter out the waste products, cancerous cells, bacteria, and viruses.
After lymph nodes are removed or damaged from radiation, there is a risk of lymph fluid not draining properly from the affected arm. The lymph fluid then collects in the tissues of the arm causing varying amounts of swelling, discomfort, and an increased risk of infection.
Although lymphedema is not curable, there are care recommendations to minimize or prevent its development. One of the recommendations is to avoid strenuous activity with the upper-body, including exercise. Does this mean no more upper body workouts? Current research helps answer this question.
Researchers studied the effects of weight lifting on women who are breast cancer survivors. The study involved 154 women with a history of breast cancer in the previous 1 to 5 years, and had at least 2 lymph nodes removed. None of the women had lymphedema at the start of the study. The women were randomly placed into one of two groups. Group 1 was offered a 1-year membership to a community fitness center, and group 2 was asked not to change their level of exercise for the length of the study.
For the first 13 weeks, women in the exercise group received instructions from certified fitness professionals on the safe performance of exercises twice weekly. The amount of weight lifted was increased for each exercise by the smallest possible amount, as was tolerated by the women.
The results showed that a supervised program of slowly progressive upper-body weight lifting does not increase the risk of lymphedema in women who are breast cancer survivors. In fact, women in the weight-lifting group who’d had at least 5 lymph nodes removed were significantly less likely to develop lymphedema in the arm.
A separate study involved 141 women breast cancer survivors with lymphedema. These women were placed into either a weightlifting group or a control group. Women in the weightlifting group initially met with specialized trainers for twice weekly 90-minute sessions, and were also given a 1-year membership to a local health club. Both cardiovascular and strengthening exercises were done, beginning with little or no resistance and gradually increasing the resistance level over a 13-week period. These women wore a compression garment on the affected arm during the weightlifting. The program continued for 1 year.
Results of the study showed that women in the weightlifting group:
- increased their bench press weight by 10 pounds and their leg press weight by 60 pounds;
- had greater relief from symptoms of lymphedema;
- had fewer episodes of worsening lymphedema.
The control group of women showed no significant change in their strength or lymphedema.
The recommendations for coping as a breast cancer survivor, returning to “normal health”, and reducing the risk of cancer recurrence are good advice for everyone. They include:
- take care of yourself emotionally and physically, including a regular exercise program;
- eat a healthy diet;
- reduce stress;
- limit alcohol;
- continue with regular health screenings;
- maintain a healthy weight; and
- take required medications as prescribed
Take Home Message
|Exercise, including upper body exercise can be part of NORMAL life for breast cancer survivors with or without lymphedema.|
There are other recommendations for preventing and treating lymphedema including:
Protect the affected arm.
- Avoid any injury to the affected arm. Cuts, scrapes and burns can all invite infection, which can result in lymphedema.
- Protect the arm from sharp objects by wearing gloves when gardening or cooking, and using a thimble when sewing.
- If possible, avoid medical procedures, such as blood draws and vaccinations, in the affected ar
Rest the affected arm while recovering. After cancer treatment, avoid heavy activity with that limb. Exercise and stretching early in the recovery process are encouraged, but avoid strenuous activity until fully recovered from surgery or radiation.
Avoid heat on the affected arm. Don’t apply heat, such as with a heating pad, to your affected limb, since heat can contribute to swelling.
Elevate the affected arm. When possible, elevate the affected limb above the level of the heart.
Avoid tight clothing. Avoid anything that could constrict the arm, such as tight fitting clothing or having blood pressure readings. Ask that the blood pressure be taken in the other arm.
Keep your arm clean. Make skin care and nail care high priorities. Inspect the skin on the arm or leg every day, keeping watch for changes or breaks in the skin that could lead to infection. Don’t go barefoot outdoors.
As always, discuss the type of exercise that is best for you with your primary health care provider, or specialist.
Breast cancer survivors check out The Pink Ribbon Crew Team
The Pink Ribbon Crew team is an outreach program sponsored by Michigan State Varsity Rowing program. Women recovering from breast cancer are encouraged to consider joining this mutually empowering recovery team. No prior rowing experience is necessary. The Pink Ribbon Crew team focuses on developing strong and healthy bodies, becoming an active participant in one’s own recovery from breast cancer, and rediscovering the joy of movement.
For more information contact: Christiina Donley, MSU Assistant Rowing Coach at email@example.com 517-432-5661.
For more information on lymphedema visit the healthwise knowledgebase at www.healthwise.msu.edu enter “lymphedema” in the search box.