Traditionally, breast cancer survivors with lymphedema were advised to avoid weight-bearing exercises or even carrying children for fear that it would worsen the condition. A new study now challenges this advice, finding that survivors who lift weights are less likely than their non-weightlifting peers to experience worsening symptoms of lymphedema, an arm- and hand-swelling chronic condition that can cause physical discomfort and infections, and hinder movement.
Published in the August issue of the New England Journal of Medicine, this relatively large and long study supports several earlier studies suggesting weight lifting is safe for breast cancer survivors with lymphedema.
"Our study shows that breast cancer survivors can safely participate in slowly progressive weight lifting and gain those benefits without any increase in their lymphedema symptoms. In fact, this type of exercise may actually help them feel better," says lead author Kathryn Schmitz, PhD, MPH, an associate professor of Epidemiology and Biostatistics. Weight lifting offers additional benefits for breast cancer survivors, note the authors, including control of body fat and improved bone health.
In the study, 141 breast cancer survivors with lymphedema were randomly assigned to either a weight lifting or non-weight lifting group (the control). Twice weekly, the weight lifters worked out for 90-minute sessions at a community fitness center. Sessions included stretching, cardiovascular warm ups, and weight-lifting exercises for both the lower and upper body. No upper limit was placed on the weight to which women could progress in any exercise. A fitness instructor led the first 13 weeks of sessions; participants then continued independently.
After one year, the number and severity of the lymphedema symptoms reportedly decreased more in the weight-lifting group than in the control. No serious adverse events were related to weight lifting, and the weight lifters were treated less than the control group for exacerbation. Also, the weight-lifting women had increased their strength compared to the control group.
Last year, the National Lymphedema Network revised its recommendations and now advises that individuals who have or are at risk of developing lymphedema can safely exercise if they follow certain guidelines and are medically cleared. It is recommended that breast cancer survivors start with a slowly progressive program, supervised by a health practitioner, and wear compression garments during exercise.
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