Q: Is it true that breast cancer survivors risk developing or worsening lymphedema if they do strength-training exercises with their arms??
A: Exercise, especially of the arms, used to be considered too risky for breast cancer survivors due to fears of lymphedema, which is an accumulation of lymph in the soft tissue with swelling. This condition is not usually life-threatening, but it can seriously impact quality of life, with decreased flexibility, difficulty fitting in clothes, feelings of heaviness and increased risk of recurrent skin infections. Yet lack of exercise can begin a cycle of physical decline with serious consequences; emerging research now suggests that the best course is safe exercise rather than no exercise.
Lymphedema, which can occur within days or years after cancer or its treatment, blocks flow in the lymph system that transports lymphocytes (white blood cells) and other infection-fighting cells throughout the body, resulting in swelling where the fluid accumulates. For breast cancer survivors, this tends to involve the arms and/or hands. As many as one in three women whose breast cancer surgery includes full removal of lymph nodes in the underarm area (axillary node dissection) experience lymphedema, and radiation therapy to the area may lead to its development, too.
Once lymphedema develops, it doesn’t go away, but some steps may make it easier to live with or possibly prevent it, according to the National Lymphedema Network. Avoid extreme exercise of the arm that could potentially be affected because it can promote inflammation or injury. Current studies in breast cancer survivors suggest that starting with low intensity upper-body exercise and progressing slowly does not increase onset of lymphedema and is better than no upper arm exercises as long as any sumptoms that develop are monitored closely and treated.
The National Comprehensive Cancer Network (NCCN) guidelines recommend that patients with or at risk for lymphedema be evaluated by a certified lymphedema therapist to ensure it is safe to exercise. Cancer survivors who have lymphedema should wear a garment know as a lymphedema sleeve during all exercise that uses the affected limb, according to the National Cancer Institute. Those without lymphedema do not need to wear this while doing exercise. If you are a survivor and it’s unclear whether you have lymphedema and what exercises to do, talk with your physician and health care team.