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Exercise Improves Lymphedema Symptoms
in Breast Cancer Survivors
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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.
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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.
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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.
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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.
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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.
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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.
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(Click above image for TV36 interview of Dr. Wascher)
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Copyright 2007 – 2009
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Robert A. Wascher, MD, FACS
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All rights reserved
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Dr. Wascher’s Archives:
8-9-2009:  Breast Cancer Recurrence, Death & Vitamin D
8-2-2009:  Honesty, Dishonesty & Brain Function
7-26-2009: Coronary Artery CT Scans & Cancer Risk
7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer
7-12-2009: Breast Cancer & Metformin (Glucophage)
7-5-2009:  Prostate Cancer & Green Tea
6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)
6-21-2009: Red Yeast Rice, Statins & Cholesterol
6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)
6-7-2009:  Diet, Soy & Breast Cancer Risk
5-31-2009: Diet and Prostate Cancer Risk
5-24-2009: Diabetes, Glucose Control & Death
5-17-2009: Drug Company Marketing & Physician Prescribing Bias
5-10-2009: Hemorrhoids & Surgery
5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)
4-26-2009: Are We Really Losing the War on Cancer?
4-19-2009:  Exercise in Middle Age & Risk of Death
4-12-2009: Can Chronic Stress Harm Your Heart?
4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?
3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease
3-15-2009: Depression, Stress, Anger & Heart Disease
3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children
3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children
2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer
2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones
2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum
2-1-2009:  Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence
1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up†Before Surgery?
1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors
1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure
1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood
12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps
12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection
12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome
12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival
11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk
11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk
11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level
11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk
10-26-2008:  Smoking & Quality of Life
10-19-2008:  Agent Orange & Prostate Cancer
10-12-2008:  Pomegranate Juice & Prostate Cancer
10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer
9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?
9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?
9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke
8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles
8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration
8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients
7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer
7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer
7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins
6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer
6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer
6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut
3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children
3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer
2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis
2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps
2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down’s Syndrome?
2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer
1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly
1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer
1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer– Reasons for Poor Compliance with Screening Recommendations
12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?
12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease
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(Click above image for TV36 interview of Dr. Wascher)
ÂÂ
ÂÂ
ÂÂ
ÂÂ
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Copyright 2007 – 2009
ÂÂ
Robert A. Wascher, MD, FACS
ÂÂ
All rights reserved
Dr. Wascher’s Archives:
8-9-2009:  Breast Cancer Recurrence, Death & Vitamin D
8-2-2009:  Honesty, Dishonesty & Brain Function
7-26-2009: Coronary Artery CT Scans & Cancer Risk
7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer
7-12-2009: Breast Cancer & Metformin (Glucophage)
7-5-2009:  Prostate Cancer & Green Tea
6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)
6-21-2009: Red Yeast Rice, Statins & Cholesterol
6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)
6-7-2009:  Diet, Soy & Breast Cancer Risk
5-31-2009: Diet and Prostate Cancer Risk
5-24-2009: Diabetes, Glucose Control & Death
5-17-2009: Drug Company Marketing & Physician Prescribing Bias
5-10-2009: Hemorrhoids & Surgery
5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)
4-26-2009: Are We Really Losing the War on Cancer?
4-19-2009:  Exercise in Middle Age & Risk of Death
4-12-2009: Can Chronic Stress Harm Your Heart?
4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?
3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease
3-15-2009: Depression, Stress, Anger & Heart Disease
3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children
3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children
2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer
2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones
2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum
2-1-2009:  Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence
1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up†Before Surgery?
1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors
1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure
1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood
12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps
12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection
12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome
12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival
11-30-2008:   A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk
11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk
11-9-2008:  Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level
11-2-2008:  Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk
10-26-2008:  Smoking & Quality of Life
10-19-2008:  Agent Orange & Prostate Cancer
10-12-2008:  Pomegranate Juice & Prostate Cancer
10-5-2008:  Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer
9-28-2008:  Publication & Citation Bias in Favor of Industry-Funded Research?
9-21-2008:  Does Tylenol® (Acetaminophen) Cause Asthma?
9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke
8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles
8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration
8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients
7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer
7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer
7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins
6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer
6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer
6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut
3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children
3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer
2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis
2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps
2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down’s Syndrome?
2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer
1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly
1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer
1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer– Reasons for Poor Compliance with Screening Recommendations
12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?
12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease
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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
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.
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.
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.
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.
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Updated:  08/16/2009

